210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10

What this rule requires your agency to do

• 1A provider must agree to periodic inspections and audits by EOHHS or its designee assessing quality of member care and compliance (§ 1.5(A)(5)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)
• 2All Medicaid home health services must be ordered by a physician and documented in a written, physician-signed plan of care meeting the content, face-to-face encounter, and 60-day review requirements of § 1.9(A); all LTSS home care services must be furnished under a person-centered plan meeting 42 C.F.R. § 441.301(c)(2) and a plan of care per 216-RICR-40-10-17 (§ 1.9(B)-(C)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)
• 3A provider must be certified by CMS to participate in Medicare as a provider of home health services and must obtain a Rhode Island Medicaid provider number before providing services (§ 1.5(A)(3)-(4)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)
• 4A provider may not assign direct care staff to a beneficiary with whom the staff resides, or to whom the staff has a family relationship (§ 1.8(A)(1)-(2)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)
• 5Staff must be assigned by the provider based on staff availability and ability to serve each individual beneficiary (§ 1.8(A)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)
• 6Home care and home health providers must comply with Electronic Visit Verification (EVV) requirements under § 12006(a) of the 21st Century Cures Act (42 U.S.C. 1396b(l)), using the EOHHS EVV system or an approved alternate third-party EVV system meeting EOHHS requirements (§ 1.10(A)-(B)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)
• 7A provider may not assign direct care staff to a beneficiary for whom the staff has any guardianship, any power of attorney, or is the authorized representative on the beneficiary's Medicaid application (§ 1.8(A)(3)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)
• 8A home care and/or home health provider must be licensed by the Rhode Island Department of Health (or in good standing with the licensure body in the provider's home state for border communities) to participate in Rhode Island Medicaid (§ 1.5(A)(1)).(210-RICR-20-05-1 — Home Care and Home Health Providers (EOHHS Medicaid Payments and Providers), Sections 1.5, 1.8, 1.9, and 1.10)