{"abstract":"This final rule with comment period implements methodology and payment rates for a prospective payment system (PPS) for federally qualified health center (FQHC) services under Medicare Part B beginning on October 1, 2014, in compliance with the statutory requirement of the Affordable Care Act. In addition, it establishes a policy which allows rural health clinics (RHCs) to contract with nonphysician practitioners when statutory requirements for employment of nurse practitioners and physician assistants are met, and makes other technical and conforming changes to the RHC and FQHC regulations. Finally, this final rule with comment period implements changes to the Clinical Laboratory Improvement Amendments (CLIA) regulations regarding enforcement actions for proficiency testing (PT) referrals.","action":"Final rule with comment period.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2014/05/02/2014-09908.html","cfr_references":[{"chapter":null,"citation_url":null,"part":405,"title":42},{"chapter":null,"citation_url":null,"part":410,"title":42},{"chapter":null,"citation_url":null,"part":491,"title":42},{"chapter":null,"citation_url":null,"part":493,"title":42}],"citation":"79 FR 25436","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective Dates: The provisions of this final rule with comment period are effective on October 1, 2014, except for amendments to Sec. 405.2468(b)(1), Sec. 491.8(a)(3), Sec. 493.1, Sec. 493.2, Sec. 493.1800, and Sec. 493.1840 which are effective July 1, 2014.","disposition_notes":null,"docket_ids":["CMS-1443-FC"],"dockets":[],"document_number":"2014-09908","effective_on":null,"end_page":25482,"executive_order_notes":null,"executive_order_number":null,"explanation":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2014/05/02/2014-09908.xml","html_url":"https://www.federalregister.gov/documents/2014/05/02/2014-09908/medicare-program-prospective-payment-system-for-federally-qualified-health-centers-changes-to","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2014-09908?publication_date=2014-05-02","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2014-05-02/2014-09908/mods.xml","not_received_for_publication":null,"page_length":47,"page_views":{"count":5709,"last_updated":"2026-04-26 02:15:03 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2014-05-02/pdf/2014-09908.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2014-09908.pdf?1398802631","publication_date":"2014-05-02","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2014/05/02/2014-09908.txt","regulation_id_number_info":{"0938-AR62":{"issue":"201404","html_url":"https://www.federalregister.gov/regulations/0938-AR62/prospective-payment-system-for-federally-qualified-health-centers-changes-to-contracting-policies-fo","title":"Prospective Payment System for Federally Qualified Health Centers; Changes to Contracting Policies for Rural Health Clinics and CLIA Enforcement Actions for Proficiency Testing Referral (CMS-1443-FC)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201404&RIN=0938-AR62&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AR62"],"regulations_dot_gov_info":{"supporting_documents":[],"regulatory_plan":{"html_url":"https://www.federalregister.gov/regulations/0938-AR62/prospective-payment-system-for-federally-qualified-health-centers-changes-to-contracting-policies-fo","title":"Prospective Payment System for Federally Qualified Health Centers; Changes to Contracting Policies for Rural Health Clinics and CLIA Enforcement Actions for Proficiency Testing Referral (CMS-1443-FC)"},"comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2013-0201","supporting_documents_count":0,"docket_id":"CMS-2013-0201","regulation_id_number":"0938-AR62","title":"Medicare Program; Prospective Payment System for Federally Qualified Health Centers; Changes to Contracting Policies for Rural Health Clinics; and Changes to Clinical Laboratory Improvement Amendments of 1988 Enforcement Actions for Proficiency Testing Re","checked_regulationsdotgov_at":"2014-07-03T05:00:40Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":25436,"subtype":null,"title":"Medicare Program; Prospective Payment System for Federally Qualified Health Centers; Changes to Contracting Policies for Rural Health Clinics; and Changes to Clinical Laboratory Improvement Amendments of 1988 Enforcement Actions for Proficiency Testing Referral","toc_doc":"Medicare Programs; Prospective Payment System for Federally Qualified Health Centers, etc.","toc_subject":null,"topics":["Administrative practice and procedure","Grant programs-health","Health facilities","Health professions","Laboratories","Medicaid","Medical devices","Medicare","Penalties","Reporting and recordkeeping requirements","Rural areas","X-rays"],"type":"Rule","volume":79}