AB 1445 Summary

• Establishes that a maximum of 2 visits on the same day at a single FQHC or RHC location can be reimbursed when a patient suffers illness or injury after the first visit, or has both a medical visit and another health visit.

• Requires FQHCs and RHCs that currently bill multiple encounters with different health professionals on the same day as a single visit to apply for rate adjustments by January 1, 2011, and bill such visits separately after approval.

• Requires the State Department of Health Care Services to submit a state plan amendment to the federal Centers for Medicare and Medicaid Services by January 15, 2010, reflecting the changes in visit reimbursement.

• Specifies that "medical visit" means encounters with physicians, physician assistants, nurse practitioners, certified nurse midwives, visiting nurses, or perinatal services practitioners, and "another health visit" means encounters with clinical psychologists, licensed clinical social workers, dentists, or dental hygienists.

• Clarifies that rate adjustments under this section do not constitute a change in scope of services under existing law, allowing FQHCs and RHCs to continue billing at existing rates pending department approval of adjusted rates.