On April 29, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that could increase Medicare payments to Federally Qualified Health Centers (FQHC) by as much as 32 percent. The new payment system, as outlined in the Affordable Care Act, establishes a Medicare prospective payment system for FQHCs, which provide access to medical services to patients in or from medically underserved areas.
Under the new PPS, Medicare will pay FQHCs a single encounter rate per beneficiary per day for all services provided, with some exceptions. The rate will be adjusted for geographic variation in costs. The rate will also be adjusted for the higher costs associated with furnishing care to a patient that is new to the FQHC and when the FQHC furnishes an initial preventive physical examination or an annual wellness visit to a Medicare beneficiary. The same services that have been paid for by Medicare in the past will continue to be covered under the new system.
For more information about the Medicare prospective payment system for FQHCs see: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-04-29.html.