Quality Management

Quality Management A. Waiver providers must follow applicable service specifications as referenced in the Elderly and Disabled (E&D) Waiver approved by the Centers for Medicare and Medicaid Services (CMS). The Waiver is available on the Division of Medicaid’s website, www.medicaid.ms.gov. B. Providers must maintain compliance with all current waiver requirements, rules, regulations and administrative codes as specified by the Division of Medicaid. 1. If an E&D Waiver provider fails to respond to contact attempts timely or respond to requests for documentation/training verification in established timeframes, the Division of Medicaid may halt the acceptance of Medicaid referrals or waiver admissions until the E&D waiver provider establishes contact or demonstrates compliance with the regulatory agency. 2. The decision to halt Medicaid referrals or waiver admissions is at the discretion of the Division of Medicaid. C. Waiver providers must report: 1. Changes in contact information, administrative staffing, ownership and licensure within ten (10) calendar days to the Division of Medicaid. 2. Critical incidences including all instances of abuse, neglect, and exploitation (including the unauthorized use of restraints, restrictive interventions, and/or seclusion) within twenty (24) hours of the occurrence or knowledge of the occurrence to the Division of Medicaid and other applicable agencies as required by law. 3. Any complaints not resolved within seven (7) days. D. A provider may not rely on any interpretation or exception to the Medicaid rules if it’s not provided, in writing, by the Division of Medicaid.