Section 10501 of the Patient Protection and Affordable Care Act (PPACA) of 2010 modified how payment is made for Medicare services furnished at federally qualified health centers (FQHC).Beginning on October 1, 2014, FQHCs will transition to a prospective payment system (PPS) in which Medicare payment is made based on a predetermined, fixed amount.
On May 2, 2014, the Centers for Medicare & Medicaid Services issued its final rule on the development of the Medicare FQHC PPS and requested public comment on three specific issues: exceptions to the limit of one PPS payment per day; establishment of G codes; and beneficiary copayment for preventive services.
Comments are due no later than July 1, 2014.
General Information
CMS Web Page on Medicare FQHC PPS Maintained by the Centers for Medicare & Medicaid Services, this web page features links to the final rule, the earlier proposed version of the rule, and other supporting documentation.
The goal of this webinar is to give participants a basic grounding in the new regulations, as well as a broad sense of the operational steps they will need to take to prepare for implementation of the Medicare PPS. Topics to be addressed include:
PPS implementation schedule;* how the nationwide Medicare PPS rate was established, as well as applicable adjustment factors for geographic location and type of service;
how the rate will be trended forward in future years;
changes in the definition of a billable visit, including treatment of same-day vists;
the role of the health center's charges in Medicare's payment, and CMS's expectation that health centers establish "G code" charges corresponding to five types of FQHC visits;
changes in health center responsibilities for collecting Medicare coinsurance;
the ongoing role of the Medicare cost report after PPS implementation.
Webcast: New Medicare PPS for Federally Qualified Health Centers - Operational Requirements Date: Wednesday, June 25, 2014 Time: 1:30 - 3:00 p.m.
This call will cover information on operational requirements of the new payment system, including a review of the PPS methodology, billing and claims processing, and cost reporting. A Q&A session will also take place at the end of the call.
For more information and to register, please click here.
