LONG-TERM CARE FACILITIES; REHABILITATIVE AND THERAPEUTIC SERVICES TO RESIDENTS

Subpart 1. Eligible providers. The providers in items A to F are eligible for medical assistance payment on a fee for service basis for restorative therapy and specialized maintenance therapy that is provided according to part 9505.0390 and that is provided at the site of a long-term care facility to a recipient residing in the long-term care facility: A. a long-term care facility as defined in part 9505.0175 , subpart 23; B. a rehabilitation agency as defined in part 9505.0385 ; C. a comprehensive outpatient rehabilitation facility as defined in part 9505.0386 ; D. a physical therapist as defined in part 9505.0390 ; E. an occupational therapist as defined in part 9505.0390 ; and F. a speech-language pathologist or audiologist as defined in part 9505.0390 , subpart 1, item E. Subp. 2. Payment limitation. To be eligible for medical assistance payment, rehabilitative and therapeutic services provided to recipients residing in a long-term care facility must comply with the requirements of parts 9505.0170 to 9505.0475 . Subp. 3. Payment for restorative therapy and specialized maintenance therapy. Medical assistance payment for restorative therapy and specialized maintenance therapy may be made according to part 9505.0445 , item O, or as provided in parts 9549.0010 to 9549.0080 or 9553.0010 to 9553.0080 , or as specified in the contract between the department and a prepaid health plan according to part 9505.0285 . Subp. 4. Payment for rehabilitative nursing services. Medical assistance payment for rehabilitative nursing services shall be as provided in parts 9549.0010 to 9549.0080 or 9553.0010 to 9553.0080 , as applicable. However, payment for a rehabilitative nursing service shall not be made on a fee for service basis. Subp. 5. Reporting of fees for service by long-term care facility. A long-term care facility that receives medical assistance payment on a fee for service basis for the provision of restorative and specialized maintenance therapy to a resident shall report the therapy income in accordance with parts 9549.0010 to 9549.0080 or 9553.0010 to 9553.0080 , as applicable. This subpart applies to medical assistance payments made to the long-term care facility for therapy services provided by an employee or by a related organization. For purposes of this subpart, "related organization" has the meaning given it in Minnesota Statutes, section 256B.433 , subdivision 3, paragraph (b). Subp. 6. Prohibited practices. If medical assistance payment is made to a provider other than a long-term care facility for restorative therapy and specialized maintenance therapy, the long-term care facility in which the recipient resides must not request or receive payment from the provider in excess of the limit on charges specified in Minnesota Statutes, section 256B.433 , subdivision 3, paragraph (c).