240.021 Equity in Government Payment for Physician Services


Equity in Government Payment for Physician Services: The Texas Medical Association supports equity in government payment for physician services as follows:

1) Medicare, Medicaid, and other government programs should pay equivalent fees for physician services, without regard to the type of facility in which the service is delivered;

2) In setting or revising fees for physician services, state and federal regulators should compare equivalent fee-for-service weighted values when setting rates for outpatient treatments in hospitals, federally qualified health clinics (FQHCs), rural health clinics (RHCs) or other settings to ensure that fees and payment bundles are equivalently priced, and that fees in one setting are not updated unless the equivalent fees in all settings are updated;

3) FQHCs, RHCs, and other entities that receive special treatment or funding because of local health care professional shortages should be required to undergo periodic re-certification. If the local economic conditions improve enough to support adequate numbers of private health care professionals, government payers should begin paying the clinics on the same fee schedules used to pay other local physicians; and

4) FQHC regulations should require boards of directors to solicit input from other community physicians regularly to improve coordination of care and handling of referrals (CSE Rep. 2-A-13).

Last Updated On

October 07, 2016