Federally qualified health centers would receive higher Medicare reimbursements starting next year, under a proposed rule issued by the CMS.
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.
Read the full story here: http://bit.ly/18HCZlW
Source: Modern Healthcare
Trump Administration’s Message to Supreme Court Puts New Wrinkle in Braidwood Case
February 21st 2025The Trump administration argues that HHS Secretary Robert F. Kennedy Jr can overrule the US Preventive Services Task Force to determine the preventive services covered under the Affordable Care Act.
Read More
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
5 Key Health Care Moments During President Trump's First Month Back in Office
February 21st 2025President Donald J. Trump pushed for significant health care changes during his first month back in office, through executive orders affecting managed care, drug pricing, and clinical trial diversity guidance.
Read More
Same-Day Breast Imaging Gaps Reveal Health Care Disparities
February 18th 2025For this retrospective study, the authors examined data on more than 3 million screening mammographies for more than 1 million female patients; of the screenings, 23.6% had abnormal results and only 6.7% were recommended for biopsy.
Read More