Each year, FQHC/RHC prospective payment system (PPS) rates are updated on Oct. 1 by the Medicare Economic Index (MEI). The Department of Human Services (DHS) has notified PACHC that the state is having a system issue with letter download to email and therefore email notifications to health centers might be delayed. That does not mean that managed care organizations (MCOs) should delay implementation of the MEI adjustments. Per DHS:
- The MCOs and Promise received the data extract last week, which is available now to the MCOs and is set up to be easily imported into the MCOs’ systems.
- For these mass MEI rate increases, DHS expects MCOs to implement the MEI increase using the data extract provided and not wait for the rate confirmation letter DHS sends to each FQHC/RHC.
- It is important to note that this is different than the process for interim to final FQHC rate changes for individual health centers. While these are also communicated to MCOs through a (quarterly) data extract update from DHS, DHS directs MCOs to use the official rate letter DHS provides to the health center as validation of the rate change.
Questions? Contact Julie Korick, PACHC COO/CFO.