Ala. Admin. Code r. 560-X-48-.03
Reimbursement
Effective Mar 16, 2020Emergency 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: Published January 31, 2020; effective March 16, 2020.Alabama Medicaid Agency
- (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.
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, et seq.
History: 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: Published January 31, 2020; effective March 16, 2020.