; monthly lump sum (1) In general The Medicare For All Program, through its regional offices, shall pay each institutional provider of care, including hospitals, nursing homes, community or migrant health centers, home care agencies, or other institutional providers or pre-paid group practices, a monthly lump sum to cover all operating expenses under a global budget. (2) Establishment of global budgets The global budget of a provider shall be set through negotiations between providers, State directors, and regional directors, but are subject to the approval of the Director. The budget shall be negotiated annually, based on past expenditures, projected changes in levels of services, wages and input, costs, a provider’s maximum capacity to provide care, and proposed new and innovative programs. (b) Three payment options for physicians and certain other health professionals (1) In general The Program shall pay physicians, dentists, doctors of osteopathy, pharmacists, psychologists, chiropractors, doctors of optometry, nurse practitioners, nurse midwives, physicians’ assistants, and other advanced practice clinicians as licensed and regulated by the States by the following payment methods: (A) Fee for service payment under paragraph (2). (B) Salaried positions in institutions receiving global budgets under paragraph (3). (C) Salaried positions within group practices or non-profit health maintenance organizations receiving capitation payments under paragraph (4). (2) Fee for service (A) In general The Program shall negotiate a simplified fee schedule that is fair and optimal with representatives of physicians and other clinicians, after close consultation with the National Board of Universal Quality and Access and regional and State directors. Initially, the current prevailing fees or reimbursement would be the basis for the fee negotiation for all professional services covered under this Act. (B) Considerations In establishing such schedule, the Director shall take into consideration the following: (i) The need for a