# COMAR Title 10 — Maryland Department of Health

## Subtitle 67 — Maryland Healthchoice Program

### Chapter 04 — Maryland Medicaid Managed Care Program: Managed Care Organizations

#### Regulation .21 Payments to Federally Qualified Health Centers (FQHC).

*COMAR 10.67.04.21*

A. FQHC’s shall be reimbursed under the Alternative Payment System (APS).

  (1) The Department shall:

    (a) Pay the MCO a prospective payment based on encounter data; and

    (b) Reconcile the prospective amount paid to the MCO with the MCO's actual expenditure amount, after receipt of MCO encounter data; and

  (2) MCOs shall reimburse any contracted FQHC, the FQHC’s rate established in accordance with COMAR 10.09.08.05-1A.

B. For self-referred services described in Regulation .20 of this chapter, the MCO shall pay the FQHC’s usual rate in accordance with §A of this regulation, regardless of the FQHC’s contracted status with the MCO.