Health Center Regulatory Issues

CMS Releases Proposed Rule on Medicare FQHC PPS

Last week CMS released its Notice of Proposed Rulemaking on the Medicare FQHC PPS, which was created in the Affordable Care Act. We are still working through the details, but we are pleased to see that CMS has created a single encounter rate, with some adjustments, but most importantly without the application of the Medicare cap or productivity screens.  This translates into an increase in Medicare payments to health centers, providing them much needed relief from the outdated payment methodology.  We will be preparing a more in depth analysis and next steps, including comments on the proposed rule, so stay tuned for more information in future Washington Updates and here on the Policy Shop. You can find the NACHC statement here, and the CMS proposed rule, fact sheet and statement here. Please don’t hesitate to contact Susan Sumrell with any questions or comments.