016.27.21 Ark. Code R. 008

Current through Register Vol. 49, No. 10, October, 2024

Rule 016.27.21-008 - SPA 21-0011; FQHC 2-21; FQHC Mental Health Clinicians added

212.200FQHC Core Services 1-1-22

Covered FQHC core services are:

A. Physician services;

B. Services and supplies incidental to physician services (including drugs and biologicals that cannot be self-administered);

C. Pneumococcal vaccine and its administration and influenza vaccine and its administration;

D. Services provided by physician assistants, nurse practitioners, clinical psychologists, clinical social workers, licensed certified social workers, licensed professional counselors, licensed mental health counselors, and licensed marriage and family therapists;

E. Services and supplies incidental to physician assistant, nurse practitioner, clinical psychologist, clinical social worker, licensed certified social worker, licensed professional counselor, licensed mental health counselor, and licensed marriage and family therapist services as would otherwise be covered if furnished by or incidental to physician services; and

F. Part-time or intermittent nursing care and related medical supplies to a homebound individual, in the case of those FQHCs that are located in an area in which the Secretary of the Department of Health and Human Services has determined there is a shortage of home health agencies.

212.260 Licensed Certified Social Worker1-1-22

A. The services of licensed certified social workers working within the scope of their State licenses are covered if the services would be covered when furnished by a physician or incidental to physician services.

B. Supplies and services incidental to a licensed certified social worker's services are covered if they would be covered incidental to a physician's services.

212.270 Licensed Professional Counselor1-1-22

A. The services of licensed professional counselors working within the scope of their state licenses are covered if the services would be covered when furnished by a physician or incidental to physician services.

B. Supplies and services incidental to a licensed professional counselor's services are covered if they would be covered incidental to a physician's services.

212.280Licensed Mental Health Counselor 1-1-22

A. The services of licensed mental health counselors working within the scope of their state licenses are covered if the services would be covered when furnished by a physician or incidental to physician services.

B. Supplies and services incidental to a licensed mental health counselor's services are covered if they would be covered when incidental to a physician's services.

212.290Licensed Marriage and Family Therapist 1-1-22

A. The services of licensed marriage and family therapists working within the scope of their state licenses are covered if the services would be covered when furnished by a physician or incidental to physician services.

B. Supplies and services incidental to a licensed marriage and family therapist's services are covered if they would be covered when incidental to a physician's services.

214.100Definition of an FQHC "Core Service" Encounter1-1-22

A Federally Qualified Health Center (FQHC) "core service" encounter is a face-to-face contact between a patient of the FQHC and a physician, physician assistant, nurse practitioner, licensed clinical psychologist, licensed clinical social worker, licensed professional counselor, licensed mental health counselor, or licensed marriage and family therapist and includes services and supplies incidental to the face-to-face contact.

ATTACHMENT 3.1-A

STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT MEDICAL ASSISTANCE PROGRAM STATE ARKANSAS

AMOUNT, DURATION AND SCOPE OF SERVICES PROVIDED

Revised: January 1, 2022

CATEGORICALLY NEEDY

2.c. Federally Qualified Health Center (FQHC) services and other ambulatory services that are covered under the plan and furnished by a FQHC in accordance with Section 4231 of the State Medicaid Manual (HCFA - Pub. 45-4). (Continued)

Covered FQHC core services are defined as follows:

* physician services;

* services and supplies incident to physician's services (including drugs and biologicals that cannot be self-administered);

* pneumococcal vaccine and its administration and influenza vaccine and its administration;

* physician assistant services;

* nurse practitioner services;

* clinical psychologist services;

* clinical social worker services;

* licensed certified social worker services;

* licensed professional counselor services;

* licensed mental health counselor services;

* licensed marriage and family therapist services;

* services and supplies incident to clinical psychologist, clinical social worker, licensed certified social worker, licensed professional counselor, licensed mental health counselor, and licensed marriage and family therapist services as would otherwise be covered if furnished by or incident to physician services; and

* part-time or intermittent nursing care and related medical supplies to a homebound individual, in the case of those FQHCs that are located in an area in which the Secretary has determined there is a shortage of home health agencies.

FQHC ambulatory services are defined as any other ambulatory service included in the Medicaid State Plan if the FQHC offers such a service, (e.g. dental, etc.). The "other ambulatory services" that are provided by the

FQHC will count against the limit established in the plan for that service.