(check one or both): Provider Qualifications Provider Type: License Certificate Other Standard (specify) (specify) (specify) Certified Public Certified by the LTCB Under State contract with LTCB as Licensed Public Accountant as an authorized an authorized provider of services and Accounting provider of services supports. Agency Sec 58-26A, UCA and supports. Comply with all applicable State • And R 156-26A, and Local licensing, accrediting, and UAC certification requirements. Understand the laws, rules and • conditions that accompany the use of State and local resources and Medicaid resources. Utilize accounting systems that • operate effectively on a large scale as well as track individual budgets. Utilize a claims processing system • acceptable to the Utah State Medicaid Agency. Establish time lines for payments • that meet individual needs within DOL standards. Generate service management, and • statistical information and reports as required by the Medicaid program. Develop systems that are flexible • in meeting the changing circumstances of the Medicaid program. Provide needed training and • technical assistance to clients, their representatives, and others. Document required Medicaid • provider qualifications and enrollment requirements and maintain results in provider/employee file. Act on behalf of the person • receiving supports and services for the purpose of payroll reporting. Develop and implement an • effective payroll system that addresses all related tax obligations. Make related payments as • approved in the budget, person’s authorized by the case management agency.
(check one or both): Provider Qualifications Provider Type: License (specify) Certificate (specify) Other Standard (specify) Licensed Public Accounting Agency Certified Public Accountant Sec 58-26A, UCA And R 156-26A, UAC Certified by the LTCB as an authorized provider of services and supports. Under State contract with LTCB as an authorized provider of services and supports. • Comply with all applicable State and Local licensing, accrediting, and certification requirements. • Understand the laws, rules and conditions that accompany the use of State and local resources and Medicaid resources. • Utilize accounting systems that operate effectively on a large scale as well as track individual budgets. • Utilize a claims processing system acceptable to the Utah State Medicaid Agency. • Establish time lines for payments that meet individual needs within DOL standards. • Generate service management, and statistical information and reports as required by the Medicaid program. • Develop systems that are flexible in meeting the changing circumstances of the Medicaid program. • Provide needed training and technical assistance to clients, their representatives, and others. • Document required Medicaid provider qualifications and enrollment requirements and maintain results in provider/employee file. • Act on behalf of the person receiving supports and services for the purpose of payroll reporting. • Develop and implement an effective payroll system that addresses all related tax obligations. • Make related payments as approved in the person’s budget, authorized by the case management agency.
ABI_Amendment_11.3.17.docx