Press release: CMS Finalizes a Medicare Prospective Payment System for Federally Qualified Health Centers

CMS: April 29, 2014

Today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that could increase Medicare payments to Federally Qualified Health Centers (FQHC) by as much as 32 percent. The new payment system, as outlined in the Affordable Care Act, establishes a Medicare prospective payment system for FQHCs, which provide access to medical services to patients in or from medically underserved areas.

FQHCs provide vital primary and preventive care services to millions of people nationwide. Medicare currently pays them based on reasonable costs subject to established payment limits for covered services furnished to people with Medicare.  The Affordable Care Act requires that the new Medicare Prospective Payment System (PPS) account for a number of factors, including the type, intensity, and duration of services provided in this setting.  The new payment system will be implemented beginning on October 1, 2014. FQHCs will be transitioned to the new payment system throughout 2015. Read More