DHS 109.52(1)(1) General. This section identifies the terms and conditions under which SeniorCare providers of drugs are certified for participation in the program. DHS 109.52(2)(a)(a) For SeniorCare certification, pharmacies located in Wisconsin shall meet the requirements for registration and practice under ch. 450, Stats., and chs. Phar 1 to 17. Pharmacies certified to serve patients under the medical assistance program under ch. DHS 105 are required to serve SeniorCare participants. DHS 109.52(2)(b)(b) Pharmacies located outside of Wisconsin are exempt from the requirement under par. (a), but shall be registered or licensed by the appropriate agency in the state in which they are located. DHS 109.52(3)(3) General conditions for participation. In order to be certified by the department to dispense drugs under this program, a SeniorCare provider shall do all of the following: DHS 109.52(3)(a)(a) Affirm in writing that the SeniorCare provider and each person employed by the SeniorCare provider for the purpose of providing the service holds all licenses or similar entitlements as specified in this chapter and as required by federal or state statute, regulation or rule for the provision of the service. DHS 109.52(3)(b)(b) Affirm in writing that neither the SeniorCare provider, nor any person in whom the SeniorCare provider has a controlling interest, nor any person having a controlling interest in the SeniorCare provider, has been convicted of a crime related to, or been terminated from, a federally-assisted or state-assisted medical program. DHS 109.52(3)(c)(c) Disclose in writing to the department all instances in which the SeniorCare provider, any person in whom the SeniorCare provider has a controlling interest, or any person having a controlling interest in the SeniorCare provider has been sanctioned by a federally-assisted or state-assisted medical program. DHS 109.52(3)(d)(d) Furnish the following information to the department in writing: DHS 109.52(3)(d)1.1. The names and addresses of all vendors of drugs, medical supplies or transportation, or other providers in which the SeniorCare provider has a controlling interest or ownership. DHS 109.52(3)(d)2.2. The names and addresses of all persons who have a controlling interest in the SeniorCare provider. DHS 109.52(3)(d)3.3. Whether any of the persons named in compliance with subd. 1. or 2., is related to another named in subd. 1. or 2. DHS 109.52(3)(e)(e) Execute a SeniorCare provider agreement with the department. DHS 109.52(4)(4) Notification of certification decision. Within 60 days after the department receives a complete application for certification, including evidence of licensure or Medicare certification, or both, if required, the department shall either approve the application and issue the certification, or deny the application. If the application for certification is denied, the department shall give the applicant reasons, in writing, for the denial. DHS 109.52(5)(a)(a) Compliance with requirements. A SeniorCare provider shall maintain compliance with the requirements in this subsection in order to maintain SeniorCare certification. DHS 109.52(5)(b)(b) Change in provider status. A SeniorCare provider shall report to the department in writing any change in licensure, certification, group affiliation, corporate name or ownership by the time of the effective date of the change. The department may require the SeniorCare provider to complete a new provider application and a new provider agreement when a change in status occurs. A SeniorCare provider shall immediately notify the department of any change of address but the department shall not require the completion of a new provider application or a new provider agreement for a change of address. DHS 109.52(5)(c)(c) Change in ownership. If the ownership of a certified SeniorCare provider changes, the provider agreement shall automatically terminate. DHS 109.52(5)(d)(d) Program compliance. A SeniorCare provider may lose SeniorCare certification for any of the reasons listed in sub. (12) or in s. DHS 106.06. DHS 109.52(6)(6) Response to inquiries. A SeniorCare provider shall respond as directed to inquiries by the department regarding the validity of provider information maintained by the department. DHS 109.52(7)(7) Maintenance of records. A SeniorCare provider shall prepare and maintain whatever records are necessary to fully disclose the nature and extent of services provided by the SeniorCare provider under the program, including those enumerated in sub. (8). Each SeniorCare provider shall maintain all required records for at least a period of 5 years from the date the department pays for the services rendered, unless otherwise stated in this chapter. If a SeniorCare provider’s participation in the program terminates for any reason, all related records shall remain subject to the conditions enumerated in this subsection and sub. (8). DHS 109.52(8)(8) Records to be maintained. SeniorCare providers shall retain all of the following records: DHS 109.52(8)(a)(a) Contracts or agreements with persons or organizations for the furnishing of SeniorCare items or services, payment for which may be made in whole or in part, directly or indirectly, by the department. DHS 109.52(8)(b)(b) Billings and records of services or supplies which are the subject of the billings that are necessary to fully disclose the nature and extent of the SeniorCare services or supplies. DHS 109.52(8)(c)(c) All policies and regulations adopted by the SeniorCare provider’s governing body. DHS 109.52(8)(d)(d) Prescriptions that support SeniorCare billings, including records of SeniorCare covered vaccines and vaccine administration.