NARHC-News: p ublished quarterly                 Your RHC News Source                                 Summer 2016 Edition
Rural Health Clinics
2017 Physician Fee Schedule Updates
On July 6th, the Centers for Medicare and Medicaid Services (CMS) released the 2017 Physician Fee Schedule (PFS) proposed rule . This is one of the major annual rules CMS uses to announce proposed changes to the Medicare program. Most notably for RHCs, this year's PFS makes numerous changes to the RHC Chronic Care Management (CCM) requirements, including changing the supervision requirement that we believe are welcome and should make it easier to implement CCM services.
Proposed Changes to CCM Requirements for RHCs:   The most significant change to the RHC CCM benefit is a change to the supervision requirement from direct to general supervision.      read more  
RHC Billing for Nursing Visits
Section 1861(aa)(1)(C) of the Social Security Act authorizes Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) located in areas with a shortage of home health agencies to furnish part-time or intermittent nursing care and related medical supplies (other than drugs and biologicals) by a Registered Professional Nurse (RN) or Licensed Practical Nurse (LPN) to a homebound individual under a written plan of treatment. The current evaluation and management codes for home health visits are not billable by RNs or LPNs furnishing RHC or FQHC home health visits.
Beginning with dates of service on or after October 1, 2016 , RHCs and FQHCs should bill Healthcare Common Procedure Coding System (HCPCS) code G0490 for these visits. HCPCS code G0490 will be paid as a visit...    .   read more
Early Bird Prices NOW...
NARHC 2016 Fall Institute
OCT. 19-21 (W-F) -- Atlantis Casino Resort Spa -- Reno, NV

The RHC Conference --   App. 12 Breakouts, 21 Sessions
AGENDA:Chronic Care Management; Medicare Incentive Payment Reform (MACRA, MIPS, APM); Getting Value from Your Back Office; Management Strategies for Hospital-Owned Medical Practices; Improving Your Revenue Cycle; RHC Billing (101 + Adv); Legislative Update; RHC Cost Reports (101 + Adv); Using Technology to Engage Patients & Improve Outcome; Data Governance & Requirements for Medical Records; Personnel Issues (from the Multi-Generational Divide); Insurance Credentialing & Provider Enrollment; Annual Evaluation & Peer Review; HIPAA Security Process (Hand-on Workshop);  The Role of an RHC Manager; Survey & Recertification; RHC Clinical Documentation & Coding: A Workflow Process.   

Room rates begin at $79 a night for a 4 star hotel (no kidding)!  Register EARLY for the conference & your room in the "NARHC" room block for the best rates. The block fills a month in advance! 
Registration now open  on the NARHC  website, click HERE Like us on Facebook to see pictures of the Spring Institute click HERE.   
Candidates Wanted for 4 Openings:

3-Year Term : January 2017-December 2019. Organization to which candidate belongs must be a current NARHC member. 

The ideal candidate will have leadership ability and extensive Rural Health Clinic knowledge. The candidate will assist in growing the NARHC Association Membership by being an advocate and it is hoped that he/she will cultivate a relationship with their particular State Association. We prefer candidates be located in a state not already represented on the Board.       read more
Ron Nelson Award Nominations Sought
NARHC Members are invited to submit NOMINATIONS for a worthy recipient of the Ron Nelson Award. This award recognizes and honors an outstanding leader and promoter of Rural Health Clinics. Please nominate an individual who has dedicated their time and talent to advancing the health and well being of others through the RHC program. Persons doing the nominating do have to be NARHC members but award recipients do not have to be NARHC members. 

This sign of our appreciation and national distinction will be awarded in Reno at the NARHC Annual Meeting on October 19, 2016. Nominations will be accepted until Aug 10. If you know of someone worthy of our recognition, please take a moment to fill out the nomination form.     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)
Chronic Care Management Fix

If you have been experiencing problems with your RHC CCM claims being paid incorrectly, the corrective action to "fix" the CMS claims processing system was scheduled to be installed on July 11th.

CMS has released the following statement, "Note that the MAC should automatically reprocess any CCM claims that were paid the incorrect amount and no refiling of the claims on the part of the RHC is required." 

Chronic Care Management Payment Correction for RHCs and FQHCs - 
Effective January 1, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) began receiving payment for Chronic Care Management (CCM) services.  read more
Meet Liberty, the Uber-like Service 

Many rural residents across the U.S. rely on public transportation for medical appointments, shopping and other necessities.  But distance and a limited number of providers can make this challenging. 

A startup in the  NMotion Accelerator  is changing that.  Liberty , a spinoff from  Integrated Global Dimensions (IGD) , is filling the gap through an Uber-like application that integrates with existing public transportation providers. "Our key solution is to improve mobility in rural areas by connecting various types of public transportation with a rural Uber version," said Valerie Lefler, President & CEO. "Our drivers can help improve service at night or on weekends, or when a public transit bus is on the other side of the county."    read more
Discounted Employment Screening

Castle Branch is pleased to offer NARHC member organizations a 20% OFF (or greater) discount on background screening, drug testing, employment verification, online HIPAA training and related services. Castle Branch works with a wide range of employers, more than half of the nation's colleges and universities, various not for profit organizations, healthcare institutions, law firms and others.
Castle Branch services are particularly useful in health care, ensuring employees are carefully screened to help reduce workplace violence, theft, & turnover as well as helping to ensure FCRA compliance. Castle Branch services are available online for applicant tracking with a fast turnaround time.     read more 
Adjustments Needed

Michael* suffered a stroke with paralysis in 2012. His needs were further complicated in 2015 when a car backed over Michael and his wheelchair. His family was not able to continue caring for him, so he had to change his home and doctors. His hospital bed needed adjustments after the move from Marysville, CA into his cousin Laura*'s home. Laura was herself a 44 year old patient of the Galt Rural Health Clinic (RHC) with many health issues of her own and required a lot of attention. At 62 year old, it seemed Michael's life was falling apart.
Michael's new doctor at the RHC was Mohiuddin Waseem, MD. Dr. Waseem's motto is "See your patients as if they are you or yours," and Michael liked him. Michael told him it was difficult to turn himself in his hospital bed. They decided a trapeze on the bed would help.     read more
HIPAA Audits Have Begun!
The healthcare industry's compliance regulations have enjoyed a period of relative obscurity. We are one of the highest regulated industries, yet some our most important regulations have been allowed to go unmonitored for over a decade. Since its inception, the government has complained that HIPAA has had no "teeth". This is because, prior to the Health Information Technology for Economic & Clinical Health Act of 2009 (HITECH), HIPAA was a reactive compliance program versus a proactive compliance program. 

Although HIPAA had been around since 1996 and was required to be implemented by 2005 (security rule), most organizations have not taken HIPAA seriously. This combined with the rapid adoption of technology in healthcare, raised some eyebrows and caused the government to allow for proactive audits of HIPAA compliance in covered entities & their business associates. read more
Billing Issues Within the RHC
There are still billing issues for RHCs. One of the most common is that the RHC is billing a procedure code and it is processing as a CO97 code. If this is happening to you, check to see if the procedure code you are using is on the Qualified Visit Code (QVC) List put out by CMS. Click read more below for the link.

Many times it is a code that will be covered effective 10/1/16. These claims for codes that are in italics on the QVC list, must be held in your system and billed on or after 10/1/16. Currently, all of the mass adjustments for claims that the MACs could not process have been adjusted. Thus, if your RHC still has claims that have not been adjusted you will need to call the RHC MAC. Beginning 10/1/16, the RHC will bill with a CG modifier on the line item that is the face-to-face service with the CPT code & the MAC will know, without a doubt, which line will be assessed the copays or deductibles. At the present time, make sure all your billers have the list of QVCs so they can put the applicable claims on hold that need to be.    read more

Health care services have traditionally been conducted through face-to-face exchange of information between provider and patient, but advanced technology has changed how, when, and where patient care can be delivered. For example, many patients prefer to communicate with their provider online, patient portals allow patients immediate access to their medical information, and providers can collaborate about patients via telemedicine, which has become a cost-effective alternative to face-to-face patient services.

The term "telemedicine" refers to the remote diagnosis and treatment of patients by means of telecommunications technology. For Medicare payment to occur, interactive audio and video telecommunications must be used, permitting real-time communication between the distant site physician/practitioner and the Medicare beneficiary. Commercial payers are beginning to follow Medicare payment guidelines and are also creating innovative ways of paying for health care services outside the scope of a traditional face-to-face encounter. You will need to review your payer contracts for the specific payment policies related to telehealth services.  
read more  
Medicare Learning Network Website

What's new:
  • Enhanced navigation - access the information you want faster
  • Improved organization - choose your preferred product type
  • Streamlined content - save time
The Medicare Learning Network (MLN) website has a fresh new look and improved navigation. Now it's easier to access MLN knowledge, resources, and training. Visit the new MLN homepage: click here
Progress in Acetaminophen Education

As a proud partner of the Know Your Dose  campaign, we're excited to highlight research showing that progress is being made to increase awareness of the safe use of acetaminophen-one of the most common drug ingredients in the United States.
According to a nationwide survey of 1,000 U.S. adult pain medicine users conducted by the Consumer Healthcare Products Association, consumer knowledge about how to use acetaminophen safely and awareness of its risks are at record highs. In addition, data collected from the National Poison Data System show a steady decline in unintentional exposures of acetaminophen, including dosing errors and accidental misuse, since a peak in 2009. 
     read more
In This Issue
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Upcoming Events
NARHC 2016 Fall Institute
Oct. 19-21, 2016 (W-F)
Atlantis Casino Resort Spa
Reno, NV
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