Sec. 10.09.56.20. Conditions for Reimbursement

Latest version.

The Department shall reimburse for services under this chapter when the services are:

A. Provided to a participant who meets the qualifications for eligibility specified in Regulation .02 of this chapter;

B. Preauthorized in the participant's plan of care by the State Department of Education and the multidisciplinary team, as being reasonable and medically necessary to prevent institutionalization;

C. Provided by an approved provider which meets the conditions for participation of this chapter; and

D. Rendered pursuant to:

(1) The relevant definition of covered services in this chapter;

(2) All other requirements specified in this chapter; and

(3) The Autism Waiver proposal and any amendments to it approved by the Secretary of the U.S. Department of Health and Human Services.

                    
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