FRONTIER EXTENDED STAY CLINIC DEMONSTRATION

On August 29, 2006, the Centers for Medicare & Medicaid Services (CMS) announced that it will provide added financial support to small health clinics serving highly remote areas in Alaska and in other states through the Frontier Extended Stay Clinic (FESC) Demonstration, fulfilling Section 434 of the Medicare Modernization Act (MMA).

“This is a big step forward in providing needed health care services for the residents of some of the most isolated and remote areas of our nation,” Dr. Mark McClellan, CMS administrator, said. “No matter where you live, Medicare wants to make sure we provide access to needed medical services.”

Through this project, Medicare will allow payment for services at FESCs, which are staffed by physicians and other health professionals. The clinics will provide services to patients who experience severe injury or illness and cannot obtain immediate transport to an acute care hospital, or patients who need monitoring and observation for a limited period of time.

According to the law, FESCs must be located in a community which is at least 75 miles away from the nearest acute care hospital or critical access hospital, or which is inaccessible by public road.

Some clinics in the lower 48 states may also qualify for the demonstration. Clinics that are interested in participating need to submit an application to CMS. The specifics and requirements of this application will appear on the CMS website shortly. This application describes the conditions of participation that will govern the operation of the clinics. These conditions include health and safety standards, facility standards set forth in the Life Safety Code of the National Fire Protection Association, and requirements for health professionals.

Under the authorizing statute, Section 434 of the MMA, the three-year demonstration must be budget-neutral. Expected Medicare payments for the care of patients treated by FESCs may be no more than Medicare payments for such patients in the absence of the demonstration.

CMS will work with prospective demonstration sites to identify the numbers of Medicare patients expected to be treated and the potential savings from reduced and avoided medical costs, including air ambulance transfers and acute care hospitalizations. CMS expects that the savings realized will cover the costs of payments made under this demonstration.

Downloads
Medicare Waiver Demonstration Application [PDF, 38 KB]
Fact Sheet [PDF, 13 KB]
Federal Register Notice [PDF, 22 KB]
Request For Proposal [PDF, 63 KB]

Source: Centers for Medicare & Medicaid Services