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President Biden Announces Trio of RHC COVID-19 Initiatives
RHC COVID-19 Testing and Mitigation Program to Allocate $100,000 per RHC

5/4/2021 5:00:00 PM

Today, President Biden announced in a White House press release a trio of COVID-19 initiatives involving rural health clinics.

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CMS Updates Transmittal to MACs Regarding New RHC Upper Payment Limits

5/4/2021 3:45:00 PM

On May 4th, the Centers for Medicare and Medicaid Services (CMS) updated Change Request 12185, which is the main document from CMS implementing the new RHC Upper Payment Limits from the Consolidated Appropriations Act of 2021.

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RHC Grandfathering Fix Signed into Law

4/15/2021 10:00:00 AM

Nathan Baugh

As expected, on April 14th, President Biden signed H.R. 1868 into law, fixing many of the issues with the RHC payment modernization law enacted in December. The legislation also retroactively extends the suspension of the 2% across-the-board Medicare sequestration through the end of 2021. Since April 1, CMS had been holding claims pending passage of this legislation, we expect CMS to lift this hold imminently.

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Johnson & Johnson Vaccine Paused

4/14/2021 11:00:00 AM

The Federal Office of Rural Health Policy (FORHP) within the Health Resources and Services Administration (HRSA) has asked us to provide the following alert on the Johnson and Johnson (J&J) vaccine pause

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New Upper Payment Limits Begin April 1st
RHC Grandfathering Fix Expected to Pass the House Soon

4/1/2021 10:00:00 AM

Today, the Rural Health Clinic (RHC) per visit upper payment limit increases from $87.52 to $100. The increased upper payment limit is a direct result of the payment changes included in Section 130 of the Consolidated Appropriations Act of 2021. Some Medicare Administrative Contractors have already sent out letters to RHCs informing them of the increased upper limit and how it will affect their All-Inclusive Rate payments.

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Survey Results: COVID-19 Vaccine Activities in Rural Health Clinics

3/26/2021 10:00:00 AM

Nathan Baugh, Director of Government Affairs

“We are glad to see that the majority of RHCs are actively involved in administering the vaccine to their communities,” said Bill Finerfrock, Executive Director of the National Association of Rural Health Clinics.

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Medicare Sequester Bill with RHC Grandfathering Fix Passes House

3/19/2021 4:00:00 PM

The House of Representatives today, by a vote of 246 to 175 has passed H.R. 1868. The bill waives a 2% across-the-board Medicare sequester that expires at the end of March and another 4% sequester cut that would take effect in 2022. The House bill also contains...

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American Rescue Plan Provides $9 Billion for Rural Providers

3/12/2021 4:00:00 PM

Yesterday, President Biden signed the $1.9 trillion American Rescue Plan into law. We are happy to report that the legislation includes a total of $9 billion for rural providers. Early versions and outlines of the American Rescue Plan did not meaningfully include rural providers and...

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New & Expanded Flexibilities for RHCs & FQHCs during the COVID-19 PHE

2/24/2021 1:00:00 PM

CMS revised this MLN Matters article to provide the updated rate effective January 1, 2021, for G2025. You’ll find substantive content updates and the updated rate for G0071.

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Education Loan Repayment Program for RHCs
Nurse Corps Loan Repayment Program Now Open to For-Profit and Not-For-Profit RHCs

2/19/2021 12:00:00 PM

Joe Lampard, VP, HPSA Acumen

The Nurse Corps Loan Repayment Program has in the past only been open to non-profit RHC’s. As of 2021 they now are accepting for-profit RHC applicants. The program forgives 60% of the nurse’s education debt over a two-year period with the option to renew for a third year for a total of 85% of the nurse’s education debt forgiven.

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Telehealth Reimbursement Set at $99.45 for 2021

1/29/2021 3:00:00 PM

According to a recently released Relative Value Unit (RVU) file, payment for RHC telehealth visits (G2025) appears to be falling from $92.03 in 2020 to $53.74 in 2021. The steep decline in reimbursement is mostly due to the complete removal of the Practice Expense RVU from G2025.

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Rural Health Clinic Modernization Included in Final COVID Package

12/21/2020 5:00:00 PM

NARHC is pleased to report that Medicare reimbursement for RHCs will undergo a massive overhaul as part of the year-end COVID-19 relief and appropriations package passed by Congress. Notably, the RHC cap will be raised to $100 on April 1, 2020 and then the cap will gradually rise each year to $190 in 2028.

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Medicare Payment Updates for RHCs
Telehealth (G2025) Coinsurance and Reimbursement Policy Updated

12/8/2020 9:00:00 AM

The MLN Matters SE20016 was recently updated in a way that significantly alters G2025 reimbursement policy. The updated section is as follows...

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HRSA to Pay RHCs Who Have Not Yet Received RHC COVID-19 Testing Program Funds on Monday

12/4/2020 6:00:00 PM

After a long approval process, HRSA has informed NARHC and NOSORH that RHCs who missed out on the initial RHC COVID-19 testing fund allocation will be receiving payments on Monday. As a result, 184 RHCs, who did not receive $49,461.42 in May, will receive this money next week.

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2021 Physician Fee Schedule Final Rule Released
CMS Finalizes Principal Care Management for Rural Health Clinics

12/3/2020 5:30:00 PM

The Centers for Medicare and Medicaid Services (CMS) released their 2021 Physician Fee Schedule final rule on December 1st and as expected, Rural Health Clinics will be able to bill for Principal Care Management services beginning in 2021.

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Data Collection Site Launched for the RHC COVID-19 Testing Program
www.RHCcovidreporting.com

10/16/2020 8:00:00 AM

Tuesday, October 6, we launched the online portal www.RHCcovidreporting.com to collect data on COVID-19 testing at Rural Health Clinics. The website is the official data collection portal for the RHC COVID-19 Testing Program which means that all RHCs that received money ($49,461.42 per RHC) from the RHC COVID-19 Testing Program are required to report through this portal per the terms and conditions of the program.

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CMS Clarifies that Provider Relief Funds & Paycheck Protection Program Loans will NOT Offset Expenses on Medicare Cost Report

9/1/2020 3:15:00 PM

Nathan Baugh, Director of Government Affairs

CMS clarified in guidance that providers who received provider relief funds (PRF) and/or paycheck protection program (PPP) loans would not need to offset expenses on their Medicare cost report by the amount received through those programs. This is a huge victory for providers reimbursed through cost-based systems such as rural health clinics and critical access hospitals who faced the prospect of having their Medicare reimbursement reduced because they received COVID-19 funds....

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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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