Rural Health Information Hub Latest News

CMS Updates Influenza Vaccine Payment Allowances for 2020-2021 Season

A new MLN Matters Article MM11882 on Influenza Vaccine Payment Allowances – Annual Update for 2020-2021 Season is available. Learn about payment allowances, effective August 1. The Medicare Part B payment allowance limits for influenza and pneumococcal vaccines are 95 percent of the average wholesale price (AWP), except where the vaccine is provided in a hospital outpatient department, Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC).  Payment for vaccine provided in these specific settings is based on reasonable cost. Annual Part B deductible and coinsurance amounts do not apply.

U.S. Reports 71,000 Drug Overdose Deaths in 2019

The Associated Press reported on July 15 that nearly 71,000 Americans died of drug overdoses in 2019, with fentanyl and similar synthetic opioids accounting for more than half, according to preliminary data released by the Centers for Disease Control and Prevention. Although some states, like Massachusetts, New Hampshire, New York, and Rhode Island saw declines, more than 30 other states showed rising overdose deaths. Read More.

Western PA Selected for “Operation Warp Speed” Trials

Hundreds of people in Western Pennsylvania will be allowed to participate in clinical research trials for COVID-19 vaccines, UPMC and the University of Pittsburgh announced last week. The trials are part of the COVID-19 Prevention Network and Operation Warp Speed, the national initiative to accelerate the development of a safe, effective vaccine for SARS-CoV-2, the coronavirus that causes COVID-19. Recruitment for the Pittsburgh trials begins immediately. Read more.

ICYMI: REVISED CMS FQHC/RHC Telehealth Guidance

The Centers for Medicare and Medicaid Services (CMS) updated the MLN Matters Article SE20016 , New and Expanded Flexibilities for RHCs and FQHCs, to clarify how the Cost Sharing modifier can be applied to preventive services furnished via telehealth. This update includes:

  • Additional guidance on telehealth services that have cost-sharing waived; in order to distinguish those telehealth services that do not have cost sharing waived from those that do, such as certain preventive services, CMS has modified the descriptor of the CS modifier to account for this additional use
  • Additional claim examples
  • New section on the RHC Productivity Standard

All other information remains the same.

FCC Designates “988” for National Suicide Prevention Lifeline

The Federal Communications Commission (FCC) adopted rules to establish 988 as the new, nationwide, 3-digit phone number for Americans in crisis to connect with suicide prevention and mental health crisis counselors. The new rules will apply to all telecommunications carriers as well as all interconnected and one-way Voice over Internet Protocol (VoIP) service providers. The rules require all phone service providers to direct all 988 calls to the existing National Suicide Prevention Lifeline by July 16, 2022. Read more.

New Registration and Recertification Requirements and Enhancements Coming Aug. 1 to 340B OPAIS

The Health Resources and Services Administration (HRSA), Office of Pharmacy Affairs (OPA) is introducing new requirements and enhancements to the new covered entity registration and recertification in the 340B Office of Pharmacy Affairs Information System (340B OPAIS). These new requirements and enhancements will become effective in the registration component of 340B OPAIS beginning August 1, 2020. Some of the requirements/enhancements only impact certain entity types.

The Medicaid billing question is modified as follows: “At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?” This change was made to clarify that the question is specific to Medicaid fee-for-service, to a covered entity site and to clearly delineate each Medicaid state that is billed for 340B drugs, and the billing number(s) listed on the bill to the Medicaid state. For more information, please review the OPA Program Update – July 2020.

Temporary Regulatory Suspension of Child Immunization Requirements

The PA Department of Health (DOH) announced there will be a temporary regulatory suspension of requirements for children’s immunizations as required by PA Code for school immunizations.  The regulations are suspended for a two-month period after the beginning of the school year or the beginning of enrollment in an early childhood education program.  DOH continues to stress the importance of immunizations, both for children and across the lifespan.

Fourth Stimulus Package Under Construction

The Senate is working on its newest relief package, CARES 2.0 Act. The $1 trillion bill including $25 billion for provider relief funding, $7.6 billion for Community Health Centers, a second round of Paycheck Protection Program loans, tax deductions for employer purchases of testing, PPE and other supplies, and a provision that telemedicine reimbursement policies are extended through the end of 2021. The bill also allows state/local governments to use CARES Act money to make up lost revenues. A draft summary of the Senate proposal can be found here. NACHC and PACHC sent letters to the two PA Senators asking for $7.6 billion for FQHCs for COVID-19 and $41.9 billion over five years for long-term stable funding for the health center program.

2020 Federal Poverty Income Guidelines Issued

The Department of Human Services (DHS) published the 2020 Federal Poverty Income Guidelines (FPIG) in the July 18, 2020 edition of the PA Bulletin, which were issued by the Department of Health and Human Services and published in the Jan. 17, 2020 Federal Register. The FPIGs are the basis for the income eligibility limits for several categories of Medicaid whose regulations are published in 55 Pa.Code (relating to human services) and administered by DHS.