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Newsletter Article


Health Centers Would Get Big Boost in Pay Under Proposed Rule

By Rebecca Adams, CQ HealthBeat Associate Editor

September 18, 2013 -- Federal health centers would get paid about 30 percent more than current rates if federal officials finalize a recently proposed rule.

The payments for federally qualified health centers will transition to the new payment system throughout fiscal 2015, Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner said in a statement.

"The new payment system will help even more patients get care in federally supported health centers," said Tavenner. "The services provided by these centers help ensure patients get important primary and preventive care that lowers costs and improves health outcomes."

The same services that CMS officials have paid for in the past will continue to be covered, but health centers will be paid differently. Medicare officials want to give the clinics a single daily rate per beneficiary for all the services that a center provides to a patient. The rate would be adjusted based on how high the costs are in that particular region. Centers would get more for a patient who is new to the health center or is getting a comprehensive initial Medicare physical exam or an initial annual wellness exam.

Federal officials also have provided hundreds of millions of dollars in grants to the centers this year.

Health and Human Services officials announced they will provide $67 million to the centers in grants.

That includes $19 million to create 32 new clinics or other health service delivery sites. The funding is available because of the health care law (PL 111-148, PL 111-152), HHS said. The new clinics will take care of more than 130,000 additional people. The other $48 million will go to nearly 1,200 health centers to pay for improvements or activities they're already doing.

CMS will accept comments on the proposed rule until Nov. 18 and will release a final regulation next year.

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