Month: December 2023

Webinar – Latest CMS Updates and the Most Frequent Findings in Rural Health Care

December 5, 2023

Webinar – Latest CMS Updates and the Most Frequent Findings in Rural Health Care

CMS Certification is not only necessary for Critical Access Hospitals (CAHs) and Rural Health Clinics (RHCs) to receive Medicare and Medicaid payments, but also for payment from many private insurers and participation in Federal grants. Preparation for a CMS survey is critically important for CAHs and RHCs, as adverse CMS survey outcomes can result in termination of your CMS Certification. Rural hospitals and rural health clinics, in particular, have unique challenges, such as limited resources.

Set your organization up for a successful survey and join this webinar to hear from a former CMS surveyor about the latest updates affecting rural hospitals and rural health clinics and the most commonly cited CMS CfCs and CoPs.

After the webinar, attendees will be able to:

  • Discuss CMS QSP Memos and Notifications affecting rural hospitals
  • Most frequent CMS findings in CAHs
  • Most frequent CMS findings in RHCs

When: Tuesday, January 16, 2024, 2:00 – 3:00 p.m.

Register Here

New Product: A Comparison of Non-Operating Revenue between Rural and Suburban Hospitals

December 4, 2023

New Product: A Comparison of Non-Operating Revenue between Rural and Suburban Hospitals

A new product exploring non-operating revenue (NOR) in rural and urban hospitals was released by the Flex Monitoring Team. NOR is an important source of hospital revenue; some hospitals are able to use NOR to offset operating losses, improve total margins, and remain profitable overall despite experiencing negative operating incomes. NOR, defined as revenue from sources other than patient care and activities closely related to patient care, is comprised of investment income, medical office rental revenue, government appropriations (such as state and local tax transfers and grants), and philanthropic sources.

The new brief, A Comparison of Non-Operating Revenue between Rural and Urban Hospitals, compares the relative percentage and composition of NOR among Critical Access Hospital (CAHs), Rural Prospective Payment System (R-PPS) hospitals, and Urban Prospective Payment System (U-PPS) hospitals. This information may be important to hospital executives seeking to improve financial performance, and to policymakers to understand how non-operating revenue affects hospital financial performance.

Read Policy Brief

CMS Webinar – Final Rules Overview – Impact for RHCs, Monday, December 11 at 2:00 p.m.

December 4, 2023

CMS Webinar – Final Rules Overview – Impact for RHCs, Monday, December 11 at 2:00 p.m.

The recently released Centers for Medicare and Medicaid Services (CMS) 2024 final rules contain a significant number of changes for Rural Health Clinics (RHCs).

This year, the rules include details about the implementation of the two additional provider types billable as RHC Medicare providers beginning January 1, 2024, as well as information on the Intensive Outpatient Services Treatment category. According to the National Association of Rural Health Clinics (NARHC), RHCs will now have a way to bill for remote physiologic monitoring and other care management services under an expanded G5011 code.

During this webinar, policy experts will provide an overview of changes to the Medicare Physician Fee Schedule and the Medicare Hospital Outpatient Prospective Payment System that will go into effect on January 1, 2024. Among many, these changes include:

  • Expanded services covered under the Healthcare Common Procedure Coding System (HCPCS) code G0511 (chronic care management and behavioral health care provided by RHC’s)
  • An extension of payment for telehealth services until December 31, 2024
  • The addition of marriage and family therapists and mental health counselors as provider types billable for substance use treatment
  • The establishment of intensive outpatient programs for substance use treatment

RHCs are encouraged to join this upcoming webinar to hear the discussion about the final rule and receive answer to your questions about the implementation of these various policy proposals.

When: Monday, December 11, 2:00 p.m. ET

Advance registration is required

Application Assistance for Rural Residency Funding – Apply by February 12

December 4, 2023

Application Assistance for Rural Residency Funding – Apply by February 12

Learn more about what’s needed to apply for the newest funding opportunity for establishing rural residencies, the Rural Residency Planning and Development Program (RRPD) – HRSA-24-022. The FORHP-supported RRPD provides start-up funding for new residency programs to address physician workforce shortages in:

  • Family medicine
  • Internal medicine
  • Psychiatry
  • General surgery
  • Preventive medicine
  • Obstetrics and gynecology

Eligible applicants are rural hospitals and graduate medical education consortiums that may include:

  • Universities
  • Historically Black Colleges and Universities
  • Tribal organizations

A maximum of 15 awardees will receive up to $750,000 for a three-year grant period to develop new and sustainable programs approved by the Accreditation Council for Graduate Medical Education, especially programs specifically designed for underserved areas and populations.

Research has shown that physicians from a rural background and those trained in rural settings are more likely to continue practicing in rural areas after completing their residencies.

Medically Underserved Areas/Populations and GME

Application Assistance

Updates to Requirements for Buprenorphine Prescribing

December 4, 2023

Updates to Requirements for Buprenorphine Prescribing

As announced by the Substance Abuse and Mental Health Services Administration in January 2023, clinicians no longer need a federal waiver to prescribe buprenorphine for treatment of opioid use disorder. Clinicians are still required to register with the federal Drug Enforcement Agency to prescribe controlled medication.

On June 27, the DEA began to require that registration applicants – both new and renewing – affirm they have completed a new, one-time, eight hour training. Exceptions for the new training requirement are practitioners who are board certified in addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the U.S. within five years of June 27, 2023.

Watch this 11-minute video that explains the changes

Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained between January 1, 2019 and December 29, 2022 (when Congress eliminated the waiver requirement). Approximately $889,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted.

Please contact DATA2000WaiverPayments@hrsa.gov for additional information.

See Training Requirements

Apply for DATA 200 Waiver Training Payment

Trends in the Prevalence of Chronic Obstructive Pulmonary Disease

December 4, 2023

Trends in the Prevalence of Chronic Obstructive Pulmonary Disease

A review of data from the Behavioral Risk Factor Surveillance System showed the prevalence of COPD has remained stable overall, but with disparities based on rural residence. Specifically, between the years 2011 and 2021, prevalence increased for adults 75 years and older, for those living in rural areas, and for those who smoked.

Researchers suggest the COPD National Action Plan provides a comprehensive framework for COPD prevention, treatment, and management strategies. These can be tailored to address risk factors specific to various populations. In rural areas, for example, there are higher rates of smoking, history of asthma, and exposure to lung irritants, but limited access to pulmonologists.

The Rural Health Information hub (RHIhub) recently updated the Rural Chronic Obstructive Pulmonary Disease Toolkit, with models for effective COPD programs, issues to consider when implementing, and resources for funding and sustainability.

Overview of Chronic Obstructive Pulmonary Disease

Rural Chronic Obstructive Pulmonary Disease Toolkit

Upcoming Webinar – RHIhub – The Maternal, Infant, and Early Childhood Home Visiting Program in Rural Areas

December 4, 2023

Upcoming Webinar – RHIhub – The Maternal, Infant, and Early Childhood Home Visiting Program in Rural Areas

Don’t miss this RHIhub webinar on Monday, December 11th at 2:00 p.m. Central Time (CT).

The National Advisory Committee on Rural Health and Human Services (NACRHHS) and the Health Resources Services Administration’s (HRSA’s) Maternal and Child Health Bureau discuss findings and recommendations from the recent Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) policy brief.

This webinar is free. High-speed internet is required to participate. A recording will be available on the RHIhub website after the live event. Connection details will be emailed immediately upon registration.

When: Monday, December 11, 12:00 p.m. CT

Register Here

OIG Issues Remote Patient Monitoring (RPM) Alert

December 1, 2023

OIG Issues Remote Patient Monitoring (RPM) Alert

The Office of Inspector General (OIG) is alerting the public about a fraud scheme involving monthly billing for remote patient monitoring. Please educate staff and patients with this important information.

Legitimate RPM involves using medical devices such as scales, glucose monitors, blood pressure cuffs, cardiac rhythm devices, and other equipment to remotely monitor for anomalies in patients with chronic medical conditions. This new treatment is beneficial for those whose condition might deteriorate quickly, where monitoring can reduce complications, hospitalizations or death.

However, the OIG has found unscrupulous companies are signing up Medicare enrollees for this service, regardless of medical necessity. Most often, the monthly monitoring never happens, but the enrollee is billed monthly anyway.

  • Scammers target Medicare enrollees through calls, texts, and Internet ads
  • Scammers steal Medicare numbers and other personal information
  • Scammers then bill Medicare for services that are unnecessary or never provided

Report Fraud

Learn More

American Institute of Healthcare Compliance – Evaluation and Management (E/M) Visits

December 1, 2023

American Institute of Healthcare Compliance – Evaluation and Management (E/M) Visits

Beginning January 1, 2024, the Centers for Medicare and Medicaid (CMS) is finalizing implementation of a separate add-on payment for healthcare common procedure coding system (HCPCS) code G2211.

  • This add-on code will better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care.
  • Generally, it will be applicable for outpatient and office visits as an additional payment, recognizing the inherent costs involved when clinicians are the continuing focal point for all needed services, or are part of ongoing care related to a patient’s single, serious condition or a complex condition.

Split (or shared) Evaluation and Management (e/M) visits

Split (or shared) E/M visits refer to visits provided in part by physicians and in part by other nonphysician practitioners in hospitals and other institutional settings.

  • For CY 2024, CMS is finalizing a revision to the definition of “substantive portion” of a split (or shared) visit to include the revisions to the Current Procedural Terminology (CPT) guidelines, such that for Medicare billing purposes, the “substantive portion” means more than half of the total time spent by the physician or nonphysician practitioner performing the split (or shared) visit, or a substantive part of the medical decision making.
  • This responds to public comments asking that it be allowed that either time or medical decision making to serve as the substantive portion of a split (or shared) visit.

Click here for more PFS information from CMS

Click here for the November press release which provides a summary of changes

American Institute of Healthcare Compliance: Recognize Holiday Workplace Stress

December 1, 2023

American Institute of Healthcare Compliance: Recognize Holiday Workplace Stress

With the holiday season here, it is important for leadership to recognize additional stresses on our workforce. The World Health Organization estimates that for every dollar U.S. employers spend treating common mental health issues, they receive a return of $4 in improved health and productivity. Employers can make a difference when it comes to helping their staff manage stress.

According to the National Institute of Mental Health, it is estimated that more than one in five U.S. adults live with a mental illness. Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe.

The Occupational Safety and Health Administration (OSHA) states workplace stress has been reported to cause 120,000 deaths in the U.S. each year! OSHA also states that workplace stress and poor mental health can negatively affect workers through:

  • Job performance
  • Productivity
  • Work engagement and communication
  • Physical capability and daily functioning

Read through helpful information about SAD (Seasonal Affective Disorder) and download the PDF from the National Institute of Mental Health.

Access resources on OSHA’s website “Workplace Stress Make Work Better – Mental Health Matters.”