Promulgation before enforcement

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  1. (a) The Department of Human Services may not use state policies, guidelines, manuals, or other such criteria in enforcement actions against providers unless the criteria have been promulgated.

  2. (b) Nothing in this section requires or authorizes the department to attempt to promulgate standards of care that practitioners use in determining medical necessity or rendering medical decisions, diagnoses, or treatment.

  3. (c) Medicaid contractors may not use a different provider manual than the Centers for Medicare & Medicaid Services Provider Reimbursement Manual promulgated for each service category.


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