Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-59 - PROVIDER-BASED RURAL HEALTH CLINIC SERVICES
Section 560-X-59-.03 - Provider-Based Rural Health Clinic Services
Current through Register Vol. 43, No. 02, November 27, 2024
(1) Services covered in the Provider-Based Rural Health Clinic are:
(2) Provider-Based Rural Health Services may be provided by a:
(3) A physician, physician assistant, nurse practitioner, certified nurse midwife, and specialized nurse practitioner must conform to all State requirements regarding the scope or conditions of their practice.
(4) A nurse practitioner, physician assistant, certified nurse midwife, or a specialized nurse practitioner must furnish patient care services at least 50 percent of the time the clinic operates.
(5) The Provider-Based Rural Health Clinic must be under the medical direction of a physician. Except in extraordinary circumstances, the physician must be physically present for sufficient periods of times, at least every 72 hours for non-remote sites and every seven (7) days for remote sites (a remote site being defined as a site not more than 30 miles away from the primary supervising physician's principal practice location), to provide medical care services, consultation, and supervision in accordance with Medicare regulations for Rural Health Clinics. When not physically present, the physician must be available through direct telecommunication for consultation, assistance with medical emergencies, or patient referral. The extraordinary circumstances must be documented in the records of the clinic.
(6) The Provider-Based Rural Health Clinic must have in effect agreements or arrangements with one or more providers or suppliers participating under Medicare or Medicaid to furnish other services to its patients, including physician services provided in the inpatient hospital setting, the office, the patient's home, or a skilled nursing facility. If the agreements are not in writing there must be evidence that patients referred by the clinic are being accepted and treated.
(7) Rural Health Clinic visits and inpatient physician services are subject to the same routine benefit limitations as for physicians. Refer to Chapter 6 of the Administrative Code for details.
Author: Ginger Collum, Program Manager, Clinic/Ancillary Services
Statutory Authority: State Plan, Attachment 3.1-A, Pages 1.2 and 2.3a.; 42 C.F.R. Section 491 Subpart A; Section 491.8(a), Section 491.9(2), Section 405.2401-.2472 Subpart X; Section 410.45; Section 440.10-.20.
