Page 381

House Bill No. 5506

Public Act No. 22-118 381 of 739

of service provided. On or before January 1, 2008, the commissioner shall report to the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies and human services on the status of the changes to the cost-based reimbursement methodology] reimburse federally qualified health centers on an all-inclusive encounter rate per client encounter based on the prospective payment system required by 42 USC 1396a(bb). Any patient encounter with more than one health professional for the same type of service and multiple interactions with the same health professional that occur on the same day shall constitute a single encounter for purposes of reimbursement, except when the patient, after the first encounter, suffers illness or injury requiring additional diagnosis and treatment. A federally qualified health center shall be reimbursed in accordance with the requirements prescribed in section 17b-262-1002 of the regulations of Connecticut state agencies. (b) A federally qualified health center may not provide nonemergency periodic dental services on different dates of service for the purpose of billing for separate encounters. Any nonemergency periodic dental service, including, but not limited to, (1) an examination, (2) prophylaxis, and (3) radiographs, including bitewings, complete series and periapical imaging, if warranted, shall be completed in one visit. A second visit to complete any service normally included during the course of a nonemergency periodic dental visit shall not be eligible for reimbursement unless (A) medically necessary, and (B) such medical necessity is clearly documented in the patient's dental record. Sec. 240. Section 36 of public act 21-2 of the June special session is repealed and the following is substituted in lieu thereof (Effective from passage): (a) As used in this section: (1) "Community action agency" means a public or private nonprofit