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.
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)
Any advice contained in this communication, including attachments and enclosures, is not intended as a thorough, in-depth analysis of specific issues. Nor is it sufficient to avoid tax-related penalties. This has been prepared for information purposes and general guidance only and does not constitute professional advice. You should not act upon the information contained in this publication without obtaining specific professional advice. 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 members, 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.
InsightAdvice for the telehealth industry: Proceed with cautionClaudine CohenWith COVID-19 bringing telehealth into focus, effective technology platforms and the impact on physician practice management groups are top issues. Learn more.
InsightCMS price transparency mandates hold greater penalties than a $300/day fineHospitals that don’t comply with CMS’s new rules, effective Jan. 1, face not only $300-a-day fines but also the potential loss of Medicare payments. Learn more.
InsightHEALTHCARE: Pent-up demand, election uncertainty, and pains of COVID-19 driving uptick in M&A activityHealthcare deal activity is on the rise amid pent-up patient demand, election uncertainty, and physicians’ feeling the pain of the COVID-19 pandemic. Read more.
InsightHEALTHCARE: Boost your cybersecurity and interoperability for the new remote landscapeCaroline Znaniec, Bhavesh Vadhani, Deborah NitkaAfter the rush to implement new technologies amid COVID-19, cybersecurity and privacy risks are higher than ever, and interoperability is critical. Learn more.
InsightHEALTHCARE: Staffing shortages top COVID-19 challenges for physician practice management (PPM) companiesPhysician practice management (PPM) and outpatient services are also adapting to high costs for fast in-house coronavirus testing. Learn more.