提供行為健康治療服務的 QAS 提供者組織和個人可以申請註冊 Medi-Cal 計劃。QAS 提供者組織和個人申請人必須通過提供者申請和註冊驗證 (PAVE) 在線入學入口網站提交電子申請，以及所有證明文件來申請註冊 Medi-Cal 計劃。​​ 

根據《福利 & 機構守則》(W & I) 第 14043.75 (b) 條授予醫療保健署署署長的權力，DHCS 署長正在為 QAS 提供者組織和申請註冊 Medi-Cal 計劃的個人制定具體申請和註冊要求，以獲得他們向 Medi-Cal 成員提供的保障行為健康護理服務的補償。這些要求實施並制定具體的 W & I 條碼第 14043.15 和 14043.26 條，因此，具有法律的全部效力和效力。有關更多信息，請參閱標題為「合格自閉症服務提供商組織和提供行為健康治療服務的個人的 Medi-Cal 註冊要求和程序」的監管提供者公告。此外，本公告不代替或消除 W & I 代碼第 14043.26 條中所列的所有其他註冊要求。
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中醫課程要求​​  

Behavioral health treatment services consist of Applied Behavioral Analysis and other evidence-based behavioral intervention services. These services include Behavioral-Analytic Assessment and development of behavioral treatment plans. In addition, behavioral health treatment intervention services are identified in the Behavioral Health Treatment Services Chart in the State Plan. Behavioral health treatment services must be provided by a QAS provider, QAS professionals, or QAS paraprofessionals as defined in the State Plan.​​  

A QAS provider organization or individual is defined as the applicant that submits the Medi-Cal application for enrollment to provide behavioral health treatment services. Note, QAS providers who currently have an enrollment pathway, including physician and surgeons, psychologists, physical therapists, occupational therapists, licensed marriage and family therapists, licensed clinical social workers, licensed professional clinical counselors, speech-language pathologists, and audiologists, do not need to enroll as a QAS provider to provide and bill for behavioral health treatment services. Individual Board Certified Behavior Analysts (BCBAs) and educational psychologists may enroll using the QAS application. The QAS applicant may be an individual or an entity such as a corporation and must meet all of the Medi-Cal enrollment requirements as specified in the Medi-Cal Enrollment Requirements and Procedures section of the aforementioned provider bulletin. Additionally, the enrolling QAS individual or organization must attest that all individuals providing services are reported to the DHCS and that all individuals meet the qualifications and follow supervision requirements listed in accordance with the State Plan for behavioral health treatment services. Please refer to the Attestation Requirement section of the aforementioned provider bulletin for more information.​​ 

所需文件​​  

根據適用的情況，收集下面列出的所需文件，以便在完成 PAVE 申請時將它們上傳到 PAVE。請確保上傳的文件易於閱讀。​​ 

• 如果沒有使用社會安全號碼，則通過提交當前的稅務局 (IRS) 產生的文件來驗證聯邦僱主識別號碼 (FEIN) 或個人納稅人識別號碼 (ITIN)。唯一可接受的文件包括 IRS 產生的信件 147-C、IRS 產生的表格 941（雇主的季度聯邦納稅申報表）、IRS 產生的表格 8109-C（存款券）或 IRS 生成的表格 SS-4（僅限 FEIN/ITIN 分配的官方確認通知）。注意：申請人或提供者的法定名稱必須與 IRS 產生的文件上完全相符；申請人/提供者必須是 IRS 文件上列出的實體的擁有者或官員。有關更多信息，請訪問國稅局致電 (800) 829-4933。​​ 
• 供應商的駕駛執照或州發出的身份證（在美國 50 或哥倫比亞特區發行），或簽署申請人，且具有法律約束申請人或提供商的權力的人。 除非提供者是公司，否則簽名必須是提供者的簽名。 如果提供商是公司，並且申請將由提供商以外的人簽署，請提交該公司章程中的部分副本，該部分確定簽署人有法律約束該公司的權力。​​ 
• Local Business License, Tax Certificate, and Permit for any city and/or county where business activities are conducted. Note: The name and business address of the applicant or provider on the application must exactly match the business name and business address on all local licenses and permits. If a business license/permit is not required, please submit a written statement from your local city/county indicating that your business does not require any license or permit. For further information, please contact your city business license office and/or visit the California State Association of Counties and click on the “California’s Counties” link, and select “County Web Sites.”​​ 
• Recorded/stamped Fictitious Business Name Statement (FBNS), issued by the county where the principal place of business is located, if using a fictitious business name AND the business name is different from the legal name on your application. For example, in the case of a corporation, any name other than the corporation name on record with the Secretary of State requires a FBNS. Note: The business name and business address of the applicant or provider on the application, all local business licenses/permits, and the FBNS must exactly match. To determine the applicable county agency where fictitious business names are filed, please visit the California State Association of Counties and  click on the “California’s Counties” link, and select “County Web Sites.”​​ 
• If your business is a corporation, processing delays may be avoided by attaching a copy of the filed Articles of Incorporation from the California Secretary of State (or a Statement of Domestic Stock Corporation if your corporation is based outside of California), and a list of directors’ and officers’ names and titles, with percent of ownership and control interest for each. To verify or change the name and/or status of your corporation or for further information, please visit the Secretary of State California Business Portal and click on the “California Business Search” link or other appropriate link.​​ 
• 商業責任保險證書（商業、一般責任或綜合責任或辦公樓宇保險），每宗賠償金額不少於 100,000 美元，年度最低總額為 300,000 美元。 可接受的驗證是自保證明，或是由保險公司發出的保險證明書或聲明表，其中包含保險公司名稱、受保人的名稱和營業地址、生效日期和保障限制。 註：申請人或提供者的姓名和營業地址，包括套房號（如適用），必須完全符合保險證明書或聲明表上的受保人姓名和地址。​​ 
• 如果您的企業有一名或多名員工，則加州法律要求提供工傷賠償保險證明。 可接受的驗證是自保證明，或是由保險公司發出的保險證明書或聲明表，其中包含保險公司名稱、受保人姓名和生效日期。 如果沒有需要工人補償保險，則必須提供解釋。 註：申請人或提供者的姓名必須與保險證明書上的受保人姓名完全相符。​​ 
• 簽署的租賃協議，如果商業處所不屬於申請人或供應商所有。注意：申請人或提供商的姓名和營業地址必須與租賃協議上的租客姓名和地址完全相符。​​ 
• 具有連帶責任協議的繼承人責任 ( DHCS 6217 )（如果適用）。​​ 

資源​​ 

• 使用PAVE 的 QAS 供應商組織/個人註冊​​ 
• Medi-Cal Provider Enrollment for QAS Provider Organizations, QAS Individuals, and CBOs Offering Behavioral Health Treatment Services – Frequently Asked Questions​​ 

鋪路門戶​​ 

前往 P AVE 門戶。
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