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Seniors Benefit from Federally Qualified
By Tracey Cousineau, LSW-C, Outreach Manager
Federally Qualified
Health Centers (FQHCs) such as Health Access Network (HAN) are able to
provide a number of primary health services as well as waive Medicare
Part B deductibles for Medicare beneficiaries.
The Omnibus Budget Reconciliation Act of 1990 established this
new Medicare Part B benefit and was designed to improve access to
outpatient care for Medicare beneficiaries residing in medically
underserved areas by increasing the number of primary health Medicare
providers, adding preventive health services to Medicare's list of
reimbursable services, and eliminating the Part B deductible for FQHC
services.
Some
FQHC covered services include physician, nurse practitioner and
physician assistant services and supplies, clinical psychologist and
clinical social worker services and supplies.
The following preventive primary health services are covered when
furnished by FQHCs to Medicare patients:
Medical social services
Nutritional assessment and referral
Preventive health education
Immunizations including tetanus-diphtheria booster and influenza
vaccine
Blood pressure measurement
Weight measurement
Physical examination targeted to risk
Visual acuity screening
Hearing screening
Cholesterol screening
Stool testing for occult blood
Dipstick urinalysis
Risk assessment and initial counseling regarding risks
Diabetes and nutrition education
For
women only:
Clinical breast examination
Referral for mammography
Thyroid function test
HAN receives
reimbursement for services from all patients according to their ability
to pay.
Patients may apply for discounts through a
sliding fee scale, which is based on family size and income level.
HAN receives third party reimbursement from private
insurance, Medicare and Medicaid.
Medicare pays FQHCs an all-inclusive per visit amount based on
reasonable costs with the exception of psychological, psychiatric
therapeutic services, diagnostic services and preventive primary
services such as eye glasses, hearing aids and preventive dental
services that are typically covered under Medicare part B. Charges
incurred from providers outside of the FQHC network and from the
hospital are not covered.
Please contact
Tracey Cousineau at Health Access Network, 794-6700 or 1-888-426-4584
for more information regarding HAN services.