(1) To enroll as a Washington apple health provider and receive payment for services, a federally qualified health center (FQHC) must:
(a) Receive FQHC certification for participation in the Title XVIII (medicare) program according to 42 C.F.R. 491;
(b) Sign a core provider agreement with the medicaid agency; and
(c) Operate in accordance with applicable federal, state, and local laws.
(2) The medicaid agency uses one of two timeliness standards for determining the effective date of a medicaid-certified FQHC.
(a) The agency uses medicare's effective date if the FQHC returns a properly completed core provider agreement and a properly completed FQHC enrollment packet within 60 calendar days from the date of CMS's written notification to the FQHC of the medicare certification.
(b) The agency uses the date when both the properly completed FQHC enrollment packet and properly completed core provider agreement have been received if either of the required documentation is submitted 61 or more calendar days after the date of medicare's letter notifying the clinic of the medicare certification.
[Statutory Authority: 42 U.S.C. 1396a(bb), 42 U.S.C. 1396d (2)(A), RCW
41.05.021, and
41.05.160. WSR 22-22-049, § 182-548-1200, filed 10/27/22, effective 1/1/23. Statutory Authority: RCW
41.05.021 and
41.05.160. WSR 15-11-008, § 182-548-1200, filed 5/7/15, effective 6/7/15. WSR 11-14-075, recodified as § 182-548-1200, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW
74.08.090, BIPA of 2000 Section 702, sections 201 and 209 of 2009-2011 budget bill, and 42 U.S.C. 1396a(bb). WSR 10-09-002, § 388-548-1200, filed 4/7/10, effective 5/8/10.]