ARTICLE 4.1. Federally Qualified Health Center Alternative Payment Model Project
Heading of Article 4.1 amended by Stats. 2022, Ch. 47, Sec. 104.
§§ 14138.1–14138.23 · 12 sections
- § 14138.1 For purposes of this article, the following definitions apply: (a) “Alternative encounter” means an encounter provided by the participating FQHC that is…
- § 14138.10 The Legislature finds and declares all of the following: (a) Health care today is more than a face-to-face visit with a provider, but rather a whole-person…
- § 14138.12 (a) (1) The department shall authorize a payment reform project for FQHCs using an APM in accordance with this article. (2) Implementation of the APM project…
- § 14138.13 (a) The department shall notify every FQHC in the state of the APM project and shall invite any interested FQHC to apply for participation in the APM with…
- § 14138.14 (a) A participating FQHC shall be compensated for the APM scope of services provided to its APM enrollees pursuant to this section. (b) A participating FQHC…
- § 14138.15 (a) A principal health plan shall be compensated by the department for the APM scope of services provided to its APM enrollees pursuant to this section. (b)…
- § 14138.16 (a) For the duration of the APM project, the department shall establish a risk corridor structure for the principal health plans relating only to the APM…
- § 14138.17 (a) In order to ensure participating FQHCs have an incentive to manage visits and costs, while at the same time exercising a reasonable amount of flexibility…
- § 14138.18 (a) This article shall be implemented only to the extent that any necessary federal approvals have been obtained and federal financial participation is…
- § 14138.21 This article shall not be deemed to affect the amounts paid or the reimbursement methodology applicable to FQHCs for dental services and for services that are…
- § 14138.22 Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret,…
- § 14138.23 For purposes of implementing this article, the department may enter into exclusive or nonexclusive contracts on a bid or negotiated basis, including, but not…