<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".21" citation="COMAR 10.67.04.21" title_num="10" subtitle_num="67" chapter_num="04" heading="Payments to Federally Qualified Health Centers (FQHC).">
  <paragraph num="A.">
    <text>FQHC’s shall be reimbursed under the Alternative Payment System (APS).</text>
    <paragraph num="(1)">
      <text>The Department shall:</text>
      <paragraph num="(a)">
        <text>Pay the MCO a prospective payment based on encounter data; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Reconcile the prospective amount paid to the MCO with the MCO's actual expenditure amount, after receipt of MCO encounter data; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>MCOs shall reimburse any contracted FQHC, the FQHC’s rate established in accordance with COMAR 10.09.08.05-1A.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>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.</text>
  </paragraph>
</regulation>