Archived News


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CMS Proposes to Expand Principal Care Management to RHCs in 2021

8/6/2020 9:45:00 AM

In 2021, Rural Health Clinics should be able to bill for Principal Care Management (PCM) through the G0511 code. Back in January, we had to clarify that RHCs were excluded from being able to provide PCM in 2020 due to confusing language in the final physician fee schedule rule. At that time, we asked CMS to allow RHCs to provide PCM in 2021, and we are glad to report that they have now proposed to do exactly that.

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President Trump Issues Executive Order Focused on Rural Health

8/3/2020 7:30:00 PM

Nathan Baugh, Director of Government Affairs

President Trump signed an Executive Order late on Monday aimed at improving rural health and telehealth access. At his news conference afterward, President Trump specifically notated the number of “rural health clinics” that received funds as a result of the CARES Act.

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Changes to Telehealth Will Require YOUR Advocacy
Congress Considering Permanent Telehealth Changes

7/22/2020 12:00:00 PM

Emma Finerfrock

When the Coronavirus pandemic first struck the United States, healthcare facilities across the country suffered a steep decline in patient volume that threatened the financial viability of many hospitals and offices. In fact, researchers from Phreesia, a healthcare technology company, and Harvard University found that outpatient visits alone declined by nearly 60 percent in early April.

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HHS Releases Millions for RHCs Left Out of Initial Provider Relief Fund Distribution

6/25/2020 12:00:00 PM

NARHC is pleased to announce that earlier today, the Department of Health and Human Services released more the $50 Million dollars in Relief Fund payments to RHCs that were left out of the original May 1 RHC distribution. This money is in addition to the more than $500 Million distributed to all other RHCs in early May.

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Telehealth Fix Takes Step Forward in Senate

6/22/2020 2:45:00 PM

Nathan Baugh, Emma Finerfrock

On June 18th, the Improving Telehealth for Underserved Communities Act was introduced in the Senate by Sen. Cindy Hyde-Smith (R-MS) and Sen. Angus King (I-ME). “Thanks to the leadership of Sen. Hyde-Smith and Sen. King, the RHC community is one step closer to fixing our telehealth reimbursement issues,” said Bill Finerfrock, Executive Director of the National Association of Rural Health Clinics.

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How to Apply for the Medicaid/CHIP Targeted Allocation

6/19/2020 11:25:00 AM

Emma Finerfrock

The Department of Health and Human Services (HHS) is hosting two, free webinars to help providers apply for the Medicaid and Children’s Health Insurance Program (CHIP) targeted allocation. This targeted allocation will only be sent to Medicaid and CHIP providers who did not receive any funds from the “General Allocation” which began paying out on April 10th.

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CMS Pushes Supplementals to Recognize Telehealth Crossover Claims

6/12/2020 4:15:00 PM

Nathan Baugh

As many of you have noted on the NARHC forums, telehealth visit (G2025) crossover claims were being denied. We begin investigating this issue and learned that the CMS contractor for “edit validation” failed to load G2025 into their system until May 27th. This means...

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Amendments to Paycheck Protection Program (PPP) Provide More Flexibility

6/11/2020 11:30:00 AM

Nathan Baugh & Emma Finerfrock

On Friday, June 5, 2020, the Paycheck Protection Program Flexibility Act (PPPFA) of 2020 was signed into law. This legislation relaxes requirements in the Paycheck Protection Program (PPP) and was passed in response to small business concerns about the requirements to qualify for loan forgiveness.

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HHS Announces Details of RHC COVID-19 Testing Fund

5/20/2020 2:25:00 PM

HHS has announced details regarding the Rural Health Clinic Testing fund in a press release here:

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Congress Introduces Improving Telehealth for Underserved Communities Act
H.R. 6792 Allows RHCs to be Paid AIR for Telehealth Visit

5/12/2020 11:00:00 AM

On May 8th, Representative Adrian Smith (R-NE) and Representative Tom O’Halleran (D-AZ) introduced the Improving Telehealth for Underserved Communities Act. The National Association of Rural Health Clinics (NARHC) strongly endorses this legislation and we sincerely thank Rep. Smith and Rep. O’Halleran for their leadership on this issue. Both members were instrumental in getting the law changed to allow rural health clinics (RHCs) and

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UPDATE: HHS Initial Plan for Rural Health Distribution Does NOT Include All RHCs

5/5/2020 6:30:00 PM

Last Friday, NARHC Executive Director Bill Finerfrock participated in a phone call with Deputy Secretary Hargan regarding the $10 billion rural provider relief allocation. After this call, we published a brief news article about the allocation. However, we are now learning that some of the details initially communicated to NARHC were inaccurate. HHS reached out to us today to correct the record.

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Rural Provider Relief Fund Details Announced
All RHCs to receive a minimum of $100,000

5/1/2020 4:30:00 PM

Today, the Trump Administration announced additional details regarding the distribution of $10 Billion from the Provider Relief fund for rural hospitals and rural health clinics and rural federally qualified health centers. As part of this announcement, National Association of Rural Health Clinics (NARHC) Executive Director Bill Finerfrock was invited...

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CMS Revises Telehealth Distant Site Guidance
Audio-Only Visits Now Considered Full Telehealth Distant Site Visits

4/30/2020 4:00:00 PM

On April 30th, 2020, CMS significantly updated their telehealth guidance for RHCs and FQHCs. There are two massive changes. First, ALL distant site telehealth visits must be billed with HCPCS code G2025.

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Pediatric RHCs Excluded from Provider Relief Fund?

4/28/2020 12:00:00 PM

The National Association of Rural Health Clinics has been working with the Department of Health and Human Services (HHS) to address the exclusion of Pediatric RHCs from the General Distribution of money from the Provider Relief Fund. We believe that HHS understands this problem and will not repeat this oversight in the next release of funds.

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Financial Programs for Rural Health Clinics During COVID-19 Pandemic

4/28/2020 6:00:00 AM

The federal government recognizes that the health care industry is in the midst of both a public health crisis and a financial crisis and while it may or may not be enough, they have appropriated $175 billion thus far to keep our industry afloat. This $175 billion has been split into multiple allocations for different purposes and it comes on top of other programs, such as the Paycheck Protection Program and the Medicare Accelerated Payment Program.

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$225 Million Grant Program Approved for Rural Health Clinics

4/24/2020 3:15:00 PM

We are pleased to report that the Congress is set to approve a new $225 MILLION grant program exclusively for federally certified Rural Health Clinics for testing and related expenses associated with the COVID-19 pandemic.

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HHS Announces $10 Billion for Rural Health Clinics and Rural Hospitals

4/22/2020 4:30:00 PM

On April 22, 2020, HHS updated their provider relief website with additional information about how they plan to spend the rest of the $100 billion allocated for healthcare providers by the CARES Act.

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CMS Allows RHCs to Temporarily Expand During PHE

4/22/2020 12:00:00 PM

CMS updated their document on COVID-19 waivers today to allow RHCs to temporarily expand locations during the public health emergency. Here is the relevant section:

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CMS Releases Guidance on Telehealth Billing for RHCs

4/17/2020 1:15:00 PM

CMS has released the long-awaited guidance on telehealth billing for RHCs. Here is a link to the MLN document: https://www.cms.gov/files/document/se20016.pdf UPDATED 4/21/2020

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Telehealth Grant Opportunities for Non-Profit and Publicly Owned RHCs

4/14/2020 1:00:00 PM

The CARES Act included $200 million in funding (via grants) to help health care providers establish telehealth services and non-profit/publicly owned RHCs are eligible to apply for these grants. The grant money can be used to “purchase telecommunications, information services, and connected devices to provide connected care services in response to the coronavirus pandemic.”

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COVID-19 Updates
Direct Deposits, Supervision Relaxation, Staffing Requirements Changed, and Modifier CS!

4/10/2020 12:00:00 PM

Direct Deposits The CARES Act included $100 billion for providers to cover their “lost revenue.” This morning HHS paid out the first $30 billion to providers based on Medicare revenues from last year, no application necessary.

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NARHC Pressures CMS to Finalize Telehealth Methodology

4/7/2020 4:00:00 PM

It gives us no great pleasure to have to write this letter but it is important that the Centers for Medicare and Medicaid Services (CMS) leadership, the President, Congress and the American people know what CMS has been doing over the last few weeks to cause enduring harm to the healthcare delivery system in rural communities around the country.

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RHC Relief Options in Recently Signed CARES Legislation
March 30, 2020 - 11:20 AM

3/30/2020 11:20:00 AM

On Friday, March 27, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act. There are several provisions in this new law that will directly affect Rural Health Clinics and your ability to remain open to see patients during the duration of the COVID-19 pandemic. In particular, there are three provisions of the bill that I wanted to go through:

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CARES Act Signed Into Law
RHCs Now Able to Bill Medicare As Distant Site Providers

3/27/2020 5:00:00 PM

UPDATE: The CARES Act has officially been signed into law by President Trump. CMS is holding internal discussions on how to operationalize the telehealth provisions and may be able to release guidance soon. RHCs may now provide telehealth visits to Medicare patients with confidence that they will be paid for those visits. Billing details are still forthcoming.

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CARES Act Passes House
***This story is developing and we will update this article as more details become available***

3/27/2020 3:00:00 PM

UPDATE: The CARES Act has passed the House of Representatives and is expected to be signed into law today by President Trump. CMS is holding internal discussions on how to operationalize the telehealth provisions and may be able to release guidance shortly after the President’s signature.

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Rural Health Clinic Relevant Provisions in the CARES Act
Legislation Provides Access to Liquidity for Small Businesses

3/26/2020 5:00:00 PM

The Coronavirus Aid, Relief, and Economic Security Act or CARES Act passed the Senate by a vote of 96-0 on Wednesday, March 25th and is expected to be passed by the House and signed into law by President Trump on Friday, March 27th. This historic legislation is one of the largest spending bills ever passed by Congress, but lawmakers have already signaled that a fourth round of COVID-19 related legislation is necessary and work will begin on that legislation immediately...

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Coronavirus Aid, Relief, and Economic Security (CARES) Act Passes Senate
Phase 3 Coronavirus Legislation Expands Telehealth to RHCs as the Distant Site

3/25/2020 12:00:00 PM

***This story is developing and we will update this article as more details become available***

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Cost Report Filing Deadlines Delayed

3/24/2020 12:00:00 PM

Will CMS delay the filing deadline of Fiscal Year End (FYE) December 31, 2019 cost reports due at the end of May due to the Covid-19 outbreak?

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Members of Congress Urge Congressional Leadership to Fix RHC Telehealth Issues

3/20/2020 5:00:00 PM

Washington D.C. ~ Representative Adrian Smith (R-NE) and Representative Tom O’Halleran (D-AZ) sent a bipartisan letter today to Congressional leadership urging them to adopt a solution for RHCs and FQHCs regarding telehealth visits during the COVID-19 pandemic. NARHC worked closely with Representative Smith and Representative O’Halleran on this effort. You can read the full letter...

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NARHC Sends Letter to Congress on Teleheath Issues

3/18/2020 12:00:00 PM

In the past few days, we have seen Congress move expeditiously to expand our nation's capacity to deal with the Covid-19 pandemic including a significant expansion of the Telehealth benefit for Medicare patients. Unfortunately, this expanded telehealth authority does not extend to the patients of rural health clinics or community health centers in underserved rural and urban areas.

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NARHC Sends Letter to Trump Administration on Telehealth Services During Covid-19 Pandemic

3/13/2020 5:00:00 PM

CMS regulations finalized in the 1970s are currently hampering the response to Covid-19 in rural areas. As you know, the CDC is encouraging patients to seek care from their home if they are experiencing Covid-19 symptoms. While fee-for-service offices are able to offer telehealth services to Medicare patients in their homes and bill for them, rural health clinics cannot. This is because rural health clinics...

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New Medicare Mandate: Appropriate Use Criteria
Affects Orders for Advanced Imaging

1/7/2020

This year, you may begin hearing from the imaging departments or imaging facilities in your area about something called the "Appropriate Use Criteria" or clinical decision support mandate. Imaging centers may begin asking for or requiring that you provide them with additional information before they can move forward with an advanced image on your Medicare patients...

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RHCs Excluded from Principal Care Management Benefit in 2020

1/6/2020

In 2020, Rural Health Clinics may not bill for Principal Care Management. Principal Care Management (PCM) is a new benefit that Medicare will cover in 2020. It is very similar to the chronic care management (CCM) benefit, except for the fact that patients can qualify for principal care management services with only one chronic condition, whereas CCM services can only be provided to patients with at least two chronic conditions.

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New RHC Policy Review, Annual Evaluation, and Emergency Preparation Final Rule 0938-AT23
Effective November 30, 2019

10/4/2019

CMS has issued final rule RIN 0938-AT23, which affects CAHs, RHCs, FQHCs, and other facility types. The following summary is taken in whole from the parts affecting RHCs §491 in the rule:

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CMS Relaxes Policy on Emergency Drugs and Biologicals for RHCs

9/16/2019 10:00:00 AM

NARHC is happy to report that CMS is significantly altering their guidance policy regarding emergency drugs and biologicals required in rural health clinics. This change is effective immediately.

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NARHC Celebrates 1,000 Members!

8/22/2019

We are happy to report that the National Association of Rural Health Clinics hit a huge milestone this summer by crossing the one-thousand members mark! To celebrate this occasion, we wanted to take a moment to thank everyone involved, reflect on the growth of NARHC, and talk briefly about the future of our association.

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The Fight to Modernize the Rural Health Clinics Program

7/19/2019

Nathan Baugh, Director of Government Affairs

As I hope you are all aware, we are working extremely hard to pass the Rural Health Clinic Modernization Act through Congress. This legislation will modernize outdated RHC rules and raise the cap or upper payment limit on Medicare reimbursement for rural health clinics.

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RHC Modernization Act Introduced in the House

5/16/2019 12:00:00 PM

WASHINGTON, D.C. - Today, U.S. Reps. Adrian Smith (R-NE-3), Terry Sewell (D-AL-07), Cathy McMorris Rodgers (R-WA-05), and Dave Loebsack (D-IA-2) introduced the Rural Health Clinic Modernization Act, H.R. 2788. This legislation provides regulatory relief for Rural Health Clinics (RHCs) and updates Medicare reimbursements to independent RHCs. The 4,100 RHCs nationwide provide essential primary care and preventative services in rural and underserved areas, either independently or aff...

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Federal Grant Opportunity for Rural Health Clinics

4/10/2019 4:00:00 PM

Bill Finerfrock, Executive Director

The Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy (FORHP) will be releasing a Notice of Funding Opportunity (NOFO) for a new Rural Communities Opioid Response Program (RCORP) initiative called RCORP-Medication-Assisted Treatment Expansion (HRSA-19-102). HRSA plans to invest approximately $8 million in rural communities as part of this funding opportunity.

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RHC Modernization Act Introduced by Senator Barrasso and Senator Smith

4/4/2019

Nathan Baugh, Director of Government Affairs

NARHC is pleased to announce that Rural Health Clinic Modernization Act has formally been introduced. We have been working hard to get this legislation introduced for the past year and it is nice to see our efforts pay off. But the job is nowhere near done!

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What's New for RHCs in 2019?

1/10/2019

Nathan Baugh, Director of Government Affairs

Calendar year 2019 is here, and with it comes a flurry of new benefits and policies for Rural Health Clinics to keep track of. The following is a quick summary and update of what has changed and what is new for RHCs in 2019:

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President Trump Signs Legislation to Combat Opioid Crisis

10/29/2018

Nathan Baugh, Director of Government Affairs

On October 24th, President Trump signed into law the "SUPPORT for Patients and Communities Act." This legislation represents the culmination of bipartisan efforts to combat the opioid crisis gripping our country. In an otherwise partisan environment, the SUPPORT for Patients and Communities Act passed the Senate (98 to 1) and the House (396 to 14) with overwhelming bipartisan majorities.

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NARHC Pitches Modernization Legislation On Capitol Hill

10/1/2018

Nathan Baugh, Director of Government Affairs

On September 20th, a small contingent of individuals from across the Rural Health Clinic (RHC) community and country came to Washington D.C. for a series of meetings with Congress on modernizing the RHC statute. This "fly-in" was organized and coordinated by NARHC as part of an effort to build support for legislation that we hope will pass this year or early next year.

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CMS Seeking to Reduce RHC Regulatory Burden

9/21/2018

Nathan Baugh, Director of Government Affairs

CMS released a proposed rule on September 20th seeking to reduce unnecessary regulatory burdens within the Medicare program. The goal of the proposal is to allow health care professionals to focus more resources and time on providing care by reducing regulatory requirements that might impede that.

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CMS Proposed E&M Coding Changes Medicare RHC
What is NARHC Doing with Respect to the RHC Cap?

8/23/2018

Bill Finerfrock, Executive Director

Q: The new Medicare payment proposals includes an option to pay a flat rate ($93 fee) sounds like what we already have as an RHC with our AIR. That proposed rate is higher than the current cap for the AIR for Ind. RHC's. If this goes through, what would be the point of continuing as an RHC for Medicare? A: It is an interesting question and one that we (NARHC) leadership and staff have discussed... ...What is NARHC doing with respect to the RHC Cap?

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CMS Requests Palmetto GBA Indefinitely Delay Its' Plans to Auto-Cancel Claims

8/4/2018

Bill Finerfrock, Executive Director

Palmetto GBA and CMS have received a number of inquiries from providers and their representatives concerning provider appeal rights as well as information on how impacted providers may re-bill responsible MA plans. CMS is working to address these concerns and provide information to MA plans that will help them be better able to identify any rebilled claims from providers. So as to afford the agency with the time needed to develop complete guidance on these topics, CMS has requested...

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CMS Proposes New "Virtual Check-In" and "Remote Evaluation" Benefit for RHCs
CMS released their thousand-plus page 2019 Physician Fee Schedule proposed rule. One major takeaway for RHCs is the proposal of a new “virtual check-in” service.

7/13/2018

Nathan Baugh, Director of Government Affairs

Despite the fact that Rural Health Clinics are not paid under the physician fee schedule, significant updates and changes for the RHC program are often included in the Physician Fee Schedule rulemaking process. Yesterday, CMS released their thousand-plus page 2019 Physician Fee Schedule proposed rule. One major takeaway for RHCs is the proposal of a new "virtual check-in" service...

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Palmetto Recoupment One-Month Filing Extension of "Improperly" Paid Claims

7/11/2018

Bill Finerfrock, Executive Director

Yesterday I expressed my disappointment that the most recent posting by Palmetto regarding challenges to the recoupment notices did not reflect an understanding we had reached with CMS last week. Specifically, that RHCs would have until mid-August to file reconsideration notices for recoupments they felt were in error. I communicated to CMS officials our disappointment with the posting and that it did not reflect what CMS said they would do. Yesterday afternoon, I received an update...

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Update on Palmetto Recoupment of "Improperly" Paid Cliams

7/10/2018

Bill Finerfrock, Executive Director

Last week I had a meeting with senior leaders at CMS to discuss the efforts by Palmetto to recoup monies they believe were improperly paid by Cahaba for Medicare beneficiaries enrolled in MA plans at the time the services were rendered. When that call ended, I believed we had an agreement... ... Late yesterday I was given an update - put out by Palmetto - that does NOT reflect the agreement I felt had been reached...

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Palmetto Recoupment Update
Meeting Scheduled with CMS

7/3/2018

Bill Finerfrock, Executive Director

As you know from my previous posts, NARHC continues to work on the Palmetto recoupment problem. To say that this is a mess would be an insult to anything I've previously described as "a mess." While I appreciate efforts by Palmetto to be responsive, the options they seem to have available for a fair resolution of this problem seem limited. For this reason, we are taking this issue to the highest levels at CMS...

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Palmetto Recoupment Educational Letter

7/2/2018

Bill Finerfrock, Executive Director

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Palmetto "Outpatient Services Incorrectly Paid"

6/22/2018

Nathan Baugh, Director of Government Affairs

NARHC has been in contact with Palmetto regarding the letters sent to RHCs this month Re: "Outpatient Services Incorrectly Paid by Medicare for Beneficiaries under a Medicare Advantage Plan." Palmetto has informed us that additional communications are forthcoming on Monday, June 25th, which should address some of the concerns we have heard from the RHC community including:

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Palmetto Audio Notification

6/21/2018

Nathan Baugh, Director of Government Affairs

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Updates From Palmetto

6/19/2018

We have been asked by Palmetto to share the following with the RHC Community. If you are not in the Palmetto service area, you can disregard this posting...

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2018 MIPS Eligibility Tool

4/19/2018

The CMS has released it's 2018 MIPS Participation Lookup Tool. You may use the updated Lookup Tool to check your eligibility in 2018 for the Merit-based Incentive Payment System (MIPS). Rural Health Clinic providers can enter their National Provider Identifier (NPI) to find out if they're required to participate during the 2018 performance year.

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New Medicare Card

3/29/2018

Beginning in April 2018, the Centers for Medicare & Medicaid Services (CMS) will start mailing new Medicare cards to all people with Medicare. The roll-out will occur over a several month period based upon the geographic location of the Medicare beneficiary. You are encouraged to talk with your Medicare patients about this so they are aware of the transition and do not think that this is a "scam".

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CMS Publishes AAPM Table (Advanced Alternative Payment Models)

2/5/2018

Today, the Centers for Medicare and Medicaid Services (CMS) published a table displaying the Alternative Payment Models (APMs) that CMS operates. In the table CMS identifies which of those APMs CMS has determined to be MIPS APMs or Advanced APMs. We will modify this list based on changes in the designs of APMs or the announcement of new APMs. See the table here...

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State Operations Manual (SOM) Appendix G - (Guidance for Surveyors: Rural Health Clinics)

2/2/2018

CMS recently released a new version of the State Operations Manual (SOM) Appendix G. This document contains significantly more detailed interpretive guidelines for RHC survey and certification than the previous version. If you have questions on how to meet the RHC rules and regulations, this document will likely have the answers you seek.

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National Advisory Committee on Rural Health and Human Services Recommendations

1/24/2018

The National Advisory Committee on Rural Health and Human Services (NACRHHS), recently released their policy brief and recommendations on how to "Modernize Rural Health Clinic Provisions." The NACRHHS picks one or two issues a year and produces a policy brief(s) for the Secretary of HHS...

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Laboratory Billing

1/10/2018

A Program Memo issued by CMS (at the time known as HCFA) which addresses laboratory billing by both independent and provider-based RHCs, states: Laboratory In light of recent inquiries regarding laboratory services, we are clarifying whether diagnostic laboratory tests furnished in the RHC/FQHC by their personnel are covered RHC/FQHC services paid under the all-inclusive rate, or whether such services are beyond the scope of RHC/FQHC services. While the law requires...

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Essential Community Provider Designation

12/15/2017

Are you an Essential Community Provider (ECP)? Most Rural Health Clinics will answer that question with a resounding YES! But for many Health Plans sold on the Affordable Care Act (ACA) Exchanges, the answer is often a resounding "maybe." Why, because many RHCs have failed to petition for ECP designation...

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RHCs Serviced by Cahaba

11/20/2017

As you should have heard, Cahaba has lost their contract as a Medicare Administrative Contractor (MAC) for Jurisdiction J (JJ) (Alabama, Georgia, Tennessee). The new contractor for MAC Region J (JJ) will be Palmetto GBA. Jurisdiction J (JJ), in addition to handling Medicare Part A and B claims for the three states mentioned above, was also the "legacy" MAC for hundreds of RHCs located outside of Jurisdiction J (JJ). This is a link...

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Emergency Preparedness

11/2/2017

November 15th is fast approaching and all RHCs must have taken steps to be in compliance with the new Emergency Preparedness requirements CMS will begin enforcing on that date.

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MACRA Proposed Rule for 2018

6/27/2017

Nathan Baugh, Director of Government Affairs

Last week, CMS released their 1,050 page MACRA proposed rule for calendar year 2018. The big proposed change is an increase in the low-volume threshold for participation in MIPS to $90,000 (up from $30,000) of Medicare allowable revenue or 200 (up from 100) Medicare part B patients. This proposed change should exempt most RHC clinicians from the MIPS program. As a refresher...

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NARHC Website has New Look + Increased SSL Security

6/14/2017

The NARHC Website has a new look & feel plus additional SSL security! We hope you like it!

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RHC Guidelines & Emergency Preparedness

6/13/2017

Please note that the RHC Guidelines & The Emergency Preparedness have undergone some recent changes. Check them out on our website.

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NARHC Addresses Senate Press Conference

5/23/2017

The National Association of Rural Health Clinics (NARHC) was invited to speak at a Senate press conference on rural health hosted by Senator Martin Heinrich (D-NM). NARHC President John Gill stressed the important role Medicaid plays in allowing RHCs to provide care in rural communities...

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Raising the RHC Cap?

4/26/2017

Bill Finerfrock, Executive Director

A question was posed about the prospects for raising the RHC cap and when this might occur. Raising the RHC cap requires an Act of Congress as the cap is set by law. The current cap is an extension of the RHC cap established in 1988 ($46.00 per visit) adjusted for medical inflation over the intervening 29 years. Obviously it is very out-of-date...

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Policy & Procedure Manual Template

4/18/2017

Bill Finerfrock, Executive Director

Below are some options. I would strongly recommend that you use these as templates. Also, please note that the P/P manual in the "How To" publication is getting old and likely needs to be updated but it will still give you a sense of how you may want to proceed. It is extremely important that the P/P manual be a reflection of how YOUR RHC intends to practice and see/treat patients.

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Are Visits to an SNF by an RHC Provider an RHC Visit?

3/27/2017

Bill Finerfrock, Executive Director

Recently, an NARHC News listserve participant posted a question/concern regarding a comment she heard during a webinar conducted by the Medicare MAC - Noridian. The commenter stated that the representative from Noridian stated that visits to a SNF by an RHC provider were not RHC visits and should be billed on the 1500 claim form and not billed on the UB-04. If correct, this would constitute a significant change in CMS policy (as well as the Medicare statute). NARHC contacted...

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Updates from Cahaba on RHC Claims

11/29/2016

Bill Finerfrock, Executive Director

ALL RHC Medicare claims - whether "single line" or "multi-line' MUST have the CG modifier on the "pay" line. If a single line, the CG modifier goes on the single line with the HCPCS code for that RHC visit. If multi-line, then the CG modifier goes...

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CG Modifier & Cahaba

11/23/2016

Nathan Baugh, Director of Government Affairs

As many of us know, beginning October 1, most RHC Medicare claims (with a few exceptions) were required to have modifier CG on the claim. While we (NARHC) communicate billing updates through this listserv as soon as we learn about them, this is ultimately a responsibility of each MAC to communicate these updates to their jurisdiction. NARHC staff has discovered...

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Election First Take Analysis

11/10/2016

Bill Finerfrock, Executive Director

The following is our quick analysis of the election for your reading pleasure. NARHC will also be creating a more RHC-centric analysis and sending that out sometime next week via List Serve...

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2017 Physician Fee Schedule Final Rule – RHC Provisions

11/4/2016

Nathan Baugh, Director of Government Affairs

While many of you were probably watching the Chicago Cubs win their first world series since 1908, we at the NARHC, were diligently reviewing the 2017 Physician Fee Schedule Final Rule for RHC related provisions. These provisions are effective as of January 1, 2017. You can find the final rule here...

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RHC Guide to the MACRA Final Rule

10/28/2016

We understand that there are a lot of questions and interest around MACRA (Medicare Access and CHIP Reauthorization Act) especially around the specifics of how it does and does not affect RHCs. We have put together the following Q&A to address many of the relevant aspects of the final rule for RHCs.

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CG Modifier

10/26/2016

Bill Finerfrock, Executive Director

CMS has produced an FAQ document that addresses many of the questions/scenarios relative to the use of the CG modifier that have been raised on this listserve. I strongly encourage you to review this document.

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HCPCS Reporting

10/1/2016

Nathan Baugh

Hopefully everyone is aware of the HCPCS reporting changes set to kick in next week. The best place to review those changes is HERE. We also wanted to clarify a few things regarding these changes...

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HCPCS Reporting Requirements Starting Oct. 1st

10/1/2016

Nathan Baugh, Director of Government Affairs

CMS recently released a new MLN Matters article detailing the new HCPCS reporting requirements starting on October 1, 2016. The article can be accessed HERE. As expected, we will no longer have to deal with a qualifying visit list. Instead...

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2018 Essential Community Provider List & Petition

9/1/2016

Under the Affordable Care Act (ACA), Qualified Health Plans (QHPs), are required to include essential community providers (ECPs) that serve predominantly low-income, medically-underserved individuals in their networks Rural Health Clinics are eligible for designation as ECPs. As part of the Plan Approval process, the Secretary Health and Human Services (HHS) has established...

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2017 Physician Fee Schedule Updates

7/13/2016

Nathan Baugh, Director of Government Affairs

On July 6th, the Centers for Medicare and Medicaid Services (CMS) released the 2017 Physician Fee Schedule (PFS) proposed rule. This is one of the major annual rules CMS uses to announce proposed changes to the Medicare program. Most notably for RHCs, this year’s PFS makes numerous changes to the RHC Chronic Care Management (CCM) requirements, including changing the supervision requirement that we believe are welcome and should make it easier to implement CCM services.

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