Sec. 10.67.04.21. Payments to Federally Qualified Health Centers (FQHC)

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A. FQHCs shall be reimbursed under the Alternative Payment System (APS).

(1) The Department shall:

(a) Pay the MCO a prospective payment based on encounter data; and

(b) Reconcile the prospective amount paid to the MCO with the MCO's actual expenditure amount, after receipt of MCO encounter data; and

(2) MCOs shall reimburse any contracted FQHC, the FQHCs rate established in accordance with COMAR 10.09.08.05-1A.

B. For self-referred services described in Regulation .20 of this chapter, the MCO shall pay the FQHCs usual rate in accordance with §A of this regulation, regardless of the FQHCs contracted status with the MCO.

                    
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