GUIDANCE Sliding Coinsurance for CMS/Medicare Care Management Services

GUIDANCE Sliding Coinsurance for CMS/Medicare Care Management Services


Publication Date: July 31, 2020


Description

While health centers are required to impose Medicare coinsurance for CMS/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.

GUIDANCE Sliding Coinsurance for CMS/Medicare Care Management Services

This resource is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $7,287,500 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

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