Federal Policy and Advocacy

In October, DC’s own Claudia Scholsberg, Senior Deputy and State Medicaid Director for DC Department of Health Care Finance presented on the FQHC Alternative Payment Methodology at a convening of MACPAC focused on Medicaid payment and FQHCs. The Medicaid and CHIP Payment and Access Commission (MACPAC) was created in the Children’s Health Insurance Program Reauthorization Act of 2009, and is non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).  The presentations at the October convening and the dialogue that followed focused on federal payment requirements regarding FQHCs, alternative payment methodologies that provide flexibility in payment and care delivery, and how FQHCs engage in value payment models.

Find all of the presentations from MACPAC’s October meeting Here: https://www.macpac.gov/public_meeting/october-2017-macpac-public-meeting/

 

https://www.macpac.gov/publication/medicaid-payment-policy-for-federally-qualified-health-centers/

The Federal Office of Rural Health Policy at the Health Resources and Service Administration is partnering with the Centers for Medicare & Medicaid Services (CMS) on the Connected Care initiative to improve chronic care management and provide resources to help you learn more about new ways to support your practice. Chronic care management services are a critical component of primary care. CMS established separate payment to increase payment for the additional time and resources you spend to manage the care of patients with two or more serious chronic conditions outside of the usual face-to-face encounters. The codes help pay for the between-appointment help your Medicare and dual eligible (Medicare and Medicaid) patients with multiple chronic conditions need to stay on track with their treatment plans and overall health. Rural Health Clinics and Federally Qualified Health Centers may currently use CPT code 99490 for 20 minutes or more of care coordination. Please note that new billing codes for provision of chronic care management and behavior health integration are being finalized for 2018.

 

Download the Connected Care Health Care Professional Toolkit to find information about eligibility, resources about service requirements and how to bill, a video featuring a health care professional talking about her experience, patient education video, postcards, and posters, and other resources to help you build an effective program in your practice. You can also order printed resources for your waiting room or download by visiting go.cms.gov/CCM. Materials are available in English and Spanish.

 

To learn more about chronic care management under FQHCs and RHCs, see our FAQs and Fact Sheet. Some updates have been made in 2017, reflected in Changes to Chronic Care Management Services for 2017 Fact Sheet, related to the allowance of oral informed consent, changes to reduce the administrative burden associated with providing CCM services, and the 2017 payment rate paid under the Physician Fee Schedule (PFS) for CPT code 99490.

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This month, health center funding is at stake, and it is critical that every health center board member, employee, patient, and supporter take action and GET LOUD. We must demand Congress take action this month to fix the health center funding cliff and protect the vital services they provide to 27 million patients. This week, call both of your Senators and your Representative in Congress, demanding action on the cliff. Make the health center voice impossible to ignore. Use this link to take action.

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Post to social media, tagging your Members of Congress. Click here for sample posts.

Email_Orange.png Send an email to your Member of Congress demanding action to fix the cliff.  
Call_elected_official_orange.png Call your Members of Congress at 1-(866) 456-3949. Click here for a script.

Ask your Representative to co-sponsor HR 3770 and your Senators to cosponsor S 1899 extending health center funding for 5 years. You can find the list of cosponsors in the House here and in the Senate here.