2019 Poverty Guidelines Released
The U.S. Department of Health and Human Services (HHS) released new U.S. Federal Poverty Guidelines (FPG) which are used to determine financial eligibility for certain federal programs. The 2019 HHS poverty guidelines published in the Federal Register on Feb. 1, 2019, are in effect as of Jan. 11, 2019.
Health Resources & Services Administration (HRSA) requires health centers to provide a sliding fee discount schedule (SFDS) based, in part, on the patient’s income relative to the poverty guidelines . In addition, centers must prepare schedules of fees or payments for center services that are consistent with locally prevailing rates or charges and designed to cover a center’s reasonable costs of operation and prepare corresponding SFDS applied to the payment of its fees or payments, by which discounts are adjusted based on the patient's ability to pay.
HRSA Health Center Program Compliance Manual, updated August 2018, further clarifies center requirements including multiple discount schedules.
What Does CohnReznick Think?
Health Centers must adopt the requirements contained in the Health Center Program Compliance Manual into its policies and procedures and implement operating procedures to ensure compliance to avoid findings during HRSA onsite visits.
In recent federal single audits and HRSA operational site visit reports, CohnReznick has noticed an increasing number of instances where our health center clients have failed to use the current FPG. This suggests that implementation of the new guidelines may be slipping through the cracks.
Now is the time to update your SFDS to reflect the new FPG schedule. It is also a good time to review your fee schedule to ensure your fees are based on your current costs and current prevailing market rates.
For more information, please contact:
Peter Epp, Partner, Healthcare Industry Practice
Dolores Di Re, Senior Manager, Healthcare Industry Practice
CohnReznick is a proud corporate sponsor of NACHC and is looking forward to connecting with fellow community health center professionals and leaders at our Policy & Issues Forum booth this March in Washington, D.C.
Section 330(k)(3)(G) of the PHS Act; 42 CFR 51c.303(f), 42 CFR 51c.303(g), 42 CFR 51c.303(u), 42 CFR 56.303(f), 42 CFR 56.30(g), and 42 CFR 56.303(u)
This has been prepared for informational purposes, is general guidance only and does not constitute legal or professional advice. You should not act upon the information contained in this publication without first obtaining professional advice specific to, among other things, your individual facts, circumstances and jurisdiction. No representation or warranty (express or implied) is made as to the accuracy or completeness of the information contained in this publication, and CohnReznick LLP, its partners, employees and agents accept no liability, and disclaim all responsibility, for the consequences of you or anyone else acting, or refraining to act, in reliance on the information contained in this publication or for any decision based on it.
On-demandBusiness Planning for Healthcare Providers: Evaluating Strategic Initiatives for Sustainability During Delivery System ReformPeter R. Epp, Aparna Melaka, and Joanne McNamaraChanges to the healthcare delivery system sparked by Value Based Payment initiatives have created opportunities for joint ventures with partners to better serve shared patient populations.
InsightNew York State Updates PCMH and APC Incentive Payment ProgramNew York State (NYS) supports the National Committee for Quality Assurance's (NCQA) Patient-Centered Medical Home (PCMH) programs and the Advanced Primary Care (APC)
InsightPrognosis Looks Good for Healthcare M&A in 2019Claudine CohenThis year, one of the real focus areas for M&A activity will be specialty services, including dermatology, ophthalmology, fertility, orthopedics, and gastroenterology.
InsightHealth Center Program Announces $50 Million New Access Point (NAP) Funding OpportunityHRSA has recently released a Notice of Funding Opportunity (NOFO) to award $50 million in New Access Point (NAP) funding. Up to $650,000 per year may be requested for up to two years, and HRSA expects to make up to 75 awards nationwide.
InsightDoes Your Compliance Program Meet OMIG Standards? Key Changes for Your Healthcare Organization to Implement in 2019The NYS Office of the Medicaid Inspector General (OMIG) requires you to implement a compliance program aimed at detecting and reducing the potential for fraud, waste, and abuse.