Don’t let the Kentucky case fool you. Medicaid waivers aren’t going anywhere. And they will likely include onerous work requirements and prohibit retroactive enrollment.
It’s tough to be sick and poor and in Florida. It’s almost as tough to be a FQHC or CHC that serves the sick and poor in Florida.
Federally Qualified Health Centers (FQHCs) must be on top of many changes coming out of the Centers for Medicare and Medicaid Services or CMS - and many of these relate to specific kinds of care and categories of treatment and evaluation. So often, CMS is updating codes, protocols, or reimbursement details for a given range of medical services, and the individual change becomes a snowflake in a blizzard of transmittals and notices, so that it's difficult for administrators to track everything that they need to optimize revenue.
When it comes to FQHC billing, Medicare reimbursement is a vital revenue stream for most federally qualified health centers (FQHCs). But many centers are missing out on the additional revenue they’re owed for Medicare Advantage patients.
Organizations that care for Medicaid patients and the underserved often end up with substantial self-pay write-offs. After all, FQHCs and other safety-net organizations don’t turn anyone away—their mission is providing high-quality care to all, regardless of insurance status or ability to pay.