Category: Health Center Regulatory Issues

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 …

Health Center Regulatory Issues

Medicaid Fee Bump Expires in 2015: The Impact on Primary Care Provider Payments in States

Due to concerns over physician reimbursement rates in Medicaid and the reported effect on participation of providers, the Affordable Care Act (ACA) included a mandatory two-year increase in Medicaid fees for primary care services by eligible providers to Medicare rates.[1] This increase, fully funded by the federal government, was approved to take effect on January …

Health Center Regulatory Issues

HRSA Webinar on Annual Recertification for 340B Covered Entities

We wanted to let you know about an upcoming webinar with HRSA’s Office of Pharmacy Affairs on the annual 340B Recertification Process.  Please see the details of the webinar below.   Should you have any questions about the webinar or the recertification process, you can contact the Prime Vendor Program at 1-888-340-2787 or ApexusAnswers@340bpvp.com. The Health …

Health Center Regulatory Issues

Electronic Health Records Incentives and Meaningful Use Penalties- A New Round of Questions Answered

Recently, we have received several inquiries from health centers regarding Electronic Health Record (EHR) Incentives and “meaningful use” (MU) requirements and penalties as prescribed in the HITECH Act. As most health centers will recall, due to the more generous benefits available under the Medicaid incentive program, virtually all eligible health center providers opted to participate …

Health Center Regulatory Issues

HRSA Issues “Frequently Asked Questions” to Clarify Certain Aspects of the Sliding Fee Discount Program Policy

In keeping with recent trends pertaining to the issuance of new policies and guidance, the Health Resources and Services Administration (HRSA) recently issued Frequently Asked Questions (FAQs) to clarify certain aspects of PIN 2014-02: Sliding Fee Discount and Related Billing and Collections Program Requirements. While some of the FAQs appear to reiterate the requirements set forth …

Health Center Regulatory Issues

HRSA Issues Revised Site Visit Guide to Include Requirements from New Policies

HRSA Issues Revised Site Visit Guide to Include Requirements from New Policies On November 24, 2014, the Health Resources and Services Administration (HRSA) issued a revised Health Center Program Site Visit Guide (the Guide), effective December 1, 2014. The updated Guide incorporates revisions and clarifications that were initially included in several HRSA policies and guidance …

Health Center Regulatory Issues

HRSA Completes Analysis of Scope Alignment Validation Submissions and Announces Next Steps

In its Primary Health Care Digest dated November 19, 2014, the Health Resources and Services Administration (HRSA) announced that it had completed its analysis of the Scope Alignment Validation (SAV) submissions and is ready to take the next steps in the process to correct health centers’ scope of project forms (Forms 5A and 5B), consistent …