NARHC-News | Spring 2019
RHC Articles in This Newsletter

• RHC Legislation Introduced in the Senate
• Synopsis of the RHC Modernization Act
• New NARHC Member Benefit
• Be a Part of the Discussion
• NARHC Board of Director Candidates Sought
• Certified RHC Professional Course (CRHCP)
• 2019 NARHC Fall Institute
• Nominations Sought for Ron Nelson Award
• Claim Rejection & Denials Effective April 1st
• Rural Health and Care Management
• Medicare Cost Reports-Time to Start Paddling
• Debunking Common Myths Hurting Providers
• What's Considered Rural? My Address Absent
RHC Legislation
Introduced in the Senate

WASHINGTON, DC - On April 4 th , Senator John Barrasso (R-WY) and Senator Tina Smith (D-MN) introduced The Rural Health Clinics Modernization Act (S. 1037). The legislation provides important regulatory relief, aligns federal and state scope of practice rules for Physician Assistants and Nurse Practitioners in rural health clinics, & improves Medicare reimbursement for rural health clinics subject to the upper limit.
“As a doctor from a rural state, I want all patients to have access to high-quality care wherever they live,” Sen. Barrasso said. “Rural health clinics have a long record of making sure that folks in rural communities receive primary care close to home. I am proud to help lead this bipartisan effort to strengthen rural health clinics so they will continue to serve patients in Wyoming and across rural America.”  Read More  
Coming Soon!
New NARHC Member Benefit

NARHC has a brand new member benefit rolling out in June!

This Introduction to RHCs course is FREE to NARHC members! It can be purchased for $50 by non-members. Click on picture to see a brief video. Email to check if your RHC is already a NARHC Member. For membership benefits, etc. Click Here
Be a Part of the Discussion

Take part of RHC discussions with your peers. Subscribing is easy!
NARHC offers 3 different Forums: 

NARHC-News : anyone can post, anyone can answer. This forum is used to post helpful information for other RHC staff as well as ask questions you may have regarding operating your RHC.

Technical Assistance:  This is a one-way communication tool from. NARHC staff as well as the Federal Office of Rural Health Policy posts breaking legislate news and updates, upcoming FREE technical assistance webinars and trainings and more! 

Consultant-News : This forum is for NARHC member consultants only to ask questions of each other and discuss many important RHC topics in a private setting. If you are interested in member benefits as a consultant, please contact us at 866-306-1961 x 1.

All forum posts are delivered directly into your email where you can choose to receive them as they are posted or in “digest” form (daily or weekly). In order to subscribe to either Forum, you must have an account on the NARHC website. There is no charge to set up an account and you DO NOT need to be a NARHC member to create an account. Many of you already have a NARHC account because you are a member or engaged in some type of transaction with the Association. Read More
Throw Your Hat in the Ring
2020 NARHC Board of Director Candidates Sought

If you would be interested in running for the 2020 NARHC Board of Directors, we're looking for a few dynamic leaders!

There will be 4 openings (and just 1 incumbent running) for the 3-year term that starts Jan. 1, 2020. These positions are voted upon by the NARHC membership at the Annual Meeting held in St. Louis in Oct. & via absentee ballot beforehand.

You must be affiliated with a current NARHC member RHC or organization in order to run and serve. Application deadline is June 30. Read More
Next Session of NARHC's...
 Certified RHC Professional Course (CRHCP)
Registration Opens: August 1st
In-Person Final Exam in St. Louis on Oct. 9

ONLINE TRAINING* will prepare you to successfully manage and run an RHC. Learn the latest information on RHC rules, regulations, and laws. Study nights, weekends, or whenever your schedule permits! Course takes approximately 30 hours. No prerequisite! Coursework is broken into 4 modules with video presentations & a series of short knowledge-based tests for each module. This course is designed to give you a well-rounded, ground level knowledge base of the major facets of RHC management. Read More

  • Module 1: Administration & Finance
  • Module 2: Billing & Coding
  • Module 3: Human Resources
  • Module 4: Regulatory Compliance & Quality
Register Now...
2019 NARHC Fall Institute
Hyatt Regency at the Arch, St. Louis, MO
Oct. 7-9, 2019  (M-W noon)  
The conference "for & about" RHCs
17 Speakers, 18 Sessions, 8 Breakouts

RHC & Billing Basics
Cost Report Basics
Survey & Certification 

Washington Update
Advocacy for RHCs
Medicare Bad Debt
Advanced RHC Billing
Is It A HIPAA Breach?
History of Opioid Addiction
Policy & Procedure Manual
Incorporating Quality in Your RHC
Provider Based Rules & Compliance
Creating a World Class Vision for RHCs
How to Maintain Compliance & Pass Survey
RHC Mgm & Develop a Practice Mgm Toolbox
What Does the Future Hold for E & M Services?
Integrating Different Services in Your RHC (Telehealth, Oral Health, Specialists)
Conducting the Annual RHC Evaluation & Emergency Preparedness Read more
Nominations Sought for NARHC's Highest Honor:

NARHC's Annual Award recognizes and honors an outstanding leader and promoter of Rural Health Clinics in the spirit of Ron Nelson. Nominate individuals who have dedicated their time and talent as he did to advancing the health and well being of others through the RHC program.

Nominations will be accepted from NARHC members through June 30th. Recipients though do not have to be NARHC members. This sign of our deep appreciation and national distinction will be awarded at the NARHC Annual Meeting in October. Learn more about this outstanding man, his accomplishments & the award: Read More
Claim Rejection & Denials for Providers on the Preclusion List

Summary: Effective April 1, 2019, Medicare Advantage (MA) and Part D plans will begin rejecting or denying claims submitted for payment for Part D drugs and MA services and items prescribed or furnished by an individual or entity on the Preclusion List. This effort supports CMS’ commitment to safeguarding patients and taxpayer funding.
Background In April 2018, CMS finalized CMS-4182-F, (Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program), which rescinded the enrollment requirements for Medicare Advantage (MA) and Part D providers and prescribers and replaced it with the Preclusion List.

The Preclusion List consists of individuals and entities that fall within either of the following categories: Read More

Rural Health and Care Management

The application of value-based care programs within the healthcare system continues its expansion throughout the country, with the intent of achieving the “triple aim” of improved health, better care and lower costs. Not surprisingly, the institution of these programs seems to lag behind in many of the United States rural communities. However, programs like Chronic Care Management (CCM) are tailor-made for a rural population – here are a few reasons why:

  Rural areas encounter higher rates of chronic conditions.  A 2017 study from the National Center for Health Statistics reported that rural residents have higher rates of multiple chronic conditions than urban residents (3.7% more with 2-3 chronic conditions) and higher rates for a majority of the most common chronic conditions (high cholesterol – 3.6% greater, hypertension – 5.5% greater, diabetes – 1.6% greater, arthritis – 6% greater). The heightened occurrence of chronic conditions combined with a higher concentration of elderly inhabitants in rural areas further exposes the issue. This leads to the next logical yet formidable statistic…   Read More

Medicare Cost Reports – It’s Time to Start Paddling

When I was young, a group of college friends went whitewater rafting. All of us played on either the football or basketball team and our bravado vastly exceeded our abilities most of the time. This was one of them. We choose to not use a guide while rafting down the rapids used in the 96 Olympics. The result was a bunch of very wet football and basketball players and a half-drowned shrimp of a field goal kicker. (we found him about 500 yards downstream). Years later, my wife and I went down the same river and her being much wiser and sensible insisted we have a guide to raft the river. The trip as can be expected went without incident. The guide told us when to paddle and when to coast and we strategically weaved our way through the boulders, railroad trestles, and rapids with ease .

We guide many Rural Health Clinics through the cost reporting process and as your guide my recommendation is “It’s time to start paddling.” Most independent RHCs are on a calendar year-end which means their cost reports are due on May 31 st of each year. We have basically 6 weeks to get everything necessary to file your cost reports and incorporate the many cost reporting changes due to the implementation of CMS-222-17 (the first major change in cost reporting forms in 25 years) into the cost reports. Read More

DeBunking Common Myths

Rural communities are on the brink of a healthcare epidemic. With nearly 20% of rural hospitals at a high-risk of closing due to insolvency, providing quality patient care isn’t the only thing lost in a healthcare desert. These financial strains impact much more than the facility, they impact the community the hospital serves.

According to the 2019 Rural Health IT Survey , declining reimbursements are the number one challenge that rural health facilities are facing. The number three challenge is improving billing processes and managing denials. With this in mind, let’s take a look at three revenue cycle management (RCM) myths we commonly hear and see how they are impacting revenue.

Myth #1: Patients are only a small portion of payer mix. Read More

What is Considered Rural?

Determining whether your clinic is rural or urban is not always cut and dry. If your desired site location is not showing up in American FactFinder, then you will need to advocate that the site is, in fact, rural by CMS standards. It is ideal to have the documentation in order before your site survey so that you know your work to become an RHC is justified and all of the legwork you just completed is not for the birds.

We hear about this issue from clinics that are not only new to the RHC program, but also clinics that have to move due to fires, flooding, landlord issues, size limitations, etc. In some cases, the potential site is in a current HPSA or MUA, but the address cannot be found to determine rural status.   Read More
Consultant members of NARHC may contribute articles to the quarterly NARHC-news.
Email for more information & include your topic idea!
National Association of Rural Health Clinics | NARHC | Ph. 866-306-1961 | Fax 866-311-9606
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