HAR §17-1740.1-2. REPEALED

[R 09/30/13] §17-1740.1-3 Calculations of the baseline PPS rates for FQHCs and RHCs who, as of May 31, 2001, have filed two annual cost reports for their respective fiscal years ending 1999 and 2000. For each FQHC and RHC, the baseline rate will be calculated using the cost reports for their respective fiscal years ending in 1999 and 2000. The baseline rate will be calculated as follows: (1) The total visits and costs shall be obtained from the “as filed” cost reports, submitted to the State for the respective FQHC or RHC fiscal years ending in 1999 and 2000. For those providers having more than one cost UNOFFICIAL 1740.1-3 report ending in either of these years, a weighted average to the current year-end will be used to make both years consistent. Vision visits and costs will be included with the medical cost per visit baseline PPS rates. (2) Each year’s total costs will be divided by the total visits. The total costs should include the costs of all Medicaid covered services provided by the FQHC or RHC. This includes all ambulatory services which were previously paid under a fee-for-service basis. (3) A two-year average of the calculated cost per visit rates for years 1999 and 2000 will be used for each facility. The average cost per visit rate will be calculated separately for each year, then added together and divided by two. [Eff 11/20/03] (Auth: HRS §346-14, 42 C.F.R. §431.10) (Imp: Pub. L. No. 106-554) §17-1740.1-4 Calculation of the baseline PPS rates for FQHCs and RHCs who, as of May 31, 2001, could have filed two annual cost reports for their respective fiscal years ending 1999 and 2000, but only filed one such annual cost report. For each FQHC and RHC, the baseline rate will be calculated using the cost report submitted. The baseline rate will be calculated as follows: (1) The total visits and costs shall be obtained from the “as filed” cost report. Vision visits and costs will be included with the medical cost per visit baseline PPS rates. A separate PPS rate will be computed for dental visits. (2) Each year’s total costs will be divided by the total visits. The total costs should include the costs of all Medicaid covered services provided by the FQHC or RHC. This includes all ambulatory services which were previously paid under a fee-for service basis. (3) If the FQHC or RHC believes it provides more UNOFFICIAL 1740.1-4 in scope of services or caseload, or both, than reflected in the base rate, it may seek an adjustment by submitting data and documentation that substantiates the difference in services or costs. [Eff 11/20/03] (Auth: HRS §346-14, 42 C.F.R. §431.10) (Imp: Pub. L. No. 106-554) §17-1740.1-5 Calculations of the baseline PPS rates for FQHCs and RHCs who did not file cost reports as of May 31, 2001. (a) FQHCs and RHCs who did not file cost reports are: (1) Those who, prior to January 1, 2001, were certified as FQHCs or RHCs; or (2) Those who are certified as FQHCs or RHCs on or after January 1, 2001. (b) Baseline rates will be calculated and assigned, as follows: (1) For a FQHC, one hundred per cent of the costs of furnishing such services based on a cost per visit rate established under this section for the FQHC in the state that is most similar in scope of service and caseload. (2) For a RHC, one hundred per cent of the costs of furnishing such services based on a cost per visit rate established under this section for the RHC in the state that is most similar in scope of service and caseload. (c) If the FQHC or RHC believes it provides more in scope of services or caseload, or both, than reflected in the base rate, it may seek an adjustment by submitting data and documentation that substantiates the difference in services or costs. [Eff 11/20/03] (Auth: HRS §346-14, 42 C.F.R. §431.10) (Imp: Pub. L. No. 106-554) §17-1740.1-6 Calculation of the baseline PPS rates for FQHCs and RHCs who submitted cost reports as of May 31, 2001 for their respective fiscal years ending in 1999 and 2000 but were not certified as FQHCs or RHCs as of December 31, 2000 for a length of time sufficient to produce two annual cost reports UNOFFICIAL 1740.1-5 based on their respective fiscal years. (a) Baseline PPS rates for these FQHCs and RHCs will be the higher of the applicable assigned rate, as described in section 17-1740.1-4(b), or a cost per visit rate calculated using the most recent “as filed” cost report. (b) If the FQHC or RHC believes it provides more in scope of services or caseload, or both, than reflected in the base rate, it may seek an adjustment by submitting data and documentation that substantiates the difference in services or costs. [Eff 11/20/03] (Auth: HRS §346-14, 42 C.F.R. §431.10) (Imp: Pub. L. No. 106-554)