Medicare & Medicaid
Q. Are Rural Health Clinics included in the ARRA? We have not been able to find anywhere where we can be included in the Medicare or Medicaid money for the EMR
A. FQHCs and Rural Health Centers do not qualify for Medicare and Medicaid "Meaningful Use" incentives. However, there are robust EHR and capital upgrade incentives in the stimulus for those facilities through HRSA.
Also, physicians who practice at an FQHC or an RHC are eligible for the Medicaid program (provided they meet the case mix requirements) and some physicians may qualify for Medicare incentives for services billed under the Medicare Physician Fee Schedule (PFS) outside of those services billed through the clinic.
Q. Do Meaningful Use payment thresholds differ for FQHCs? We are paid as a group, not by individual provider.
A. FQHCs, as they do not bill through the IPPS, are not eligible for meaningful use incentives at the organizational level. Individual clinicans may or may not be eligible for Medicare incentives based on services paid through the Physician Fee Schedule (PFS).
Q. If an FQHC as an entity is not eligble for the Medicaid incentive, but the provider is, how is that incentive paid? Is the provider directly incented? How would an FQHC benefit other than knowing the providers would be delivering a high level of care?
A. There is a chance that a provider practicing at an FQHC could qualify for incentives. Providers are allowed to assign their payment to another entity (like a group practice or a hospital, for example) if they choose to.
Q. So, if RHCs are not eligible for incentives, can we assume they will not be concerned with the fee reduction for non-adoption?
A. Correct. An RHC or FQHC will not be subject to a Medicare fee reduction / penalty at the institutional level
Return to Main FAQ Page
The information in this FAQ was produced and provided by Manatt Health Solutions.
THIS COMMUNICATION IS NOT INTENDED TO BE USED AS LEGAL ADVICE, AND VITERA DOES NOT GUARANTEE THE ACCURACY OR RELIABILITY OF THE INFORMATION. ANY RELIANCE ON INFORMATION IN THIS COMMUNICATION IS AT YOUR OWN RISK.