Ala. Admin. Code r. 560-X-48-.03

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-48-.03 - Reimbursement

(1) Federally Qualified Health Centers (FQHCs) will be reimbursed under a prospective payment system as described in Chapter 56 of the Administrative Code.

(2) Inpatient and outpatient surgery is reimbursed as fee for service and is subject to the routine benefit limitations and policies as stated in Chapter 6 of the Administrative Code.

(3) FQHCs that are enrolled as Pharmacy providers (take home drugs) are reimbursed in accordance with routine benefit limitations and policies as stated in Chapter 16 of the Administrative Code.

Ala. Admin. Code r. 560-X-48-.03

Emergency rule effective October 1, 1990. Permanent rule effective January 15, 1991. Amended: April 15, 1993. Amended: Filed November 5, 1997; effective December 10, 1997. Amended: Filed June 5, 1998; effective July 10, 1998. Amended: Filed May 11, 2001; effective June 15, 2001. Amended: Filed March 14, 2002; effective April 18, 2002.

Amended by Alabama Administrative Monthly Volume XXXVIII, Issue No. 02, November 29, 2019, eff. 3/16/2020.

Author: Calvin Binion, Associate Director, State, Agency,

Vision, & Clinic Services

Statutory Authority: State Plan, Attachment 4.19-B; Title XIX,

Social Security Act; 42 C.F.R. §§ 413, etseq.