23 Miss. Code. R. 211-1.2 - Provider Requirements
A. To participate
as a Federally Qualified Health Center (FQHC) in the Medicaid program, an
organization must be approved by the Department of Health and Human Services,
Centers for Medicare and Medicaid Services (CMS) as an FQHC.
B. FQHC providers must comply with the
requirements set forth in Miss. Admin. Code Part 200, Rule 4.8 for all
providers in addition to the specific provider type requirements outlined
below:
1. National Provider Identifier (NPI),
verification from the National Plan and Provider Enumeration System
(NPPES),
2. A copy of the interim
rate notice or current rate letter from CMS,
3. Copy of the nurse practitioner's protocol
and license to practice. If the nurse practitioner is not enrolled with the
Division of Medicaid as a provider, the nurse practitioner must complete a
provider application and obtain an individual provider number, and
4. Clinical Laboratory Improvement Amendments
(CLIA) Information form and current CLIA certificate, if applicable.
C. The Division of Medicaid does
not allow co-mingling.
D.
Physicians and non-physician practitioners cannot operate a private Medicare or
Medicaid practice during FQHC hours of operation using the FQHC's
resources.
E. The effective date of
the Medicaid provider enrollment will be:
1.
The date of Medicare certification if the provider requests enrollment in the
Medicaid program within one hundred twenty (120) days from the date the
Medicare Tie-in Notice was issued to the provider, or
2. The first day of the month in which the
Division of Medicaid receives the provider's completed enrollment packet if the
provider requests enrollment after one hundred twenty (120) days of the
issuance of the Medicare Tie-in Notice.
F. The Division of Medicaid does not enroll
out-of-state providers to provide FQHC services, except as described in Miss.
Admin. Code Part 200, Rule 4.2 B.
G. FQHC mobile units must be surveyed by the
Mississippi Department of Health (MSDH) and receive an approval letter from the
Centers for Medicare and Medicaid Services (CMS) prior to providing services.
1. All federal and state requirements for
FQHC mobile units must be met.
2.
The mobile unit must have a fixed set of locations where the unit is scheduled
to be providing services at specified dates and times.
a) Locations for FQHC mobile unit services
must meet the rural and shortage area requirements at the time of
survey.
b) The schedule of times
and locations must be posted on the mobile unit and publicized by other means
so that beneficiaries will know the mobile unit's schedule in
advance.
3. NPs must
remain within a seventy-five (75) mile distance from the primary physician.
Notes
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No prior version found.