Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1740.1 - REIMBURSEMENT OF FEDERALLY QUALIFIED HEALTH CENTERS AND RURAL HEALTH CLINICS
Section 17-1740.1-11 - Adjustment for changes to scope of services
Current through February, 2024
The PPS payment rates may be adjusted for any increases or decreases in the scope of services furnished by the FQHC or RHC.
(1) Providers must notify the department in writing of any changes to the scope of services and the reasons for those changes within sixty days of the effective date of such changes.
(2) Providers must submit data, documentation, and schedules that substantiate any changes in services and the related increases or decreases of reasonable costs following Medicare principles of reimbursement.
(3) Providers must propose a projected adjusted rate to which the department must agree. Upon agreement by the department, the provider will be paid the projected rate effective the date of change in scope of services through the date that a rate is calculated based on the submittal of cost reports for the first two full fiscal years which include change in scope of services as required by section 17-1740.1-13(b)(1).
(4) Upon receipt of the costs reports required by section 17-1740.1-13(b)(1), the PPS rate will be adjusted following a review by the fiscal agent of the cost reports and documentation.
(5) Adjustments will be made for payments, (Deleted: ¶) for the period from the effective date of the change in scope of services through the date of the final adjustment of the PPS rate.
