Blogs

Medicare Physician Fee Schedule Comment Templates

The Centers for Medicare and Medicaid Services is seeking comments on proposed changes to the Medicare Physician Fee Schedule. Comments must be submitted here by September 13 at 10:59 PM. The National Association of Community Health Centers (NACHC) has prepared a Medicare Physician Fee Schedule CY22 template comment letter. Below is a summary of the comments:

• CMS should amend the FQHC cost report and instructions to ensure FQHCs receive Medicare reimbursement at 100% of the reasonable costs for the COVID-19 vaccine and its administration, Monoclonal antibodies infusion, and Medicare Advantage enrollees’ vaccine administration.
• We encourage CMS to increase COVID-19 vaccine administration reimbursement for mass vaccination events that occur outside of the health center, to effectively reach vulnerable and underserved communities. 
• CMS should use its regulatory authority to permit FQHCs to provide remote services by revising the definition of medical and mental health FQHC visits to include services furnished using interactive, real-time, audio and video telecommunications, or audio-only interactions under defined circumstances.
• We encourage CMS to provide maximum flexibility for health centers implementing in-person service requirements for patients receiving virtual mental health services.
• CMS should use its authority to align FQHC patient choice with other Medicare beneficiaries by permitting patients to change their attending FQHC provider after they have made their initial election to receive hospice benefits.

Medicare Shared Savings Program ACOs Save $4.1 Billion+

Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program collectively saved Medicare $4.1 billion last year. Community health centers participating in the Patient Care Network of Oklahoma saved $8.3 million by providing high-quality care to seniors in the Medicare program. Read more.
 

OHCA Updates Legislature on Medicaid Expansion

On Monday, Oklahoma Health Care Authority (OHCA) CEO Kevin Corbett told the House and Senate appropriations committees 167,483 adults are currently enrolled in SoonerCare due to Medicaid expansion. He explained that 101,821 are new enrollees and 65,662 previously participated in programs like Insure Oklahoma or SoonerPlan. "Right now," Secretary Corbett said, "About 800 [members] a day is kind of what we think we're likely to incur for a period of time and trail off from there."

Legislators also asked about why the $164 million appropriated to OHCA through an increase in the Supplemental Hospital Offset Payment Program (SHOPP) fee remains unused. "I think with the American Rescue Plan and the two-year funding we received, it did create some options of how to (pay for Medicaid expansion) but clearly on a sustained basis this is a program that will allow for a two-year special FMAP [Federal Medical Assistance Percentage] and so having the ability to have a funding source to do that is important," Corbett said. "SHOPP does give that opportunity to do that."

Secretary Corbett also spoke regarding the halted rollout of managed care and its future. "There is no RFP being developed," he told the group. "There's no RFP being submitted to the street for the purposes of response. That is still in the pending hold, if you will, in regard to what we're going to do from a delivery system."