Rural health clinic services and other ambulatory services shall be covered under the Kansas medical assistance program pursuant to 42 CFR 447.371, effective September 30, 1986, when provided by clinics accepted by the health care financing administration as qualified to furnish rural health clinic services for participation under the medicare program. A clinic may be certified as either an independent or a provider-based rural health clinic. Covered rural health clinic services and other ambulatory services shall include the following: (a) Physician services. These are professional services performed by a physician.

1. (b) Advanced registered nurse practitioner and physician assistant services. These are professional services furnished by an advanced registered nurse practitioner or a physician assistant under both of the following conditions:

   1. (1) Services are in accordance with medical orders prepared by a physician for the care and treatment of a patient.
   2. (2) A physician is available at least once every two weeks to supervise the delivery of services and to perform services that are not in the scope of advanced registered nurse practitioner and physician assistant services as defined in the Kansas statutes.
2. (c) Services and related medical supplies furnished incident to professional services provided by a physician, advanced registered nurse practitioner, or physician assistant. These are services and supplies commonly furnished in physician offices under the direct supervision of a physician, advanced registered nurse practitioner, or physician assistant.

3. (d) Visiting nurse services. These are home health nursing services and related medical supplies provided by a registered nurse or a licensed practical nurse under the supervision of a registered nurse at the beneficiary's place of residence, which shall not include a hospital or long-term care facility, under all of the following conditions:

   1. (1) The rural health clinic is located in an area where there is no home health agency.

      (2)The services are furnished to a homebound individual who is confined to the individual's place of residence because of a medical condition.

   2. (3) Services are provided under a written plan of treatment established by a physician, advanced registered nurse practitioner, or physician assistant and reviewed at least once every 60 days by a supervising physician.
4. (e) Other ambulatory services covered by the medicaid state plan.
5. (f) Referral for covered services not provided by the rural health clinic, to other practitioners enrolled as providers in the Kansas medical assistance program shall be covered.
6. (g) Screening and appropriate referral for the "kan be healthy" program shall be covered.

This regulation shall take effect on and after January 1, 1999.

(Authorized by and implementing K.S.A. 1997 Supp. 39-708c; effective May 1, 1981; amended Jan. 2, 1989; amended July 1, 1989; amended, T-30-1-2-90, Jan. 2, 1990; amended, T-30-2-28-90, Jan. 2, 1990; amended Dec. 29, 1995; amended Jan. 1, 1999.)