DHS 105.37(1)(c)2.2. The EPSDT provider shall release information on the results of the health assessment to appropriate health care providers and health authorities when authorized by the patient or the patient’s parent or guardian to do so.

DHS 105.37(2)(a)(a) Case management reimbursement. Providers certified under sub. (1) as providers of EPSDT health assessment and evaluation services shall be eligible to receive reimbursement for EPSDT case management in accordance with the limitations contained in the case management agreement between the provider and the department.

DHS 105.37(2)(b)1.1. All EPSDT providers who apply to receive reimbursement for EPSDT case management services shall submit to the department a case management plan. The case management plan shall describe the geographic service area, target population, coordination with support activities conducted by the department and other health-related services, case management activities and the method of documenting the activities.

DHS 105.37(2)(b)2.2. The department shall evaluate the adequacy of each provider’s case management plan according to the case management requirements of the proposed service area and target population, the extent to which the plan would ensure that children receive the necessary diagnosis and treatment services for conditions detected during EPSDT health examinations, the proposed coordination with the EPSDT central notification system and other health related services, and proposed methods for documenting case management services. Based on the evaluation, the department shall either approve or deny the provider’s request for reimbursement of case management activities and shall impose on providers as conditions for reimbursement any personnel, staffing or procedural requirements that it determines are necessary pursuant to 42 CFR 441 Part B.

DHS 105.37(2)(c)(c) Records and documentations. Providers shall maintain records and documentation required by the department in order to verify appropriate use of funds provided by the department for EPSDT case management activities.

DHS 105.37(3)(3) Diagnosis and treatment services. Providers of diagnosis and treatment services for EPSDT recipients shall be certified according to the appropriate provisions of this chapter.

DHS 105.38(1)(1) For MA certification, ambulance service providers shall be licensed pursuant to s. 256.15, Stats., and ch. DHS 110, and shall meet ambulance inspection standards of the Wisconsin department of transportation under s. 341.085, Stats., and ch. Trans 309.

DHS 105.38(2)(2) An ambulance service provider that also provides air ambulance services shall submit a separate application under s. DHS 105.01 for certification as an air ambulance provider.

DHS 105.38 NoteNote: For a copy of the application form for an ambulance service provider license, write the EMS Section, Division of Public Health, P.O. Box 2659, Madison, Wisconsin, 53701.

DHS 105.38 HistoryHistory: Cr. Register, February, 1986, No. 362, eff. 3-1-86; renum. 105.38 to 105.38 (1) and am., cr. (2), Register, November, 1994, No. 467, eff. 12-1-94; correction in (1) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 1999, No. 520; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636.

DHS 105.39(1)(1) For MA certification, a specialized medical vehicle provider shall meet the requirements of this section and shall sign the affidavit required under sub. (6) stipulating that the provider is in compliance with the requirements of this section as well as with the requirements of the department of transportation for human service vehicles under ss. 110.05 and 340.01 (23g), Stats., and ch. Trans 301, and shall provide proof of compliance when requested by the department.

DHS 105.39(2)(a)(a) Insurance of not less than $250,000 personal liability for each person, not less than $500,000 personal liability for each occurrence and not less than $10,000 property damage shall be carried on each specialized medical vehicle used to transport a recipient.

DHS 105.39(2)(b)1.1. The proper functioning of the vehicle systems including but not limited to all headlights, emergency flasher lights, turn signal lights, tail lights, brake lights, clearance lights, internal lights, windshield wipers, brakes, front suspension and steering mechanisms, shock absorbers, heater and defroster systems, structural integrity of passenger compartment, air conditioning system, wheelchair locking systems, doors, lifts and ramps, moveable windows and passenger and driver restraint systems;

DHS 105.39(2)(b)2.2. That all brakes, front suspension and steering mechanisms and shock absorbers are functioning correctly;

DHS 105.39(2)(b)3.3. That all tires are properly inflated according to vehicle or tire manufacturers’ recommendations and that all tires possess a minimum of 1/8-inch of tread at the point of greatest wear; and

DHS 105.39(2)(b)4.4. That windshields and mirrors are free from cracks or breaks.

DHS 105.39(2)(d)(d) All deficiencies shall be corrected before any recipient is transported in the vehicle. Corrections shall be documented by the driver. Documentation shall be retained for not less than 12 months, except as authorized in writing by the department.