Medicare Payment Bump Proposed for Federally Qualified Centers

Federally qualified health centers would receive higher Medicare reimbursements starting next year, under a proposed rule issued by the CMS.

CMS will pay 30% higher rates to federally qualified centers under the proposal. The new prospective payment system will pay centers a single, bundled rate for each encounter that will cover all services. But the CMS will adjust payments to reflect the higher costs of some areas and provide an extra payment for an initial exam.

“The new payment system will help even more patients get care in federally supported health centers,” CMS Administrator Marilyn Tavenner said in a news release. “The services provided by these centers help ensure patients get important primary and preventive care that lowers costs and improves health outcomes.”

Right now, Medicare's payments to federally qualified health centers are based on reasonable costs, but are subject to established payment limits. However, under rules set out by the Patient Protection and Affordable Care Act, the new Medicare prospective payment system for the centers will use type, intensity and duration of services to help determine reimbursements, without regard to payment limits.

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Source: Modern Healthcare