Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities

What this rule requires your agency to do

• 1All SCAs and providers must have grievance procedures and, upon admission, must provide a copy of their complaint/grievance procedures to the beneficiary; procedures and forms shall also be given upon request any time after admission. (Section 7.4, p.6)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)
• 2Support coordination agencies (SCAs) and service providers must assist beneficiaries to exercise their rights and responsibilities, and are bound by their provider agreement with Medicaid to adhere to the beneficiary rights policies. (Section 7.4, p.1)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)
• 3Providers may not initiate a request for change/adjustment of service(s), or modifications to the POC, without the participation and consent of the beneficiary; OAAS RO or its designee must approve changes. (Section 7.4, p.4)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)
• 4Providers shall operate in accordance with Title VI and VII of the Civil Rights Act of 1964, as amended, the Vietnam Veterans Readjustment Act of 1974, and all requirements imposed by or pursuant to U.S. DHHS regulations. (Section 7.4, p.6)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)
• 5Providers are required to maintain privacy and confidentiality in all interactions related to the beneficiary's services, and beneficiaries must receive services from provider employees who have been trained and are qualified to provide them. (Section 7.4, p.5)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)
• 6Providers must reasonably assure that the beneficiary's health and welfare needs are met. (Section 7.4, p.5)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)
• 7The support coordinator is responsible for reviewing the beneficiary's rights and responsibilities with the beneficiary and/or responsible representative as part of the initial intake process and at least annually thereafter. (Section 7.4, p.7)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)
• 8In the event of a fair hearing, a representative of the service provider and SCA must participate by telephone, or in person, if requested. (Section 7.4, p.7)(Louisiana Medicaid Services Manual, Chapter 7: Community Choices Waiver, Section 7.4 — Beneficiary Rights and Responsibilities)