Category: Health Center Regulatory Issues

Health Center Regulatory Issues

Regulatory Affairs: A Year in Review

NACHC’s Regulatory Affairs Department has seen a lot of action over the last year, with many important regulations and guidances released and the addition of new staff.  Below are some of our highlights from 2015: We welcomed a new Director of Regulatory Affairs! As many of you know, Roger Schwartz, the former Director of the …

Health Center Regulatory Issues

NACHC submits Medicaid Managed Care Comments

On July 27, NACHC submitted our final comments on the CMS Proposed Rule on Medicaid Managed Care. We encourage you to review our  final comments in full. We would like to thank everyone who provided feedback on our draft comments, with a special thanks to those who submitted comments to CMS on behalf of their organization. NACHC is also currently reviewing several other …

Health Center Regulatory Issues

Request for Comments on CMS Medicaid Managed Care NPRM

NACHC is pleased to share our draft comments on the recent CMS proposed rule on Medicaid managed care. This rule is the first time since 2002 that CMS has proposed to update the rules governing Medicaid Managed Care Organizations (MCOs.)  As such, it touches on a broad range of issues of direct relevance to health centers and their …

Health Center Regulatory Issues

What We Are Reviewing This Week

We wanted to let you know about several rules that NACHC is currently reviewing with upcoming comment deadlines.  Please be on the lookout for more information on our draft comments as the comment deadlines approach. Recently Submitted Comments: Department of Veterans’ Affairs Interim Final Rule on 40 mile driving distance calculation – NACHC comments CMS’ Proposed Rule on Stage …

Health Center Regulatory Issues

CMS Releases Final Rule on Accountable Care Organizations

Last week CMS issued its final rule on the Medicare Shared Savings Program and Accountable Organizations (ACOs).  This rule encompasses a number of important changes for the Medicare ACO program, which you can read about in the final rule and fact sheet.   While we are still going through the rule more thoroughly, we wanted to …

Health Center Regulatory Issues

Regulations NACHC is Currently Reviewing

We wanted to let you know about several rules that NACHC is currently reviewing with upcoming comment deadlines.  Please be on the lookout for more information on our draft comments as the comment deadlines approach. Recently Submitted Comments: Department of Justice proposed rule on FTCA de-deeming – NACHC submitted comments Currently Reviewing and Drafting Comments …

Health Center Regulatory Issues

Provider Enrollment Requirements for Writing Prescriptions for Medicare Part D Drugs

By: Alyssa Shinto, NACHC Intern  The Centers for Medicare and Medicaid Services’ (CMS) Medicare Learning Network (MLN) released an article regarding the authorization of CMS’s final rule on 2015 policy and technical changes to the Medicare Advantage and Part D programs. This final regulation requires physicians and other eligible professionals who write prescriptions for Part D …

Health Center Regulatory Issues

CMS Clarifies PQRS Penalties for Physicians at FQHCs and RHCs

We previously reported that providers that bill Medicare Part B for services outside the FQHC service package will be subject to the PQRS penalties, however, last week, CMS put out further clarification on this issue that we wanted to make you aware of. In a recent MLN Matters article, CMS clarified that the PQRS penalties …

Health Center Regulatory Issues

CMS Publishes Finals Rules for the Federally-facilitated Marketplaces; some Rural Health Clinics to Qualify as Essential Community Providers in 2016

On February 20, 2015, CMS released the finalized 2016 “Letter to Issuers” and final rule on “Benefit and Payment Parameters” establishing requirements for Qualified Health Plans (QHPs) to be sold in Federally-facilitated Marketplaces in 2016. NACHC previously submitted comments on both documents, which address network adequacy and payment rules. Among the issues impacting FQHCs directly, …

Health Center Regulatory Issues

CMS 2015 PQRS Payment Adjustments and Implications on RHCs/FQHCs

By Alyssa Shinto, NACHC Federal and Regulatory Affairs Intern On January, 26 2015, the Centers for Medicare and Medicaid Services (CMS) released a Frequently Asked Question document on the 2015 Physician Quality Reporting System (PQRS) Payment Adjustment and Providers who Rendered Services at Rural Health Clinics (RHC)/ Federally Qualified Health Centers (FQHC). We have heard …