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Notice #: 0000031444-01





Pursuant to 42 C.F.R. 447.205, the Department of Human Services (“DHS”) is proposing to change the methods and standards that it uses to set payment rates for Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) services provided by public and private providers participating in the Medicaid program. The proposed changes will be submitted for review by the federal government as an amendment to the Medicaid State Plan, to be effective as of the day following the date of this notice.

The significant changes are:

1. For FQHC and RHC services, fully compensatory supplemental payments will be made for the difference between managed care payments and the payment that would have been made under the prospective payment system (PPS) methodology at a frequency of not more than four months following the receipt of a claim.

2. For FQHC and RHC services, PPS rate adjustments due to changes in scope of service will be processed for acceptance or rejection by the Department of Human Services within one hundred twenty days of the receipt of all requested documentation.

3. For FQHC and RHC services, clarification of the circumstances qualifying as a change in scope of service has been added to the proposed Medicaid State Plan.

4. For FQHC and RHC services, clarification of the types of services to be considered

eligible for supplemental PPS payment has been added to the proposed Medicaid State Plan.

A copy of the proposed changes will be available for public viewing from the first working day

that the publication of this public notice in the Honolulu Star Bulletin, Hawaii Tribune Herald,

West Hawaii Today, The Maui News, and The Garden Island, from Monday – Friday between

the hours of 7:45 a.m. to 4:30 p.m. at the following locations:

On Oahu: Department of Human Services

Med-QUEST Division

Policy & Program Development Office

601 Kamokila Blvd., Room 518

Kapolei, Hawaii 96707-2021

Phone: 692-8132

Mailing Address:

Med-QUEST Division

Program & Policy Development Office

P. O. Box 700190

Kapolei, Hawaii 96709-0190

On Maui: Med-QUEST Division

Maui Section

210 Imi Kala Street, Suite 101

Wailuku, Hawaii 96793

Phone: 243-5780

On Kauai: Med-QUEST Division

Kauai Section

4473 Pahee Street, Suite A

Lihue, Hawaii 96766

Phone: 241-3575

On Hawaii: Med-QUEST Division

East Hawaii Section

88 Kanoelehua Ave., Room 107

Hilo, Hawaii 96720

Phone: 933-0339

Med-QUEST Divison

West Hawaii Section

Lanihau Professional Center

75-5591 Palani Road, Ste. 3004

Kailua-Kona, Hawaii 96740

Phone: 327-4970

In addition, written comments concerning the proposed changes may be sent to P.O. Box

700190 at the Oahu mailing address noted above. Any written comments that are received

may also be reviewed by the public at the locations noted above. There are currently no public

hearings scheduled with respect to the proposed changes. Public hearings will be held in

conjunction with amendments to the Hawaii Administrative Rules that are made to conform

those rules to the changes described in this notice. A notice of the time and place of those

hearings will be published at a later time. To be assured of consideration, comments should

be submitted no later than June 12, 2008.

(SB31444 5/13/08)