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HBS Update - January 14, 2016

Essential Community Provider petitions are due by Friday

One important notice that ALL RHCs should be aware of is the Essential Provider Petition process deadline has been extended to January 15, 2016. Please review and complete this process immediately. HHS announced the extension of the Essential Community Provider (ECP) Petition deadline for entities to submit their petition to be on the 2017 list of Essential Community Providers until January 15, 2016.  

Here is some general information:

Tools to help you Confront Change
Ch-ch-ch-ch-changes  (Turn and face the strange)
With the passing of David Bowie this week one of the musical icons of my youth is gone. Being a child of the 70's his music served as a soundtrack to a misspent youth. Many of the songs struck a chord. Especially the song Changes which came out when I was about 12 or 13. Remember the awkwardness of Junior High. Yeah, that paints a pretty grim picture.  But over time we learn to accept changes and sometime even thrive in an environment of change. If you are a healthcare provider or a rural health clinic administrator you know too well the feeling of facing the strange to quote the Bowie song. In this article we will look at the changes affecting RHCs in 2016 and how you can find out and prepare for the changes.
CMS Rural Health Clinics Center Website
First, it is difficult to prepare for change if you are not aware it exists. Just as Bowie sang about Ground Control calling Major Tom in a space ship in Space Oddity, Ground Control in this case is CMS (Centers for Medicare and Medicaid Services) our RHCs are Major Tom to push the metaphor. Both parties need to communicate with each other or we become lost in space with nothing that can be done. So how does Ground Control (CMS) communicate with us changes to the RHC program? Thankfully, they have a window into their control center called the rural health clinics center. This is the first place I look to find communication from CMS on changes to the RHC program. On this website you will find the latest on billing, regulations, enrollment, certification, resources, and up to date information. Remember to print this site or copy the information in some type of electronic form if it has something useful as it changes often. The spotlight section is very important as it provides information on billing changes. Last month for example it included how to bill for chronic care management and this month it has how to bill Advanced Care Planning. Go ahead get lost on the site. You are bound to learn about rural health clinics. Here is the link.
Here for example is the spotlight section of the website as of January 12, 2016.
  • Effective January 1, 2016, RHCs will be able to bill for Chronic Care Management (CCM) services when all CCM requirements are met. See MM9234 [PDF, 94KB] .
  • Effective January 1, 2016, Advanced Care Planning (ACP) will be a stand-alone billable visit in a RHC.
  • Effective April 1, 2016 all RHCs, including those exempt from electronic reporting, will be required to report HCPCS and other codes as required on RHC claims to Medicare.
CMS Medlearn Matters Website
CMS communicates regulatory changes to the Medicare program through transmittals and memorandums. The team at Medlearn Matters has a goal of communicating those transmittals and memorandums in easily understandable communications to providers. The Medlearn Matters Articles are archived by year and are searchable by provide type (ie. Rural Health Clinic). This site is important to monitor for changes to reimbursement and how to actually bill for those services (ie. The announcement that venipuncture (CPT 36415) was now a part of the RHC benefit and not billable to Medicare Part B was made in an MLN Matters Article in November, 2013).
Here is the link to the website:

Some of the major announcements from Medlearn Matters recently are accumulated in this table.
Chapter 13
Chronic Care
Cost Report
UPL = $81.32
Medlearn Matters also produces a weekly newsletter that is full of links to valuable information for every Medicare provider called MLN Connects Provider News. The link below is to the most recent issue and includes a link to subscribe to this valuable newsletter.

Medlearn Matters also produces Fact Sheets on just about every subject that Medicare is in involved. Just Google whatever the subject matter you are looking for with the words "Medicare Fact Sheet" and you will typically find a concise, understandable document about the subject matter that you are interested in. For example,searcfor Rural searched Rural Health clinics, you would find this RHC Fact Sheet:
CMS Rural Health Open Door
CMS offers Rural Health Open Door teleconferences every six weeks or so. The next one is scheduled for Thursday, January 14, 2016 at 2:00pm is as follows: Announcements & Updates; RHC and FQHC Updates; CMMI Accountable Health Communities Model Update.  This agenda is subject to change. If you wish to participate, dial 1-800-837-1935 Conference ID 37066618. Here is the website for more information.
RHC Technical Assistance Webinars from HRSA and NARHC
HRSA and the NARHC have partnered for many years providing technical assistance to Rural Health Clinics through teleconferences and webinars. These presentations are archived and assessable from the HRSA website. The next next call/webinar will be held on Tuesday, January 19th from 2:00pm - 3:00pm EASTERN.  The call/webinar will be on the new Chronic Care Management (CCM) benefit and how RHCs and their patients can benefit from this new service. To participate on the call, phone 1-800-779-1416 and use the passcode 4343459. Here is a link to the archives of previous calls and webinars:

National Association of Rural Health Clinics
Of course there is the National Association of Rural Health Clinics which is the voice of RHCs in Washington, DC. The NARHC offers two institutes each year in the spring and fall which provide invaluable updates and in-depth information for rural health clinic administrators and providers. Here is a list of upcoming events with the next one occurring in San Antonio, Texas on March 14th to the 16th. Here is the link to information on the conference including an agenda and the costs: NARHC Spring Institute - March 14-16, 2016.
If you cannot make the conferences, there is the List Serve that provides timely information and updates as well as an opportunity to ask questions and submit feedback to other RHCs throughout the country. If you are not familiar with what a list serve is it is a mail list which allows its members to communicate through email posts. To post a question on list serve, you must first be signed up on the list serve. To sign up for list serve, click here. The list serve is free to join.
However, remember RHCS need representation on a national level. The numbers bear out that RHCs/FQHCs are the most cost effective way to provide healthcare to vulnerable populations. That story needs to be told and your membership in the NARHC will help tell that story.
There you have it. A lot of resources to help you stay abreast with change. David Bowie has done his part to change the world through his music and cultural influence on generations (Where is that Ziggy Stardust costume hidden in the confines of my closet). We still have a lot of work to do. RHCs exist to provide healthcare to people in rural and underserved areas and we have been doing our mission well. However, with the added pressures of hospital closings due to unintended consequences of the ACA (Affordable Care Act), RHCs are being called upon more than ever to change the way they fit in the provision of healthcare to vulnerable populations. The mission is difficult and the resources few. Hopefully, this article will help you to find and seek out the information and guidance you require to plot your path to success in this new and turbulent environment we call healthcare in 2016. If you need help, please give me a call or text at 423.243.6185 or email at
Avoiding Deficiencies in Rural Health Clinic Surveys
Thursday, January 14, 2016  

Listeners will learn what to avoid and how to avoid deficiencies on survey day. Kate Hill and Gail Nickerson have joined together to bring you an hour of good solid learning about Rural Health Clinics surveys. Gail is the President of the California Association of Rural Health Clinics and Vice President of the National Association of Rural Health Clinics group and Kate is the Director of the Rural Health Clinic program at The Compliance Team and a National Association of Rural Health Clinics board member. Together they will present you with real world scenarios of deficiencies in the clinics and how to help your clinic avoid those deficiencies. 

Target Audience: Critical Access Hospital Chief Executive Officer, Chief Nursing Officer, Director of Nursing and Rural Health Clinic providers and staff. 
FY 2016 Small Health Care Provider Quality Improvement  Grant Program 

The Federal Office of Rural Health Policy is pleased to announce the release of the FY 2016 Small Health Care Provider Quality Improvement  Grant Program (announcement number: HRSA-16-019).  Application materials are available at: 

The purpose of this funding opportunity is to provide support to rural primary care providers for implementation of quality improvement activities. 
Applicants may request up to $200,000 per year for up to three years.  The deadline to apply is March 4, 2016.  Applications must be submitted electronically at .   

There will be a live technical assistance webinar on Tuesday January 19, 2016 at 2:00 PM EST to assistapplicants in preparing their applications.  The webinar will be recorded.
To participate on the webinar, use the following:

Audio 1-888-603-9222, passcode: 5381444 
For further questions on this funding opportunity, please contact Ann Ferrero at:

Our Partners and what they do



Contact & Phone Number

HPSA Acumen
National Health Service Corp Loan, HPSAs, and MUAs
Joseph Lampard

(716) 483 - 0888

Rural Behavioral
 Health, LLC
Mental Health Services
Dave Jolly
(423) 243-6185
Heart Watch Wellness

& Weight Loss

Dan Haye
(615) 732-0768
AMS Software
RHC Software 
and Services

Matt Kannan
(800) 440-6949

Care 24 / 7
Chronic Care Management
Huy Nguyen, MD
1 (800) 218-3780

 Please use referral code HBS with these partners for special pricing or offers

Healthcare Business Specialists
RHC Cost Reports, Annual Evaluations, Chronic Care Management, Mental Health Services, Preventive Health services including weight loss programs, RHC Seminars and webinars, and Startup consulting for new RHCs. Please call or text Mark R. Lynn, CPA (inactive) at 423.243.6185 or email Please visit our website at for more information.

T hank you for reviewing this information and your confidence in us to assist you with your cost report preparation, annual evaluations, RHC startups, and RHC education. We look forward to seeing you at one of the conferences, seminars, or webinars in the near future.


Mark R. Lynn, CPA (Inactive)
Healthcare Business Specialists, LLC
Suite 214, 502 Shadow Parkway
Chattanooga, Tennessee 37421
Telephone: (423) 243-6185