45-18-6.1. Reimbursement rates offered under state employees’ health insurance plan.

As used in this Code section, the term:#

1. (1)

   “Federally qualified health center” means an entity which meets the definition of a federally qualified health center as described in 42 U.S.C. Section 1905(l)(2)(B).#

2. (2)

   “Medicare” means coverage under both Parts A and B of Title XVIII of the Social Security Act, 42 U.S.C. Section 1395, et seq., as amended.#

3. (3)

   “State health benefit plan” means the health insurance plan or plans established pursuant to Article 1 of Chapter 18 of Title 45 and Part 6 of Article 17 of Chapter 2 of Title 20 for state and public employees, dependents, and retirees.#

On and after January 1, 2020, any contracts entered into or renewed by the department for health care coverage for enrollees under the state health benefit plan shall include payment for services furnished to enrollees by federally qualified health centers in an amount no less than the then applicable Medicare maximum allowable reimbursement rate to federally qualified health centers for any such service.#

This Code section shall not apply to any licensed group model health maintenance organization with an exclusive medical contract.#