Iowa Admin. Code r. 441-22.6 - Provider network
The
(1) A
provider shall be approved to participate in the autism support program
provider network if the provider meets one of the following standards in
paragraph 22.6(1)"a, " "b " or"c":
a. The autism service provider is certified
as a behavior analyst by the Behavior Analyst Certification Board; or
b. The autism service provider is a
psychologist licensed under Iowa Code chapter 154B; or
c. The autism service provider is a
psychiatrist licensed under Iowa Code chapter 148; and
d. A provider shall be deemed eligible to
participate in the autism support program provider network if the autism
service provider meets the standards in paragraph 22.6(1) "a,
""b" or"c" and the provider is approved to
provide applied behavioral analysis services through Medicaid .
(2) The administrator 's provider
network shall accept the rate established by the department through the
department 's contract with the administrator as payment in full for the
services rendered and will not charge eligible individuals any additional fees
for services rendered, except for those eligible individuals who are required
to pay a portion of the cost of services due to cost-sharing
requirements.
(3) The department is
responsible for calculating the cost-sharing amount according to standards
established in this chapter.
(4)
The autism service provider is responsible for collecting the cost-sharing
amount from the eligible individual and will only be reimbursed by the
administrator for the balance of the service fee minus the amount of cost
sharing.
Notes
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