Sec. 32.03.04.11. Provider-Participant Service Agreement  


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  • A. A provider shall enter into a written agreement with a participant on a form provided or approved by the Department that specifies the obligations of both parties, including:

    (1) The services to be provided;

    (2) The fees to be charged by the provider;

    (3) If applicable, the amount of subsidy to be paid on behalf of the participant; and

    (4) That the provider give at least 30 days notice of any proposed change in a fee charged by the provider for a particular service.

    B. The provider shall give one copy of the executed agreement to the participant and keep a second copy on file for 3 years after the termination date of the agreement. Any modifications to the agreement shall be reflected in an addendum signed and dated by both parties.

    C. A change in the amount of a participant's required contribution following a reassessment of the participant's financial eligibility:

    (1) May be imposed immediately; and

    (2) Is not subject to the 30 day notice requirement of §A(4) of this regulation.