Medicare Monthly Review, Issue 2008-03A: Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases

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	National Government Services, Inc. Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter

MMR-2008 03AB, March 2008

MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)

Announcement of Medicare Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Payment Rate Increases

MLN Matters Number: MM5896
Related Change Request (CR) #: 5896
Related CR Release Date: February 1, 2008
Effective Date: January 1, 2008
Related CR Transmittal #: R1426CP
Implementation Date: February 12, 2008

Provider Types Affected
Providers and suppliers submitting claims to Medicare contractors (fiscal intermediaries (FI), and/or Part A/B Medicare Administrative Contractors (A/B MAC)) for services provided to Medicare beneficiaries

Provider Action Needed
This article is based on Change Request (CR) 5896 which provides instructions for the calendar year (CY) 2008 Payment Rate Increases for Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) services

Background
In accordance with the Social Security Act (Section 1833(f) at http://www.ssa.gov/OP_Home/ssact/title18/1833.htm on the internet) the Centers for Medicare & Medicaid Services (CMS) is increasing the calendar year (CY) payment rates for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) effective for services on or after January 1, 2008, through December 31, 2008 (i.e., CY 2008) as follows:

The Rural Health Clinics (RHCs) upper payment limit per visit is increased from $74.29 to $75.63. The 2008 rate reflects a 1.8 percent increase over the 2007 payment limit in accordance with the rate of increase in the Medicare Economic Index (MEI) as authorized by the Social Security Act (Section 1833(f)).
The Federally Qualified Health Centers (FQHCs) upper payment limit per visit for urban FQHCs is increased from $115.33 to $117.41, and the maximum Medicare payment limit per visit for rural FQHCs is increased from $99.17 to $100.96. The 2008 FQHC rates reflect a 1.8 percent increase over the 2007 rates, in accordance with the rate of increase in the MEI.

To avoid any unnecessary administrative burden, Medicare contractors will not retroactively adjust individual RHC/FQHC bills paid at previous upper payment limits. However, they will adjust such claims that you bring to their attention. Also, they retain the discretion to make adjustments to the interim payment rate or a lump sum adjustment to total payments already made to take into account any excess or deficiency in payments to date.

Additional Information
The official instruction, CR5896, issued to your Medicare FI or A/B MAC regarding this change may be viewed at http://www.cms.hhs.gov/Transmittals/downloads/R1426CP.pdf on the CMS Web site.

If you have any questions, please contact your Medicare FI or A/B MAC at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

Disclaimer This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.

MLN Matters. . .Information for Medicare Providers (Issued by the Centers for Medicare & Medicaid Services)

MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)