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TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

Proposed Rule
LSA Document #22-392

DIGEST

Amends 405 IAC 5-16-5 to revise the list of practitioners for rural health clinics and federally qualified health centers under the Medicaid prospective payment system reimbursement methodology. Effective 30 days after filing with the Publisher.




SECTION 1. 405 IAC 5-16-5 IS AMENDED TO READ AS FOLLOWS:

405 IAC 5-16-5 Rural health clinics and federally qualified health centers; reimbursement

Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2

Sec. 5. Medicaid reimbursement is available to rural health clinics (RHCs) and federally qualified health clinics centers (FQHCs) for services provided by the following providers:
(1) A physician.
(2) A physician assistant.
(3) A nurse practitioner.
(4) A clinical psychologist.
(5) A clinical social worker. A provider listed in IC 12-15-13-9(a).
Reimbursement is also available for services and supplies incident to such services as would otherwise be covered if furnished by a physician or as an incident to a physician's services. Services to a homebound individual are only available in the case of those FQHCs that are located in an area that has a shortage of home health agencies as determined by the office. Any other Ambulatory service included in the Medicaid state plan is considered a covered FQHC service if the FQHC offers such a that service. FQHC services are defined the same as the services provided by RHCs.
(Office of the Secretary of Family and Social Services; 405 IAC 5-16-5; filed Jul 25, 1997, 4:00 p.m.: 20 IR 3326; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA; readopted filed Jul 28, 2022, 2:21 p.m.: 20220824-IR-405220205RFA)



Posted: 03/15/2023 by Legislative Services Agency

DIN: 20230315-IR-405220392PRA
Composed: May 17,2024 4:53:42AM EDT
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