On Monday CMS released a Frequently Asked Questions document on the Exchanges, Market Reforms and Medicaid. These FAQs cover questions on several hot topics, including the state based and federally facilitated exchanges, consumer issues, and the Medicaid expansion. Most newsworthy is the question on partial Medicaid expansion, which CMS states that the ACA does not …
Author: Rob
CMS Announces FY2013 FMAP Rates
CMS announced the Federal Medical Assistance Percentages (FMAP), the Enhanced Federal Medical Assitance Percentages (eFMAP) and the disaster recovery FMAP adjustments for FY 2013 in the November 30, 2012 Federal Register. These rates are effective October 1, 2012 through September 30, 2013. You can view the new rates in the Federal Register Notice, which can …
2013 Medicare Upper Payment Limits Announced
By: Susan Sumrell CMS has released the 2013 Medicare Upper Payment Limits (also known as the “Medicare cap”). For rural centers, the limit will be $110.78 and for urban centers the limit will be $128. This represents a 0.8% increase in the Medicare Economic Index (MEI) over the 2012 limits. This limit is effective January …
CMS Announces 2013 Application Fee for Medicare, Medicaid and CHIP
By: Susan Sumrell On November 30, 2012, CMS announced the 2013 application fee for those providers initially enrolling in Medicare, Medicaid, or CHIP or revalidating an enrollment or adding a new location. This application fee applies to those providers submitting an 855A application form, which is the form that health centers use to enroll in …
Exchange Requirements on Contracting and Payment to FQHCs
We’ve been hearing from a lot of you with questions on the Exchange and the contracting and payment requirements for Qualified Health Plans and FQHCs. We’ve put together this Q&A in hopes that it helps answer your questions and provides you with some additional helpful resources. Please don’t hesitate to contact Roger or Susan with …
CMS Issues Proposed Rule on Essential Health Benefits and State Medicaid Directors Letter on Benchmark Plans
By: Susan Sumrell Yesterday the Center for Consumer Information and Insurance Oversight (CCIIO), the group within CMS responsible for the development of the Exchanges, issued proposed rules on the Essential Health Benefits package. You may remember that they issued an EHB Bulletin last December and this proposed rule is the next step in establishing EHBs. …
Sebelius Announces Delay in State Exchange Blueprint Deadline
On November 9, 2012, HHS Secretary Sebelius announced a delay in the deadline for states to submit their Blueprint for Approval of State-based and State Partnership Exchanges. While the Declaration Letters for a State-Based Exchange are still due this Friday November 16, states now how some additional time to prepare their Blueprint, which will now …
HRSA Issues New Health Center Site Visit Guide
Recently, HRSA issued a new Health Center Site Visit Guide, incorporating changes to the Nineteen Key Health Center Program Requirements as well as some modifications in terminology. In general, the changes to the Program Requirement align the language of the Program Requirements with applicable requirements set forth in Section 330 of the Public Health Service Act, the implementing regulations at 42 C.F.R. Part 51c, and …
2012 State Election Results
By: Rob Kidney Tuesday’s election delivered big gains for both parties at the state level. Democrats won governorships in six states (Washington is still too close to call, but appears to favor Democrat Jay Inslee) while Republicans picked up four and legislatures in nine states switched party control. Voters in five states considered measures related to …
OPA Alerts Health Centers that Recertification Process will begin January 2013
By: Susan Sumrell This week HRSA’s Office of Pharmacy Affairs emailed health centers to let them know that the 340B Recertification process for health centers will begin January 2013. This recertification process is one of the step in OPA’s plan to strengthen 340B program integrity. OPA notes in its email that It is the responsibility …