- STATE OF HAWAII
- DEPARTMENT OF HUMAN SERVICES
- MED-QUEST DIVISION
- PUBLIC NOTICE
- MED-QUEST DIVISION
- DEPARTMENT OF HUMAN SERVICES
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)
- 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.
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