2017 NARHC-News                       Your RHC News Source                     Fall 2017 Edition
NARHC's Certified RHC Professional™

It's finally here!!!    Registration opens on Thursday, Dec. 1 , for NARHC's new online course designed to teach Clinic Directors, Administrators, and other RHC Professionals how to run a successful RHC!  We are accepting the first 50 who register and pay, so don't delay. 
This 6-8 week course may be taken at your convenience (nights, weekends, etc.) as long as the coursework is completed before you attend the 2018 NARHC Spring Institute (a requirement).  Those with no prior experience may need 8 weeks.  An in-person exam is scheduled in San Antonio the day before the conference (Sun., March 18, 3-5 p.m.). The coursework is broken into 4 modules with optional videos & pre-tests at the end of each: 
  • Administration & Finance
  • Billing & Coding
  • Human Resources
  • Regulatory Compliance & Quality          Read More
PQRS Questions & Answers

QUESTION:   I received a letter recently from CMS that states we did not perform the PQRS and will now be receiving a 2% reduction for all future Medicare Part B payments. I understood I didn't have to participate, and was somewhat shocked to receive that letter. 
We are an independent RHC & only perform as a Rural Health Clinic.  I was sure that for the past couple of years we were told that as a RHC we did not need to participate in this program. I was informed that there was no exception for RHC and that we would be receiving the reduction.  My consultant believes that, while we are not exempt from the penalty, the work/expense in keeping up with PQRS was worse than the 2% cut.
ANSWER: RHC claims (those submitted on the UB-04 claim form) are NOT subject to PQRS adjustments.  This program applies to claims submitted using a 1500 claim form.   Read More
Early Bird Rates Right Now!
Hyatt Regency Riverwalk -  San Antonio, TX

Mar. 19-21, 2018 (Mon.-Wed.)
A Conference "for & about" RHCs!

23 Speakers,  21 Sessions, 10 Breakouts
Featuring Capt. Corinne Axelrod from CMS!

PRECONFERENCE:  App Tutorial; RHC Basics & Beg. Billing; Cost Report Basics; Compliance Basics.

CONFERENCE: Emergency Preparedness Risk Assessment;  Care Management; Legislative Update; Putting It All Together: Annual Meeting + Emergency Plan; RHC Round Tables with the Experts; Advanced Billing; Power, Change, Conflict Mgm & Leadership; PCMH & Other Innovations; HIPAA Case Studies; Advanced Cost Reporting; Document & Select Outpatient Levels of E&M Services; Building Your RHC Quality Program; Policy & Procedure Manual; MAC Discussion: Novitas; How RHCs Fit in a Regional Health Network; Develop Your Practice Management Toolbox; Texas Session; and Audit Your Practice Like a CPA.

Room rates begin at $185/night! 
NARHC Membership Sale

Now is a great time to join or renew your membership!  Members receive free benchmarking, 10% off AAAASF & The Compliance Team certifications & recerts, $100 off NARHC conference registrations per person, $150 off Certified RHC Professional training, representation & your voice in Washington plus a host of other benefits!

If your clinic is a 1st-time NARHC member, join now to receive the remaining months of 2017 (free) plus all 12 months of 2018 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  admin@narhc.org  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
NARHC Policy Committee

The past year has brought a lot of uncertainty to health care policy. Here is a brief review of health care events since October 2016:
  • October 2016:  Polls indicate Hillary Clinton should win presidency which means that the ACA (Affordable Care Act) will be tweaked, improved, and expanded
  • November 2016:  Republicans sweep the election and many Washington insiders expect ACA repeal on day one of Trump presidency with a replacement to come later
  • February 2017:  Republicans now looking to repeal and replace the ACA at the same time, they hope to pass legislation by the summer
  • May 2017: House passes The American Health Care Act just weeks after their first iteration failed
  • July 2017:  Senate fails to pass their version of repeal and replace The Better Care Reconciliation Act
  • September 2017:  Senate reignites repeal and replace debate with Graham-Cassidy but that effort falls short
  • October 2017:  President Trump ends "CSR" Cost Sharing Reduction payments and signs healthcare executive order
As you can see, we have had a lot of politics and policy to grapple with over the past year. Simultaneously, RHCs had other things to deal with...          Read More
CDC Releases 2017 National Diabetes Statistics Report!

The Centers for Disease Control and Prevention (CDC) recently released updated statistics about diabetes in the United States.  The report includes prevalence and incidence of diabetes, prediabetes, risk factors for complications, acute and long-term complications, deaths, and costs.  Let's help focus our efforts to prevent and control diabetes across the nation.  

Diabetes Fast Facts
  • Total: 30.3 million people have diabetes (9.4% of the US population)
  • Diagnosed: 23.1 million people
  • Undiagnosed: 7.2 million people (23.8% of people with diabetes are undiagnosed)
Prediabetes Fast Facts
  • Total: 84.1 million adults aged 18 years or older have prediabetes (33.9% of the adult US population)
  • 65 years or older: 23.1 million adults aged 65 years or older have prediabetes
Here's a link to that full report:       Read More
Jurisdiction J Medicare Part A & B Contract Awarded to Palmetto GBA

CMS announced on September 8, 2017 the award of the Jurisdiction J (Alabama, Georgia, and Tennessee) Medicare Part A and Part B contract to Palmetto GBA.  Cahaba Government Benefit Administrators ®, LLC (Cahaba) has been privileged to serve the providers in these states for many years.  Palmetto GBA may be reaching out to you directly to open communications and introduce themselves. We will continue to work diligently to provide excellent service and will work closely with Palmetto GBA to ensure a smooth transition.  
As the details of the transition are solidified, Cahaba will be posting them on our website, and announcing them via our ListServ.   Should you need any of those details, please visit our website for updated information.  Thank you,
Provider Outreach and Education
Cahaba Government Benefit Administrators®, LLC
JJ A/B Medicare Administrative Contractor
5 Ways for Healthcare Providers to Get Ready for New Medicare Cards

Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft & protect essential program funding & the private healthcare & financial information of our Medicare beneficiaries.
CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards & in various CMS systems we use now. We'll start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.      Read More

What's New in CPT® for 2018?

Woo-hoo!  Of the approximately 200 new 2018 CPT/HCPCS ® codes, two of them were created just for RHCs and FQHCs.  How about that?  These two new care management codes G0511 and G0512 will be used to report Chronic Care Management (CCM), Behavioral Heath Integration (BHI) and Psychiatric Collaborative Care Model (CoCM).  Updated information on these services and use of the new codes can be found in CMS MM 10175. Deductibles and coinsurance amounts are applied to the care management services.
Chronic Care Management: Beginning January 1, 2018, CCM will be reported using HCPCS ® Code G0511. This code will reimburse at a higher rate than CPT ® 99490 giving us the average of the two CCM codes and the one general BHI code or $62.28 per month.  99490 will NOT be billable by a RHC for services after January 1st.   The same requirements exist for reporting CCM services under G0511 as were in place for reporting code 99490.          Read More
Disclosures to Avert Serious Threats
to Health or Safety

As a Rural Health Clinic (RHC), you disclose protected health information (PHI) throughout the day for treatment, payment, and health care operations (TPO).  These TPO disclosures do not require you to obtain an authorization from the patient.  Examples of treatment disclosures include when you draw a patient's blood work at your clinic, but you send the specimen to a reference lab to obtain the results. Similarly, you see a patient who needs to see a specialist, so you refer the patient to another provider.  This is also viewed as a treatment disclosure.  

Payment disclosures occur when you bill an insurance provider for care rendered.  For many RHC's, payment for care is obtained by billing Medicare Part A.  Healthcare operations disclosures are those management actions you take to administer your overall healthcare program.  Examples of healthcare operations disclosures include reviewing the competence or qualifications of your health care professionals, licensing or credentialing activities, conducting or arranging for medical review or legal services, as well as customer support to name a few.  Bottom line, you are permitted to use and disclose PHI for TPO without the patient's authorization.       Read More
In This Issue
Quick Links
Upcoming Events
NARHC 2018 Spr Institute
Mar. 19-21, 2018 (M-W)
Hyatt Regency Riverwalk
San Antonio, Texas
Click here for  more info  .
NARHC, 2 E. Main St., Fremont, MI 49412  |   Ph. (866) 306-1961  |  FAX 866-311-9606
Email: newsletters@narhc.org  |  Website:  www.narhc.org