      *********************************************
      *   04/06/2017  RELEASE - V20171            *
      *            Production                     *
      *********************************************
NOTE TO: Shared System Coordinators, MEDICARE Coordinators

SUBJECT: Federally Qualified Health Center (FQHC) Prospective Payment
         System (PPS) Pricer Release, Version 20171
(July 01, 2017)  --ACTION-- Refer to CMS change request CR #10021

This FQHC Pricer release is designed for implementation in conjunction
with the IOCE V##.# lines in the shared claims payment systems on or
about 01Jul2017.


This release includes the following updates:
--------------------------------------------
  - Version 2017.1.
  - Updated 2017 Grandfathered Tribal FQHC (GFTF) rate (349.00)
    in the following tables: BASEGFTF and COPYGFTF.
  - Updated this README and the MANIFEST members for this release.

  **********************************************


A partitioned data set of the Version 20171 code
(MU00.@BF12390.FQHC.V20171.COBOL) is at the CMS Data Center for users
to obtain by Connect:Direct (Network DataMover).

The 12 members below comprise the FQHC Pricer:

1  source program - FQHCCAL.

4  copybooks  - COPYADD,COPYBASE,COPYGAF,COPYGFTF

4  databooks  - BASEADD,BASEBASE,BASEGAF,BASEGFTF

3  text files - copy of this Release Memorandum,
                a list of the return codes (expanded by user notes),
                a manifest listing files associated with this release
              - README,RTNCODES,MANIFEST


If you have any questions concerning this release or any other FQHC
Pricer-related issues, please call Tracey Mackey - (410) 786-5736.





                              Crystal Graham & Tamara Howard
                              Computer Specialist/Systems Analyst
                              Division of Data Systems
                              CMS/CMM/PBG/DDS



                                   Page 1 of 2
FQHC Pricer Release Notes:

Below are brief descriptions of the FQHC Pricer modules in
the system plus a copy of the Linkage Section and
the CALL statement needed to access the module.

BASEADD  - human-readable data from which the COPYADD copybook is built

BASEBASE - human-readable data from which the COPYBASE copybook is built

BASEGAF  - human-readable data from which the COPYGAF copybook is built

BASEGFTF - human-readable data from which the COPYGFTF copybook is built

COPYADD  - copybook of add-on rates by effective date for FQHCCAL

COPYBASE - copybook of base rates by effective date for FQHCCAL

COPYGAF  - copybook of GAF rates by carrier-locality for FQHCCAL

COPYGFTF - copybook of GFTF rates by effective date for FQHCCAL

FQHCCAL  - source code for FQHC pricing subroutine

MANIFEST - list of files associated with the release

README   - copy of this memorandum

RTNCODES - list of FQHC Pricer claim and line level return codes




This is the LINKAGE SECTION defined in FQHCCAL.


       LINKAGE SECTION.

      ***************************************************************
      ***************************************************************
      ***                                                         ***
      **         LINKAGE SECTION INPUT AND OUTPUT RECORDS          **
      ***                                                         ***
      ***************************************************************
      ***************************************************************
      *                                                             *
      *   1) INPUT RECORD FROM CONTRACTOR                           *
      *   2) OUTPUT RECORD TO CONTRACTOR                            *
      *                                                             *
      ***************************************************************


      ***************************************************************
      *  INPUT RECORD FROM THE CONTRACTOR                           *
      *-------------------------------------------------------------*
      * BELOW ARE THE VARIABLES THAT WILL BE PASSED TO PRICER FROM  *
      * THE CONTRACTOR (INCLUDES ITEMS FROM THE CLAIM AND IOCE;     *
      * CLAIM LEVEL AND LINE LEVEL VARIABLES)                       *
      ***************************************************************
       01  INPUT-RECORD.
           05  I-CLAIM-LEVEL-INPUT.
               10  I-PROVIDER-NUMBER          PIC X(06).
               10  I-CARRIER-LOCALITY.
                   15  I-CARRIER              PIC X(05).
                   15  I-LOCALITY             PIC X(02).
               10  I-MA-PLAN-AMT              PIC 9(09)V99.
               10  I-SRVC-FROM-DATE           PIC 9(08).
               10  I-SRVC-THRU-DATE           PIC 9(08).
               10  I-SRVC-LINE-CNT            PIC 9(03).
           05  I-SERVICE-LINE OCCURS 450 TIMES
                     DEPENDING ON I-SRVC-LINE-CNT.
               10  I-LINE-LEVEL-INPUT.
                   15  I-HCPCS                PIC X(05).
                   15  I-MODIFIERS.
                       20  I-MODIFIER-1       PIC X(02).
                       20  I-MODIFIER-2       PIC X(02).
                       20  I-MODIFIER-3       PIC X(02).
                       20  I-MODIFIER-4       PIC X(02).
                       20  I-MODIFIER-5       PIC X(02).
                   15  I-LINE-SRVC-DATE       PIC 9(08).
                   15  I-REVENUE-CODE         PIC X(04).
                   15  I-TOT-UNITS            PIC 9(09).
                   15  I-COV-UNITS            PIC 9(09).
                   15  I-COV-CHARGES          PIC 9(09)V99.
               10  I-IOCE-LINE-FLAGS.
                   15  I-SRVC-IND             PIC X(02).
                   15  I-PYMT-IND             PIC X(02).
                   15  I-DISCOUNT-FACT        PIC 9(01).
                   15  I-LITEM-DENY-REJ-FLAG  PIC X(01).
                   15  I-PKG-FLAG             PIC X(01).
                   15  I-PYMT-ADJ-FLAG        PIC X(02).
                   15  I-PYMT-METHOD-FLAG     PIC X(01).
                   15  I-LITEM-ACT-FLAG       PIC X(01).
                   15  I-COMP-ADJ-FLAG        PIC X(02).



      ***************************************************************
      *  OUTPUT RECORD TO THE CONTRACTOR                            *
      *-------------------------------------------------------------*
      *   BELOW ARE THE VARIABLES THAT WILL BE PASSED BACK TO THE   *
      *   CONTRACTOR ASSOCIATED WITH THE BILL BEING PROCESSED       *
      ***************************************************************
       01  OUTPUT-RECORD.
           05  O-CLAIM-LEVEL-OUTPUT.
               10  O-CALC-VERS                PIC X(07).
               10  O-TOT-CLM-PYMT             PIC 9(09)V99.
               10  O-TOT-CLM-COIN             PIC 9(09)V99.
               10  O-GEO-ADJ-FACT             PIC 9(01)V9(04).
               10  O-CLM-RETURN-CODE          PIC 9(02).
           05  O-LINE-LEVEL-OUTPUT OCCURS 450 TIMES
                   DEPENDING ON I-SRVC-LINE-CNT.
               10  O-LITEM-PYMT               PIC 9(09)V99.
               10  O-LITEM-ADD-ON-PYMT        PIC 9(09)V99.
               10  O-LITEM-COIN               PIC 9(09)V99.
               10  O-LITEM-RETURN-CODE        PIC 9(02).



   ***************************************************************
   *    PROCESSING:                                              *
   *        Below is the CALL STATEMENT and variables listed     *
   *             required by the FQHCCAL module.                 *
   ***************************************************************

       PROCEDURE DIVISION  USING INPUT-RECORD
                                 OUTPUT-RECORD.


