CMS Finalizes Payment System for Federally Qualified Health Centers

Brenda Neugent

Medicare/Medicaid

| May 18, 2014

Federally qualified health centers may see their Medicare/Medicaid payments go up under the Affordable Care Act, based on a new payment system going into effect this fall.

The Centers for Medicare and Medicaid Services (CMS) currently estimates that payments could go up by as much as 32 percent under the Patient Protection and Affordable Care Act.

Federally qualified health centers are generally required to treat all patients regardless of their ability to pay, and are currently reimbursed based on what CMS considers to be reasonable costs.

Under the new guidelines, Medicare would pay the centers a single encounter rate per beneficiary per day for all services provided, adjusting for geographic variation in cost as well as other variables.

The new system will take effect beginning Oct. 1, and centers will be transitioned to the new reimbursement method through 2015.

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