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(1) prescription drugs subject to the drug coverage limitations in 7 AAC 120.100 — 7 AAC 120.130 and paid in accordance with 7 AAC 145.400 — 7 AAC 145.410; and

(2) labor and delivery services provided by a physician, a physician assistant, or an advanced practice registered nurse paid in accordance with 7 AAC 145.050. (f) Changes in the scope of services that are provided by a health clinic will be used to adjust the per-visit rate for a health clinic. These adjustments will be made upon the written notification of the provider and approval by the department. The change in scope of services must have increased or decreased a health clinic’s cost per visit by more than two and one-half percent. The change in the scope of services must be directly related to a new or terminated program or service, and may not include general increases or decreases in costs associated with programs that were already a part of an established rate. The department will examine a written request for a change in scope of services no more than 60 days after receipt to determine if the change satisfies the requirements of this subsection. The health clinic shall submit to the department a brief narrative describing the services that are to be added or deleted or that result in an increase or decrease in the scope of services. Additionally, a health clinic that proposes a change in the scope of services for future implementation must provide a one-year budget that specifies the change in the scope of services, shows the projected number of visits, and provides revenue and expense projections associated with the proposed change. If the department determines that a change in the scope of services has occurred, the per-visit rate will be adjusted. A final decision regarding the disposition of a request for a change in scope of services will be given to a clinic in writing. If the health clinic notifies the department

(1) before implementing the change in the scope of services that a change will occur, any adjustment will be made to coincide with the implementation date of the change;

(2) after implementing the change that an increase or decrease in the scope of services occurred, any adjustment will be made to coincide with the

(A) date of notification, for the addition of a category of service; a post-implementation request for a rate adjustment must be received no later than 45 days after the change in scope of services occurred; or

(B) implementation date of the change, for the deletion of a category of service or a change in the intensity of a service. (g) A health clinic that enrolls during or after health clinic fiscal year 2000, and that

(1) submits cost data for a minimum of six months during the health clinic fiscal year 1999 and 2000 period, may request payment at a per-visit rate that is based on the submitted data;

(2) does not submit cost data for a minimum of six months, will be paid a per-visit rate equal to the statewide weighted average of the total Medicaid per-visit payment rates made to health clinics; the base per-visit rate will be re-determined