Sec. T-1. 22 MRSA §3174-V is enacted to read:
§3174-V. Federally qualified health center reimbursements
Beginning in fiscal year 1999-00, the reimbursement requirements listed in subsections 1 and 2 apply to payments for certain federally qualified health centers as defined in 42 United States Code, Section 1395x, subsection(aa)(1993).
1. Services furnished by center. The department shall reimburse a federally qualified health center no less than 100% of reasonable costs for services furnished by the center if that center:
A. Is receiving a grant under Section 330 of the federal Public Health Services Act; or
B. Is receiving funding under contract with the recipient of a grant under Section 330 of the federal Public Health Services Act, is identified as a subrecipient in the Section 330 grantee's approved scope of work and meets the requirements to receive a grant under Section 330 of that Act.
2. Contracted services. When a federally qualified health center otherwise meeting the requirements of subsection 1 contracts with a managed care plan for the provision of Medicaid services, the department shall reimburse that center the difference between the payment received by the center from the managed care plan and 100% of the reasonable cost incurred in providing the services. Any such managed care contract must provide payments for the services of a center that are not less than the level and amount of payment that the managed care plan would make for services provided by an entity not defined as a federally qualified health center.
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