Current through September 21, 2024
(a) The Department
shall reimburse for covered services provided to clients in a FQHC or RHC using
a prospective payment rate determined pursuant to this Chapter.
(b) The Department shall establish a separate
payment rate for each FQHC and RHC. The rate shall be determined using the base
period Medicaid allowable costs, which are calculated as follows:
(i) The Department shall calculate a per
visit cost for each FQHC and RHC for the FQHC's and RHC's 1999 and 2000 fiscal
years. A fiscal year shall be the twelve (12) month period used by a FQHC or
RHC for accounting and tax purposes.
(ii) The Medicaid baseline rate (rate
established using the base period for each FQHC and RHC) with 1999 and 2000
fiscal year data shall be determined by calculating a per visit rate (total
allowable costs divided by total patient visits) for fiscal years 1999 and
2000; adding the two (2) rates together; and dividing the sum by two
(2).
(iii) The Medicaid baseline
rate for each FQHC and RHC with only 2000 fiscal year data shall be determined
by calculating a per visit rate (total allowable costs divided by total patient
visits) for fiscal year 2000.
(iv)
Scope of service changes for baseline rate.
(A) An FQHC or RHC which desires an
adjustment to its baseline rate due to an increase or decrease in its scope of
service shall:
(I) Notify the Department, in
writing, of the increase or decrease; and
(II) Submit a settled Medicare Cost Report
which documents the change in services and substantiates the costs associated
with that change.
(B) The
Department shall assess the information provided and shall determine if a rate
change is warranted and the amount of any such change. Those determinations
shall be based upon:
(I) The nature of the new
or discontinued service regarding the type, intensity, duration, and amount of
services. A change in the cost of a service is not considered in and of itself
a change in the scope of services; and
(II) The reasonableness of the FQHC's or
RHC's costs.
(C) The
Department may request that the FQHC or RHC provide additional information to
document the change in service. The information shall be provided before the
Department is obligated to consider the FQHC's or RHC's request.
(v) The per visit rate calculated
pursuant to this Section, as adjusted for changes in scope of service pursuant
to this Section, shall be the FQHC's or RHC's baseline rate for services
provided on or after January 1, 2001, and shall be the basis for future rate
determinations.
(vi) For any FQHC
or RHC that was not in operation during 1999 or 2000 fiscal years, refer to
Section 7.
(c) The Department shall base all
cost and rate calculations on a FQHC's or RHC's most recently settled Medicare
Cost Report. If a settled Medicare Cost Report is not available, the Department
shall use the FQHC's or RHC's Medicare Cost Report as filed.
(i) If a cost or rate calculation is based on
an "as filed" Medicare Cost Report, the Department shall recalculate the cost
or rate within a reasonable time after the FQHC's or RHC's settled cost report
becomes available. If the cost or rate based on an "as filed" cost report is
different from the cost or rate calculation based on the settled cost report,
the Department shall only adjust the rate prospectively and shall not
retroactively reimburse the FQHC or RHC for any underpayment or recover any
overpayment.
(ii) A change in a
FQHC's or RHC's rate pursuant to this subsection shall not affect any
averages.
(d) The
Department shall re-determine each provider's Medicaid allowable payment each
Federal fiscal year beginning on or after October 1, 2001, as follows:
(i) The provider's Medicaid allowable payment
in effect on October 1 of each year shall be adjusted by the percentage
increase in the MEI as calculated using the annual data published in the fourth
(4th) calendar quarter in the Federal Register or posted at the CMS Health Care
Indicators website at
https://www.cms.gov on the Market Basket Data
updates page.
(ii) The provider's
Medicaid allowable payment shall be adjusted prospectively to reflect any
increase or decrease in the scope of services furnished by the FQHC or RHC
during the FQHC's or RHC's fiscal year. The provisions of Section (b)(iv) shall
apply to any proposed rate changes based on a change in services.
(iii) The payment established pursuant to
Section 7(d)
of this Chapter shall be effective for the calendar year beginning January 1
following the determination of the new rate.