Category: Current Affairs

California Finds 6% Higher Mortality After Closure

May 1, 2023

California Finds 6% Higher Mortality After Closure

In January, Madera Community Hospital — the only hospital in all of Madera County, Calif. — was forced to close due to financial loss. Now the nearest emergency health care facilities are at least 30 miles away. A recent study found the mortality rate increased in rural California communities by 5.9 percent upon the closure of a hospital. Additionally, the American Hospital Association says persistent high costs, the end of the PHE, and the expected departure of millions of Americans from the Medicaid rolls spell trouble for hospitals. NRHA will share strategies to maintain rural health care access and keep rural hospitals open at NRHA’s 8th Rural Hospital Innovation Summit May 16-19 in San Diego.

University Launches Ambitious Effort to Reduce Disparities

May 1, 2023

University Launches Ambitious Effort to Reduce Disparities

Over the past two decades, life expectancy in rural areas has declined, with one major factor being the prevalence of diabetes. To improve the health and well-being of rural and minority populations, UVA School of Medicine has launched a new Center for Health Equity and Precision Public Health. Additionally, new research led by NRHA member Jan Probst of the Rural and Minority Health Research Center looks at how close some ZIP codes were to different kinds of health care and access in areas with higher proportions of racial and ethnic minorities. Your chance to explore the intersection of health equity and social determinants with the experts is at NRHA’s 46th Annual Rural Health Conference and 28th Health Equity Conference May 15-19 in San Diego.

Convenience vs Compliance: How Much is it Costing You?

April 28, 2023

Convenience vs Compliance: How Much is it Costing You?

Federal law requires that rural health clinics (RHCs) are HIPPA compliant. An RHC could face stiff fines and penalties if they are not compliant or if there is a breach. In today’s age of electronics, many RHCs are already using the various EHR/EMR programs that are available to them.

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Public Health Emergency Ends May 11th – Implications for Rural Health Clinics

April 28, 2023

Public Health Emergency Ends May 11th – Implications for Rural Health Clinics

The COVID-19 Public Health Emergency (PHE) initially declared on January 27, 2020, will conclude on May 11, 2023. Please note: this is a separate emergency declaration from the COVID-19 National Emergency declared by the President that can be ended via a joint resolution from Congress. For a full explanation of these provisions please review the recent NARHC webinar.

RHC Specific Waivers

The conclusion of the PHE will end the below waivers:

Certain Staffing Requirements. 42 CFR 491.8(a)(6)

  • During the PHE, CMS waived the requirement that a NP, PA, or CNM be available to furnish patient care services at least 50% of the time the RHC is operating.

Temporary Expansion Locations. 42 CFR §491.5(a)(3)(iii)

  • During the PHE, CMS waived the requirement that RHCs be separately considered for Medicare survey and certification if services were expanded into more than one permanent location, including areas that would not typically meet RHC location requirements. Upon termination of the PHE, these expanded locations will be subject to location requirements and separate survey and certification.

Bed Count for Provider-Based RHCs

  • During the PHE, CMS permitted provider-based RHCs subject to their clinic-specific, grandfathered upper payment limit to increase their hospital bed count to 50+ without losing their grandfathered status. At the conclusion of the PHE, grandfathered RHCs must lower their bed count or lose their grandfathered payment status.

Nursing Home Visits

  • During the PHE, CMS removed the requirement that RHCs in an area without a current home health area shortage needed a written request and justification in order to provide home nursing services.

Virtual Communication Services

  • During the PHE, CMS allowed for online digital evaluation and management services (99421, 99422, and 99423) to be reimbursed under G0071. After the PHE, G0071 should only be used for G2012 and G2010. This was one of the first telecommunications flexibilities granted to RHCs during COVID, but the passing of the CARES Act allowed many more services to be done via telehealth during the PHE and beyond.

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RHC COVID-19 Program Reminders and Updates

April 28, 2023

RHC COVID-19 Program Reminders and Updates

The Rural Health Clinic (RHC) COVID-19 Testing & Mitigation (RHCCTM) program final reporting requirements are open for RHCs or their parent TIN organizations to complete on RHCcovidreporting.com. As a reminder, this program allocated $100,000 per eligible RHC in 2021 for COVID-19 testing-related and mitigation-related expenses and could be spent between January 1, 2021 and December 31, 2022.

The RHCCTM program closeout reporting requires RHCs to attest whether they fully spent, partially spent, or did not spend the funding. It is a simple one question attestation that does not require any submission of cost documentation.

Click Here for More Information

Use Your Voice – Advocate on Behalf of RHC Burden Reduction Act

April 28, 2023

Use Your Voice – Advocate on Behalf of RHC Burden Reduction Act

The National Association of Rural Health Clinics (NARHC) is requesting your help in generating support for the Rural Health Clinic Burden Reduction Act (S.198). This important piece of legislation modernizes 5 pieces of the RHC statute written in 1977 to better reflect the changing world of health care delivery.

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CMS Releases Intermediate Policy on Rural Health Clinic (RHC) Rurality Determinations

April 28, 2023

CMS Releases Intermediate Policy on Rural Health Clinic (RHC) Rurality Determinations

In late March, the Centers for Medicare & Medicaid Services (CMS) released the interim process that will be used in determining Rural Health Clinics (RHCs) rural location determination following the Census Bureau’s definition changes.

The interim process is as follows:

  • RHC applicants or relocating RHCs will meet the rural location requirement if the physical address is “non-urbanized” or in an “urban cluster” per 2010 Census Bureau Data, OR if the physical address is not an urban area per the 2020 Census Bureau Data
  • Both 2010 and 2020 Census Bureau Data can be found here

For questions, please contract Nathan Baugh, NARHC Executive Director at Nathan.Baugh@narhc.org or Sarah Hohman, NARHC Director of Government Affairs at Sarah.Hohman@narch.org 

Click Here for Full Details

Webinar – Rural Emergency Hospital Conversion and Technical Assistance Educational Webinar

April 17, 2023

Webinar – Rural Emergency Hospital Conversion and Technical Assistance Educational Webinar

Medicare designated the Rural Emergency Hospitals (REH) as a new provider type through the Consolidated Appropriations Act of 2021 to address concerns that some rural hospitals would not be able to sustain operations and are at risk of closure. Under the new REH designation, which became effective January 1, 2023, CAHs and certain rural hospitals can convert to a REH, allowing continued access to certain health services in the communities they serve.

On May 1, 2023, 11:00 a.m. – noon ET, the Rural Health Redesign Center (RHRC) and Mathematica, will host a 60-minute webinar to provide an overview of the REH program. During the webinar, participants will learn about the REH provider type, conversion and participation requirements, and no-cost technical assistance available through the Rural Emergency Hospital Technical Assistance Center (REH-TAC) for hospitals considering a conversion. If you have questions about this event, please email ctalkington@mathematica-mpr.com.

Register Here

MBQIP Data Reporting Reminders – April 2023

April 13, 2023

MBQIP Data Reporting Reminders – April 2023

Important Notice

Dates for measure submission and manual/CART versions are based on currently available information and may be subject to change.

April 30, 2023

Emergency Department Transfer Communication (EDTC)

  • Patients seen Q1 2023 (January, February, March)

May 1, 2023

CMS Population and Sampling (optional)*

  • Patients seen Q4 2022 (October, November, December)
  • Inpatient** and outpatient
  • Entered via the Hospital Quality Reporting (HQR) HARP account

May 1, 2023

CMS Outpatient Measures:

  • Patients seen Q4 2022 (October, November, December)
  • CMS Hospital Outpatient Reporting Specifications Manual version 15.0b 
  • Submitted to HQR via CART or by vendor
  • CART version – 1.21.0

May 15, 2023

Healthcare Personnel Influenza Vaccination – HCP/IMM-3

  • For data October 1, 2022 – March 31, 2023
  • Submitted through the National Healthcare Safety Network (NHSN)

May 15, 2023

CMS Outpatient Web-based Measure:

  • Measure OP-22: Patient Left Without Being Seen – full calendar year 2022
  • CMS Hospital Outpatient Reporting Specifications Manual version 15.0b
  • Entered via HQR HARP account

May 15, 2023

CMS Inpatient Measures**:

  • Patients seen Q4 2022 (October, November, December)
  • CMS Hospital Inpatient Reporting Specifications Manual version  5.12
  • Submitted to HQR via CART or by vendor
  • CART version –  4.30.0

*Population and sampling refers to the recording of the number of cases the hospital is submitting to Hospital Quality Reporting thru a HARP account.

** Currently there are no inpatient core MBQIP measures required.

For questions:  Stroudwater Associates, Carla Wilber, cwilber@stroudwater.com

MBQIP Monthly – April 2023 Now Available

April 13, 2023

MBQIP Monthly – April 2023 Now Available

MBQIP Monthly is an e-newsletter that highlights current information about the Medicare Beneficiary Quality Improvement Project (MBQIP) and provides critical access hospitals (CAHs) information and support for quality reporting and improvement. MBQIP Monthly is produced through the Rural Quality Improvement Technical Assistance program by Stratis Health.

April content:

  • CAHs Can! Engaging Hospital Boards in Quality
  • Data: CAHs Measure Up – New Birthing-Friendly Hospital Designation
  • Tips: Robyn Quips – Annual Measures OP-22 and HCP
  • Tools and Resources – Helping CAHs succeed in Quality Reporting & Improvement

MBQIP Monthly – April 2023