471 NAC 18-003. PROVIDER REQUIREMENTS

003. PROVIDER REQUIREMENTS. 003.01 GENERAL PROVIDER REQUIREMENTS. To participate in Nebraska Medicaid, providers of physician services must comply with all applicable provider participation requirements in this title . . 003.02 INDEPENDENT CLINICAL LABORATORIES. An independent clinical laboratory must have a separate provider agreement with Nebraska Medicaid. In addition to the provider agreement, independent clinical laboratories must meet the following requirements: (A) When state or applicable local law requires licensing of independent clinical laboratories, the laboratory must be licensed under the law; and (B) The laboratory must meet the health or safety requirements of the United States Secretary of Health and Human Services. 003.03 PROVIDERS OF PORTABLE X-RAY SERVICES. To be approved as a Nebraska Medicaid provider, providers of portable x-ray services must be certified by the Centers for Medicare & Medicaid Services (CMS) . Each provider must submit to Nebraska Medicaid a copy of the appropriate Nebraska Medicaid approved certification form , and remain in compliance with federal regulations . An out-of-state portable x-ray provider must provide Nebraska Medicaid with verification of certification from the Centers for Medicare & Medicaid Services (CMS) . Enrollment as a Nebraska Medicaid provider will be approved or denied based on the certification information received from the Centers for Medicare & Medicaid Services (CMS) . 003.03(A) APPLICABILITY OF HEALTH AND SAFETY STANDARDS. Providers of portable x-ray services, except physicians who provide immediate personal supervision during the administration of diagnostic x-ray services, must comply with all health and safety standards in Nebraska regulations . 003.04 PROVIDERS OF NURSE MIDWIFE SERVICES. A nurse midwife is approved for enrollment in Nebraska Medicaid under a group provider agreement with the physician with whom they have a practice agreement. 003.05 PROVIDERS OF NURSE PRACTITIONER (NP) SERVICES. A nurse practitioner (NP) may provide services within the specialty areas in which they hold certification. They must be enrolled in accordance with the provider agreement. 003.06 FEEDING AND SWALLOWING CLINIC. Along with the completed appropriate Nebraska Medicaid approved provider agreement form , the provider must submit a program overview which demonstrates the following components of service are available within the program: (A) Interdisciplinary team evaluation which provides information to team members on the beneficiary’s medical status, nutrition and diet status, and also addresses feeding and behavioral concerns. In the process of the interdisciplinary team evaluation, the team must review and consider information from other available resources such as attending or referring physician, nursing facility (NF) , and school; (B) Assessment by an occupational therapist (OT) of the beneficiary’s tone and posture to determine seating and positioning for feeding and for the video fluoroscopy procedure; (C)Examination by a speech-language pathologist to assess the beneficiary’s oral structures and clinical swallowing evaluation; (D)A video fluoroscopy swallow study to determine conditions which are most favorable for a safe, efficient swallow and management of feeding problems; (E) Assessment of oral motor function and feeding behaviors. Depending on the needs of the beneficiary, some or all of the team members may be involved in this component. This assessment includes presentation of a variety of amounts and types of foods and liquids to the beneficiary to provide additional information used to establish therapeutic intervention; (F) Conference by team members to review findings, establish priorities, and coordinate treatment and follow-up recommendations; and (G)Presentation of a plan of care to the beneficiary or family, including instruction, demonstration, and written recommendations for feeding procedures at home and in other environments.