Provider Eligibility. (a) To be considered for an SRSA, a provider shall apply to the commissioner or have been chosen as an SRSA provider prior to June 30, 2009, and have complied with all requirements of the SRSA agreement. Priority for funds is given to providers who had agreements prior to June 30, 2009. If sufficient funds are available, the commissioner shall make applications available to additional providers. To be eligible to apply for an SRSA, a provider shall:
(1) be eligible for child care assistance payments under chapter 119B;
(2) have at least 25 percent of the children enrolled with the provider subsidized through the child care assistance program;
(3) provide full-time, full-year child care services; and
(4) have obtained a level 3 or 4 star rating under the voluntary Parent Aware quality rating system.
(b) The commissioner may waive the 25 percent requirement in paragraph (a), clause (2), if necessary to achieve geographic distribution of SRSA providers and diversity of types of care provided by SRSA providers.
(c) An eligible provider who would like to enter into an SRSA with the commissioner shall submit an SRSA application. To determine whether to enter into an SRSA with a provider, the commissioner shall evaluate the following factors:
(1) the provider's Parent Aware rating score;
(2) the provider's current or planned social service and employment linkages;
(3) the geographic distribution needed for SRSA providers;
(4) the inclusion of a variety of child care delivery models; and
(5) other related factors determined by the commissioner.
Provider Eligibility. Provider represents that it is currently licensed and/or certified under applicable State and federal statutes and regulations and by the appropriate State licensing body or standard-setting agency, as applicable. Provider represents that it is in compliance with all applicable State and federal statutory and regulatory requirements of the Medicaid program and that it is eligible to participate in the Medicaid program. Provider represents that it does not have a Medicaid provider agreement with the Department that is terminated, suspended, denied, or not renewed as a result of any action of the Department, CMS, HHS, or the Medicaid Fraud Control Unit of the State’s Attorney General. Provider shall maintain at all times throughout the term of the Agreement all necessary licenses, certifications, registrations and permits as are required to provide the health care services and/or other related activities delegated to Provider by Subcontractor or Health Plan under the Agreement. If at any time during the term of the Agreement, Provider is not properly licensed as described in this Section, Provider shall discontinue providing services to Covered Persons. Provider shall submit copies of all applicable licenses to Subcontractor and/or Health Plan as required by the State Contract.
Provider Eligibility. Eligible child care providers are those who are eligible child care providers as defined in the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n(5)).
Provider Eligibility. Provider must be enrolled in the Mississippi Medicaid program and must use the same National Provider Identifier (NPI) number. Health Plan and Subcontractor will exclude from its network any provider who has been terminated or suspended from the Medicare or Medicaid program in any state.
Provider Eligibility. The Provider agrees to the provisions of 7 AAC 81, Grant Services for Individuals (Appendix A), as well as all other applicable state and federal law; and declares and represents that it meets the eligibility requirements for a Provider for this Agreement by meeting these established criteria:
Provider Eligibility. The Provider agrees to the provisions of 7 AAC 81, Grant Services for Individuals (Appendix A), as well as all other applicable state and federal law; and declares and represents that it meets the eligibility requirements for a Service Provider for this Agreement. With the signed Agreement, the Provider must submit the following documentation:
A. Proof of a Federal Tax ID Number;
B. A current State of Alaska Business License;
C. Alaska Native entities1 entering into a Provider Agreement with DFCS must provide a waiver of immunity from suit for claims arising out of activities of the Provider related to this Agreement using Appendix D;
D. Necessary credentials for service personnel, such as copies of valid and current certifications or licenses;
E. Necessary licensing/certifications for the service facility;
F. Upon request: proof of any other mandatory education/training/relationship/location/agency P&P, etc. that is necessary for eligibility as a provider.
G. Provider Background Check Policy and Procedures per Section IX(A)(1)(ii) of this Provider Agreement;
H. Certificates of Insurance per Section IX (B) of this Provider Agreement
I. Completed Appendix E – SOA DFCS HIPAA Business Associates Agreement By submission for the signed Agreement, the Provider further agrees that they will comply with the following:
A. The provisions of Appendix C, Privacy & Security Procedures.
Provider Eligibility. The Provider agrees to the provisions of 7 AAC 81, Grant Services for Individuals (Appendix A), as well as all other applicable state and federal laws; and declares and represents that it meets the eligibility requirements for a Service Provider for this Agreement.
A. A signed General Relief Assisted Living Home Provider Agreement (Rev. 10/19);
B. A State of Alaska Provider Verification Number (PVN) administered by the Division of Finance at 000-000-0000 or xxx.xxx.xxxxxx.xxxxxxxx@xxxxxx.xxx. This number is to be documented on the Contact Form (attachment 4);
C. A Direct Secure Messaging (DSM) email address. To sign up for DSM visit xxxx://xxxxxxx.xxx/inpriva/index.php/ak-dsm-ss2. Once obtained, record your DSM email address on the Contact Form (attachment 4);
D. Current State of Alaska Business License;
E. Current Assisted Living Home(s) License(s) to provide assisted living home services in the State of Alaska;
F. Certificate(s) of Insurance per Section IX (B) of this Provider Agreement;
G. Alaska Native entities1 entering into a Provider Agreement with DHSS must provide a waiver of immunity from suit for claims arising out of activities of the Provider related to this Agreement using Appendix G. By submission for the signed Agreement, the Provider further agrees that they will comply with the following:
A. Facilities and staff utilized for delivery of services meet current State of Alaska Health Care Facilities Licensing Assisted Living Home licensure requirements as outlined in AS 47.33 and 7 AAC 75.
B. Assisted living xxxx xxxxx are considered mandated reporters and will report the abuse, neglect, and exploitation of vulnerable adults as outlined in AS 47.24.
C. The provisions of Appendix F, Privacy & Security Procedures for Providers.
D. Facilities utilized for delivery of services meet current fire code, safety and ADA standards and are located where clients of the program services have reasonable and safe access.
E. During the effective period of this Agreement, the provider agrees to keep current any and all licenses, certifications and credentials required of the provider agency, staff and facility to qualify for providing services to DHSS clients through this Agreement and to keep current the necessary documentation on file with DHSS to demonstrate compliance. Failure to maintain current licenses, certifications, credentials, and insurance will result in the immediate termination of the provider agreement.
Provider Eligibility. The programme must be accredited by NZQA or CUAP. You will supply us with written evidence of the programme’s accreditation status prior to the commencement of the programme. Providers of the clinical placements must comply with the Health and Disability Services Standards (NZS 8134.00:2008; 8134.01:2008; 8134.02:2008 and NZS 8134.03:2008).
Provider Eligibility. The Provider agrees to the provisions of 7 AAC 81, Grant Services for Individuals (Appendix A), as well as all other applicable state and federal law; and declares and represents that it meets the eligibility requirements for a Provider for this Agreement by meeting these established criteria:
A. Proof of a Federal Tax ID Number;
B. A current State of Alaska Business License;
C. Alaska Native entities1 entering into a Provider Agreement with DHSS agree to provide a waiver of immunity from suit for claims arising out of activities of the provider related to this Agreement (Appendix D);
D. Must ensure Locum Tenens has a criminal background check completed prior to entering the API. (The Provider must complete background checks within 30 days of employment but prior to medical and/or psychiatric practitioners entering in API) and in accordance with The Joint Commission and Centers for Medicare & Medicaid Services guidance for hospitals to maintain accreditation.)
E. Providers will agree to the provisions of the attached Privacy & Security Procedures (Appendix C).
F. Must have current malpractice insurance as a provider and/or by Locum Tenens as your company policy dictates. A copy of the current malpractice insurance will be sent to API prior to the Locum Tenens’ arrival at API. Malpractice insurance is NOT available through the Department of Health and Social Services.
