Ala. Admin. Code r. 560-X-59-.03
Current through Register Vol. 43, No. 1, October 31, 2024
Section 560-X-59-.03 - Provider-Based Rural Health Clinic Services(1) Services covered in the Provider-Based Rural Health Clinic are: (a) Medically necessary diagnostic and therapeutic services and supplies that are an incident to such services or as an incident to a physician's service and that are commonly furnished in a physician's office or a physician home visit;(b) Basic laboratory services essential to the immediate diagnosis and treatment of the patient that must include but are not limited to the six (6) tests that must be provided directly by the rural health clinic:1. Chemical examinations of urine by stick or tablet methods or both (including urine ketones)2. Hemoglobin or hematocrit4. Examination of stool specimens for occult blood6. Primary culturing for transmittal to a certified laboratory(c) Medical emergency procedures as a first response to life threatening injuries and acute illness.(2) Provider-Based Rural Health Services may be provided by a:(b) Physician assistant, nurse practitioner, certified nurse midwife, or a specialized nurse practitioner as an incident to a physician's service.(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
Ala. Admin. Code r. 560-X-59-.03
Emergency rule effective October 1, 1993. This Rule effective December 14, 1993. Amended: Filed February 7, 1996; effective March 14, 1996. Amended: Filed July 7, 1997; effective August 11, 1997. Amended: Filed March 14, 2002; effective April 18, 2002. Amended: Filed September 11, 2003; effective October 16, 2003.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.