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Sliding Fee Schedule of Discounts February 2025 - Cooper
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The Department of Health and Human Services has updated the federal poverty guidelines for 2025. Per the guidelines, Physical Health (FQHC) operations are required to offer services for individuals and families with annual income greater than 100% and up to and including 200% of the federal poverty guidelines. The Medical, Dental, and Mental Health programs within Physical Health that are part of the FQHC must comply with section 330(k) (3)(G) for the Public Health Services Act, 42 USC. A nominal fee or flat rate based on poverty levels for dental, medical, and laboratory services was previously approved by the Governing Council. Given the changes in the federal poverty guidelines, we are requesting to update our sliding fee scale, effective April 1, 2025.
Under the Illinois Family Planning Program services code, 77 Illinois Admin Code 635, the Family Planning Program requires a schedule of discounts for income levels up to 250% of the federal poverty guidelines, with 5-8 breakpoints. These discounts must not exceed 25% and applied proportionally. The requested change in federal poverty guidelines for the Family Planning program is proposed to go in effect on July 1, 2025.
Behavioral Health Services is required to provide discounted services for outpatient programs under the Department of Mental Health and Department of Substance Abuse. A discounted scale has been approved, covering up to 250% of the federal poverty level with eight income levels. It is recommended to adopt the Department of Human Services poverty guidelines as of April 1, 2025, for this sliding fee scale.
Behavioral Health Services is required to provide discounted services for residential programs under the Department of Substance Abuse. The approved discounted scale covers up to 500% of the federal poverty level with eight income levels. It is also recommended to adopt the Department of Human Services poverty guidel...
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