On April 11, 2012, as required by the Affordable Care Act, the Secretary of Health and Human Services (HHS) submitted a proposal to Congress to reform Medicare’s wage index. After considering the studies and recommendations executed by the Medicare Payment Advisory Commission (MedPAC) and Acumen LLC, DHHS is proposing to implement a Commuting Based Wage Index (CBWI) system.
The CBWI is a provider specific wage index which accounts for a hospital’s cost of labor using commuting patterns. The commuting patterns represent a hospital’s labor market by the number of workers that commute from home to work. This information can be collected from Census results and the Bureau of Labor Statistics (BLS); however HHS believes the most accurate reflection of commuting data derives from hospital records (e.g. payroll). Therefore, the CBWI would likely create a new data collection process, whereby providers would submit employee information by geographic unit (e.g. zip codes, census tracts). (more…)
The California Department of Health Care Services (DHCS) began receiving claims on July 1 for the newly established Code 19 rate. Similar to the Code 18 rate for Medi-Cal Managed Care services, Code 19 will be imbedded into the prospective payment system (PPS) rate for services provided by FQHCs and RHCs to beneficiaries of the Children’s Health Insurance Program(CHIP). The Code 19 rate equals the difference between what the clinic receives for Healthy Families services and their Medi-Cal PPS rate.