Sec. 10.09.20.12. Conditions for Reimbursement

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The Program shall reimburse for the services specified in Regulations .09-.11 of this chapter, if provided in accordance with the requirements of this chapter, and if the service:

A. Is recommended on the participants plan of service as necessary to assure the health and safety of an applicant or participant in the community;

B. Has been preauthorized by the Department in the participants plan of service;

C. Is provided to an enrolled participant;

D. Is medically necessary; and

E. Is provided by a Medicaid provider who meets the conditions for participation under this chapter.

                    
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