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016.06.38-201.000. Arkansas Medicaid Participation Requirements for Visual Care Providers.

AR ADC 016.06.38-201.000Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 38. Visual Care Provider Manual (Refs & Annos)
Section 200.000. Visual Care General Information.
Ark. Admin. Code 016.06.38-201.000
016.06.38-201.000. Arkansas Medicaid Participation Requirements for Visual Care Providers.
Currentness
Visual Care Program providers meeting the following criteria are eligible for participation in the Arkansas Medicaid Program:
A. Provider must be licensed by the State Board of Optometry to practice in his or her state. A current copy of the optometrist's license must be submitted with the provider application for participation. Subsequent licensure must be provided when issued.
1. Subsequent license renewal must be forwarded to Provider Enrollment within 30 days of issue. If the renewal documents have not been received within the 30-day deadline, the provider will have an additional and final 30 days to comply.
2. Failure to ensure that current licensure is on file with Provider Enrollment will result in termination from the Arkansas Medicaid Program.
B. Provider must be enrolled in the Title XVIII (Medicare) Program.
C. Provider must complete a provider application (form DMS-652), a Medicaid contract (form DMS-653) and a Request for Taxpayer Identification Number and Certification (Form W-9). View or print the provider application (form DMS-652), the Medicaid contract (form DMS-653) and the Request for Taxpayer Identification Number and Certification (Form W-9).
D. Enrollment as a Medicaid provider is conditioned upon approval of a completed provider application and the execution of a Medicaid provider contract. Persons and entities that are excluded or debarred under any state or federal law, regulation or rule are not eligible to enroll, or to remain enrolled, as Medicaid providers.
E. The Visual Care provider must adhere to all applicable professional standards of care and conduct.

Credits

Eff. Dec. 1, 2006.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through March 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.38-201.000, AR ADC 016.06.38-201.000
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