FORHP Announcements – February 14

January 14, 2017

Announcements from the Federal Office of Rural Health Policy

What’s New

Flexibility for Transportation Services.  The Office of the Inspector General for the U.S. Department of Health & Human Services recently issued a final rule that eases the ability to provide free or discounted transportation services for health care.  Under the rule, Federal health care programs arranging service from local transportation providers are granted a “safe harbor” exemption from the anti-kickback statute, which prohibits offering, soliciting or accepting of any type of remuneration for referral to a federal health care program business. Thus, the rule allows for federal health care providers to make financial arrangements with local transportation providers when carrying patients to and from the patient’s home for up to 50 miles in rural areas (air, luxury, or ambulance transportation excluded).

Funding Opportunities

AI/AN Health Equity Initiative – April 3.  Up to seven American Indian and/or Alaska Native organizations will be awarded federal funding of up to $350, 000 for programs that address the negative health impact of violence and substance abuse for AI/AN adolescents.  Studies suggest the incorporation of traditional cultures and engaging youth in Native teachings as an effective public health approach.  Successful applicants will implement promising practices for culturally-appropriate services and build capacity for healthcare professionals serving AI/AN youth.

Policy Updates

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Comment: Changes to Medicare Advantage and Prescription Drug Plan – March 3. CMS recently announced proposed changes to the Medicare Advantage (MA) and Part D prescription drug program, opening a 30-day public comment period. Proposed changes include a net increase to payment rates by 0.25% for an average revenue increase of 2.75%.  CMS also reminds rural MA organizations that they’re obligated to analyze enrollee data to identify disparities and need for increased preventive services and care. CMS will continue to implement policies for access to preferred cost-sharing pharmacies, including outliers in rural areas, which have been in place since 2016.  The final rate announcement and call letter will be published on Monday, April 3, 2017.

EHR Attestation Deadline Extended – March 13. CMS recently extended the deadline for hospitals, critical access hospitals (CAHs), and eligible physicians to attest their participation in the Medicare Electronic Health Records (EHR) Incentive Program. Attestation to the 2016 requirements for the program is required by March 13 to avoid a 2018 payment adjustment. The new deadline aligns with that for hospitals and CAHs to submit data for the electronic Clinical Quality Measure (eCQM) and the Hospital Inpatient Quality Reporting (IQR) Program. Of note for Medicare-enrolled rural practitioners, elements of the EHR Incentive Program will be consolidated into the new Quality Payment Program to streamline reporting and avoid redundant requirements. As a reminder for rural providers and hospitals that considered submitting hardship exceptions, the deadline to submit an EHR Incentive Program Hardship Exception application to avoid the 2017 Medicare EHR payment adjustment has passed. Email for questions.

Physician Quality Reporting Deadline Extended – March 13.  CMS recently extended the deadline for 2016 Physician Quality Reporting System (PQRS) Electronic Health Record (EHR) Submission.  Rural providers including individual eligible professionals and PQRS group practices as well as qualified clinical data registries and qualified EHR data submission vendors now have until March 13, 2017 to submit 2016 EHR data. For more information visit CMS’s PQRS webpage.

Beneficiary Engagement and Incentive Models. CMS is seeking provider participation in two new models from the CMS Innovation Center that will increase patient engagement in care decisions by putting more information in the hands of Medicare beneficiaries.  The Direct Decision Support (DDS) Model under the Beneficiary Engagement Model (BEI) will test whether engaging beneficiaries outside the clinical setting will inform and empower their health care decisions. CMS will partner with up to seven Decision Support Organizations (DSOs) to provide direct decision support to at least 100,000 Medicare beneficiaries in a geographic region (e.g. state and/or region). Engaged beneficiaries will interact with decision support mechanisms such as web-based tools, decision support via telephone, and/or mobile e-health applications throughout the course of the model, which could be useful in rural areas.  Also under BEI, the Shared Decision Making (SDM) Model will test integrating a structured four-step shared decision-making process into the clinical practice of Medicare Shared Savings Program (MSSP) and Next Generation Accountable Care Organizations (ACOs). The shared decision-making process is a collaboration between the beneficiary and the practitioner.  CMS plans to operate and provide financial support for the SDM Model in 50 ACOs nationwide.  Letters of Intent for both models are due March 5th.

Resources, Learning Events and Technical Assistance

Annual MIPS Call for Measures and Activities – Thursday, February 16th, 10:30 – noon ET. Providers and quality measurement stakeholders can learn more and ask questions on how to submit measures and activities for three of the four MIPS performance categories.  CMS quality measure selection is a rigorous process requiring stakeholder input on specifications, related research, and background for CMS to review and consider. This information is necessary to determine whether or not the quality measure is applicable to clinicians as well as feasible, reliable, and valid at the individual clinician level and that they are evidence-based and scientifically acceptable.

Application Assistance: NURSE Corps Loan Repayment – Thursday, February 16, 7:00 – 9:00 pm ET.  NURSE Corps supports registered nurses, advanced practice registered nurses, and nurse faculty by paying up to 85 per cent of their unpaid nursing education debt. HRSA’s Bureau of Health Workforce will hold its second technical assistance call to provide help with applications due February 23.

Understanding Chronic Care Management Services – Tuesday, February 21, 1:30 – 3:00 pm ET. Health care professionals who are interested in or currently billing chronic care management (CCM) services to Medicare can learn about a new campaign to help providers and patients understand the value of CCM and encourage its adoption. New coding and separate payment for CCM services were adopted in 2015 as part of the Physician Fee Schedule final rule.

Controlling Tobacco Use in Rural Areas – Wednesday, February 22, 3:30 – 5:00 pm ET.  This free webinar will feature examples from Oklahoma and Mississippi of how state health departments can collaborate with local health departments in rural areas to deliver tobacco control resources and messaging to rural populations, highlighting efforts that combat the use of smokeless tobacco.  The event is hosted by the Association of State and Territorial Health Officials and the National Association of City and County Health Officials.

The IMPACT Act in 2017  – Thursday February 23, 1:30 – 3:30 pm ET.  CMS will host a teleconference followed by a question and answer session to discuss what to expect in 2017 for the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act).  Implemented in 2014, the IMPACT Act requires reporting of standardized patient assessment data by Post-Acute Care (PAC) providers, including skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and long-term care hospitals.

Approaching Deadlines

Opioid Help for Women Letters of Intent – February 16
NURSE Corps Loan Repayment Program – February 23
Request for MACPAC Nominations – February 24
AHRQ Seeks Information From Healthcare Delivery Orgs – February 28
Comment: Changes to Medicare Advantage and Prescription Drug Plan – March 3
Direct Decision Support (DDM) Model Letters of Intent – March 5
Shared Decision Support (SDM) Model Letters of Intent – March 5

Black Lung Clinics Program (BLCP) – March 6
Radiation Exposure Screening and Education Program –  March 6
Black Lung Center of Excellence (BLCE) – March 6
Request for MedPAC Nominations – March 10
Physician Quality Reporting Deadline Extended – March 13
EHR Attestation Deadline Extended – March 13
New Deadline for Hospital Data Submission – March 13

Broadband Service for Rural Communities – March 13
Community Facilities Program – Ongoing