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A FQHC Prospective Payment System (PPS) was scheduled to be implemented in 2014. [4] The Patient Protection and Affordable Care Act (ACA) mandates that the Centers for Medicare and Medicaid Services (CMS) collect and analyze health services data prior to developing and implementing the new payment system.
In 1989, Congress created the Federally Qualified Health Center (FQHC) program, which established a preferential payment policy for health centers by requiring "cost-based" reimbursement for both Medicaid and Medicare. [1] The policy designated FQHC services as a mandatory Medicaid service that all states must cover and reimburse on a cost ...
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...
HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]
The Medicare Payment Advisory Commission has urged the federal government to restructure the hospice benefit to remove such incentives by reducing payments for longer stays, warning that such changes are “imperative.” The Centers for Medicare and Medicaid Services has the authority to reform the system but has not adopted the proposed changes.
The various providers within an ACO work to provide coordinated care, align incentives and lower costs. [31] ACOs are different from health maintenance organizations (HMOs) in that they allow providers much freedom in developing the ACO infrastructure. [32] Any provider or provider organization may assume the role of running an ACO.
The surveys are free to anyone who wants to use them. They focus on aspects of healthcare quality that patients find important and are well-equipped to assess, such as the communication skills of providers and ease of access to healthcare services. [2] To customize a standardized CAHPS survey, users can add questions on a variety of topics.
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