Sliding Coinsurance for CMS/Medicare Care Management Services

While health centers are required to impose Medicare coinsurance for Medicare care management services, the coinsurance may be “slid” commensurate with the sliding fee discount program (SFDP) policy of the health center. Federal anti-kickback statutes and beneficiary inducement prohibitions include exceptions allowing health centers to discount coinsurance for patients who are eligible for the health center’s sliding fee discount program without violating Medicare rules. To assist health centers in compliance, the National Association of Community Health Centers (NACHC), a HRSA-funded National Training and Technical Assistance Partner (NTTAP), shares GUIDANCE Sliding Coinsurance for CMS/Medicare Care Management Services.