7 AAC 43.872. Payment for services

(a) The department will reimburse a federally qualified health center on the basis of a rate of payment per federally qualified health center visit, and in the same manner as the department reimburses a rural health clinic under 7 AAC 43.860, except as provided in (b) of this section.

(b) For purposes of calculating a rate under (a) of this section and 7 AAC 43.860(g) (1)(B)(iii), the department will consider the total number of visits to be the sum of the following:

(1) the total number of federally qualified health center visits for all patients provided services by a full-time equivalent physician employed by the center; the department will calculate this figure by using the greater of the actual number of visits or a number that represents the minimum federally qualified health center productivity standard, as follows:

(A) at least 3,050 visits per year per full-time equivalent physician employed by an urban federally qualified health center;

(B) at least 2,100 visits per year per full-time equivalent physician employed by a rural federally qualified health center;

(C) 50 percent of the number set out in (A) or (B) of this paragraph, as applicable, for a federally qualified health center's first year of enrollment, and 75 percent of that number for a federally qualified health center's second year of enrollment;

(2) the total number of federally qualified health center visits for all patients provided services by a full-time equivalent midlevel practitioner employed by the center; the department will calculate this figure by using the greater of the actual number of visits or a number that represents the minimum federally qualified health center productivity standard, as follows:

(A) at least 1,550 visits per year per full-time equivalent midlevel practitioner employed by an urban federally qualified health center;

(B) at least 1,050 visits per year per full-time equivalent midlevel practitioner employed by a rural federally qualified health center;

History: Eff. 9/28/95, Register 135; am 7/11/2002, Register 163

Authority: AS 47.05.010

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