NARHC-News: p ublished quarterly               Your RHC News Source                                 Fall 2016 Edition
Rural Health Clinics
Rural Health Clinics HCPCS Reporting  Not a Precursor to PPS Payment
On October 1, 2016 the RHC HCPCS reporting requirements changed once again. While NARHC believes the new process involving the "CG" modifier is an improvement from the previous "Qualifying Visit List" process, we understand that there are still issues with the new process. Most notably, we believe that the way RHCs are forced to report inaccurate charges will have negative long term implications and needs to be fixed.
We also wanted to take the time to address a notion that we have heard regarding what HCPCS reporting means for RHCs. It has been expressed by some that the purpose behind the HCPCS reporting requirements is to slowly move RHC Medicare reimbursement away from the All-Inclusive Rate and towards some sort of Prospective Payment System (PPS). This is misleading and not very accurate.       read more  
It is no news to any of us that the healthcare industry of the past several years has been filled with rapid change.  These changes always represent a new menu of acronyms for us to learn, such as UPIN, BBA, NPI, and HIPAA.  More recently, these have been PQRS, ICD-10, and QVLs among many others.  The operative acronyms this year are MACRA, MIPS, and APMs. 
Amidst all of the political noise which has been increasing in volume over the past 18 months, real change was affected by the President & Congress in passage of the  Medicare Access & CHIP Reauthorization Act . According to the CMS website: 
"The   MACRA   makes 3 important changes to how Medicare pays those who give care to Medicare beneficiaries. These changes create a Quality Payment Program (QPP).  read more
NARHC 2016 Fall Institute
OCT. 19-21 (W-F) -- Atlantis Casino Resort Spa -- Reno, NV
Conference --  App. 12 Breakouts, 21 Sessions
Are you unable to attend?  Be sure to add our next conference to your calendar: NARHC 2017 Spring Institute will be March 13-15 (Mon.-Wed.) in San Antonio!  See more info. on our website in December.  

In the meantime, you can purchase a Flash Drive of the Fall 2016 Speaker Presentations now! NARHC member discounted cost is $100. Non-member cost is more. If unsure of your member status, email or call 866-306-1961 for a quick lookup.  read more
FREE Benchmark Reports For
NARHC Members!

Now is the best time of year to request a FREE Benchmark Report of your RHC(s). This benefit is available exclusively to NARHC Member RHCs! The free report may be requested once a year. Data for the report is extracted from the Cost Report so not Pediatric-only practices who don't file a cost report won't be able to participate. CMS does not typically release the latest Cost Report data until Fall.

Participating in the RHC Benchmark Report©  will enable your organization to benefit from both state and national data and knowledge of other rural health clinics. This data will assist you in analyzing the strengths and weaknesses of your RHC (e.g., facility and personnel costs, visits, staffing, and other key performance metrics) and enable you to make informed decisions to improve the operations of your organization.    read more
NARHC Membership Sale

If your clinic is a 1st-time NARHC member, join now to receive the remaining months of 2016 (free) plus all 12 months of 2017 for the one-year price! The 1st-time rate is also discounted! Associations, Consultants and Governmental entities are also welcome to join, however, the sale is just for 1st-time RHCs. For rates see the Membership Application. If unsure of member status, email or call 866-306-1961 for a quick lookup.

NARHC also offers a group discount (add. RHCs after the first join for $130 ea.) & discounted Joint Memberships with 3 State Assns (CA, MO, TX)!  
Renewal Memberships for existing NARHC members will be billed in Dec.   read more
2017 Code Books For Sale

The Association of Rural Health Professional Coders (ARHPC) is excited to announce a new Code Book partnership with NARHC!  Take a look at our selection of 2017 Code Books available at exclusive, discounted, pre-sale prices!

$99......2017 CPT® PROFESSIONAL EDITION, Spiral-Bound (CPT-AMA17) 
$70......2017 ICD-10-CM FOR PHYSICIANS, EXPERT, Spiral-Bound (17-ICD10CM)
$70......2017 ICD-10-PCS, Softbound (ITPC17)
$60......2017 HCPCS LEVEL II EXPERT, Spiral-Bound (17-HCPCS)
Changes to the FLSA Overtime Regulations
The final rule changes to the Fair Labor Standards Act (FLSA) Overtime Regulations were published on May 23, 2016, and will become effective on December 1, 2016. It is anticipated that as many as 4.2 million workers across the country may now be eligible for overtime pay within the first year of implementation. The Department of Labor (DOL) estimates that employers will spend $592.7 million to prepare to comply with the new rule, which includes time spent becoming familiar with the current regulations and making adjustments to policies and procedures and the related managerial costs. The impact is significant and affects all industries.

Why the Changes to FLSA?   In March 2014, President Obama issued a memorandum to the Secretary of Labor indicating that the  "regulations regarding exemptions from the Act's overtime requirement, particularly for executive,  administrative, and professional employees ("EAP," often referred to as the "white collar" exemptions)  have not kept up with our modern economy. Because these regulations are outdated, millions of Americans lack the protections of overtime and even the right to the minimum wage." President Obama then issued a Presidential Directive to "propose revisions to modernize and streamline the existing overtime regulations."      read more
Closing the Documentation Gaps
in Your EHR

Documenting accurate health care data is important to both practitioners and patients, because as we've all heard, "if it isn't documented it isn't done". Reimbursement regulations require correlating notes to billed services, and patients expect accurate, compiled health records. With the adoption of EHRs, the resulting document can compile so much data that a one page SOAP note is now six pages, including a variety of demographic and historical information not necessarily reviewed by the provider generating the final document.  The practitioner may not recognize items missing.
Checking for Documentation Gaps in your EHR -  To maximize the potential of an EHR and for patient safety, it's important to ensure there are no documentation gaps, and that what is captured in the EHR is consistent with the document produced. To avoid being caught with vital, trapped data in the chart, we recommend performing a documentation gap analysis.    read more
What's in a Record?

Regardless of the size or complexity of your organization, you are likely to be faced with the issue of determining the difference between a Designated Record Set and a Legal Health Record.  Both serve a purpose in your organization, and it is prudent that your organization identify the difference in advance.
A legal health record is the business record generated at or for a healthcare organization. It constitutes the official business record of an organization for evidentiary purposes.  It is the record that would be released upon receipt of a request.  The legal health record is the officially declared record of healthcare services provided to an individual delivered by a provider and serves to...    read more  
October 2016 CPT® & HCPCS® Revisions

Every October 1st, the beginning of the new federal fiscal year, brings with it additions, revisions and deletions of HCPCS ® codes--some of which we more commonly call CPT ® codes. In the RHC community, we are still getting our heads around the HCPCS ® reporting on our UB-04 claims and the new use of the CG modifier to identity the qualifying visit code and trigger our AIR payment.  Plenty has been written about these changes in our TA calls and on the Listserve. However, there are a few other code changes which may matter to you as well. Make sure that your practice management systems and EHRs have been updated in order to report any code changes.

Last year CMS granted a one-year grace period giving providers the flexibility to code within the correct "family of codes" without any consequences in reimbursement if the code assignment did not reflect the highest level of specificity as clinically documented.  read more  
Rural Health Clinic Program Changes

Here are just a few suggestions to stay abreast of the ever-changing RHC rules, regulations & interpretations:
  • Become a NARHC member! RHCs & Non-RHCs may join. CLICK HERE
  • Sign up to receive NARHC Newsletters (4x a year) such as the one you are reading (if this newsletter has been forwarded to you).
  • Join one or both List Serves. The NARHC-News List Serve is our blog where anyone can post and anyone can answer. Our administration monitors & jumps in if we see wrong answers going out. You may get up to 6 emails a day if the topic is a hot one. Prefer not to get that many emails?  Still want to know about Free Trainings & Announcements? Join the Technical Assistance List Serve.  
  • Visit the NARHC website frequently: News and Legislative Updates.
  • Like us on FaceBook!    
In This Issue
Quick Links
Upcoming Events
NARHC 2016 Fall Institute
Oct. 19-21, 2016 (W-F)
Atlantis Casino Resort Spa
Reno, NV
Click here for   more info.

NARHC 2017 Spr Institute
March 13-15, 2017 (M-W)
Hyatt Regency Riverwalk
San Antonio, TX
Watch for more details in Dec.
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