Speaker: Ted Waters, Managing Partner, Feldesman Tucker Leifer Fidell, LLP
Contact: Jaime Hirschfeld
In this 90 minute webinar, we will provide an overview of the new Medicare federally-qualified health center prospective payment system (PPS) payment methodology, which will take effect for cost reporting periods beginning on or after October 1, 2014.
We will begin with a short discussion of general FQHC Medicare reimbursement principles that, for the most part, will not change under the Medicare PPS; including the scope of allowable FQHC services and the definition of a billable visit. Then, we will describe the methodology for a Medicare PPS set forth in the Affordable Care Act and the implementing regulations finalized on May 2, 2014.
We will review:
- 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 thathealth 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
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.