CHC REBASE Act of 2026
Sponsored By: Representative Rulli, Michael A. [R-OH-6]
Introduced
Summary
Rebase Federally Qualified Health Center payments to match actual costs. This bill would create a data-driven process to reset FQHC Prospective Payment System rates and expand telehealth and Medicare Advantage payment rules.
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- FQHCs and clinics: Would be required to submit cost reports and other health center data and participate in a Secretary-convened working group that must recommend PPS changes. The Secretary would adjust 2028 rates so aggregate prospective payments equal 100% of estimated reasonable costs.
- Telehealth patients and clinics: Telehealth services furnished by FQHCs and Rural Health Clinics beginning January 1, 2027 would be paid as FQHC or RHC services under their payment systems. Costs of providing those telehealth services would be treated as allowable costs.
- Medicare Advantage enrollees and FQHCs in MA networks: CMS would have to issue guidance by December 31, 2026 to standardize wraparound payments and bar requiring MA contract terms as a condition for payment. The Comptroller General would report within 180 days on FQHC inclusion in MA networks and recommend steps to improve access for rural and underserved populations.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
Higher Medicare payments for community clinics
If enacted, this bill would require HHS to reset Medicare payment rates for community health centers so aggregate prospective payments for services in 2028 equal 100% of estimated reasonable costs. The calculation would be done without a per-visit payment limit or a productivity screen and before certain prior adjustments. The Secretary would require centers to submit cost reports and Uniform Data System reports within 90 days and convene a working group within 180 days. Rate changes would be implemented through notice-and-comment rulemaking after the group's recommendations.
Standardized Medicare wrap payments for clinics
If enacted, the Secretary would issue guidance by December 31, 2026 on how community health centers should calculate and claim Medicare Advantage wraparound payments. The guidance would require Medicare contractors to standardize timely and accurate payments and would bar contractors from demanding the MA plan contract before paying. The Secretary would also create a way for centers to seek review of contractor payment decisions.
Telehealth pay parity for community clinics
If enacted, telehealth services provided by community health centers and rural clinics on or after January 1, 2027 would be paid under the clinics' Medicare payment methods. Costs of furnishing those telehealth services would count as allowable costs for those payment systems. This would support continued telehealth offerings and access for Medicare patients.
Sponsors & CoSponsors
Sponsor
Rulli, Michael A. [R-OH-6]
OH • R
Cosponsors
Rep. Dingell, Debbie [D-MI-6]
MI • D
Sponsored 9/15/2026
Rep. Thompson, Glenn [R-PA-15]
PA • R
Sponsored 9/15/2026
Rep. Bilirakis, Gus M. [R-FL-12]
FL • R
Sponsored 9/15/2026
Rep. Landsman, Greg [D-OH-1]
OH • D
Sponsored 9/15/2026
Rep. Barragán, Nanette Diaz [D-CA-44]
CA • D
Sponsored 9/15/2026
Rep. Taylor, David J. [R-OH-2]
OH • R
Sponsored 9/15/2026
Rep. Carter, Troy A. [D-LA-2]
LA • D
Sponsored 9/15/2026
Rep. Pfluger, August [R-TX-11]
TX • R
Sponsored 9/15/2026
Rep. Tokuda, Jill N. [D-HI-2]
HI • D
Sponsored 9/15/2026
Rep. Trahan, Lori [D-MA-3]
MA • D
Sponsored 9/15/2026
Rep. Soto, Darren [D-FL-9]
FL • D
Sponsored 10/5/2026
Rep. Carbajal, Salud O. [D-CA-24]
CA • D
Sponsored 10/5/2026
Rep. Langworthy, Nicholas A. [R-NY-23]
NY • R
Sponsored 10/5/2026
Rep. Mackenzie, Ryan [R-PA-7]
PA • R
Sponsored 10/5/2026
Roll Call Votes
No roll call votes available for this bill.
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