- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- NRHA Continues Partnership to Advance Rural Oral Health
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
- Q&A: What Are the Challenges and Opportunities of Small-Town Philanthropy?
How Does Reimbursement for the COVID-19 Vaccine Work?
COVID-19 vaccine is provided at 100% no cost to the vaccine recipient. COVID-19 vaccination providers cannot charge vaccine recipients for the vaccine (which is provided free by the U.S. government to enrolled providers) or charge recipients any administration fees, copays, or co-insurance. COVID-19 vaccination providers cannot deny vaccination to anyone who does not have health coverage, is underinsured, or is out of network. If a vaccine recipient has health coverage, providers may seek appropriate reimbursement from the recipient’s plan or program (e.g., private health insurance, Medicare, Medicaid) for a vaccine administration fee. However, providers cannot balance bill the recipient. Providers may also seek reimbursement for uninsured vaccine recipients from the Health Resources and Services Administration’s COVID-19 Uninsured Program. COVID-19 vaccination providers cannot charge an office visit or other fee to the recipient if the only service provided is a COVID-19 vaccination. Additional healthcare services can be provided at the same time and billed as appropriate. However, providers cannot require additional services in order for a person to receive a COVID-19 vaccine.
Medicare To Make Lump Sum Payments for COVID-19 Vaccine Administration
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for COVID-19 vaccines and administration at 100% reasonable cost like influenza and pneumonia vaccines. FQHCs will have the option to receive a lump sum adjustment based on the flu and pneumococcal vaccine costs from the most recent cost report or provide 60-90 days of actual COVID-19 vaccine and administration cost data. Contact your Medicare Administrative Contractor (MAC) for more information. Novitas is the MAC for Pennsylvania and their contact email address to request lump sum payments is NovitasReimbursement@novitas-solutions.com. Some Pennsylvania health centers still have National Government Service (NGS) as their MAC for some site locations. For more information from NGS on the lump sum process, visit their website.
Resources on Revisions to SAMHSA 42 CFR Part 2 Rule
A presentation and companion FAQ provide clarification and information about the new SAMHSA guidance for the revised SAMHSA 42 CFR Part 2 Rule. Released in July 2020, the revised rule was designed to improved coordination of care for patients in treatment for substance use disorder (SUD) while protecting their confidentiality against unauthorized disclosure and use of patient health information (PHI). Prepared by the Center of Excellence for Protected Health Information as well as the University of New Hampshire Institute for Health Policy and Practice, answers are provided for common questions that arose during the HITEQ Center’s webinar on Jan. 19, 2021, including clarification on health center specific questions regarding patient consent, telehealth, SUD and medication-assisted treatment (MAT). Access the slides, transcript and FAQs. HITEQ is a HRSA National Training & Technical Assistance Partner, under contract to the Bureau of Primary Health Care to support health centers in full optimization of their IT systems.
CMS Advisory Panel on Outreach and Education Meets
The Centers for Medicare and Medicaid Services (CMS) Advisory Panel on Outreach and Education (APOE) was established to advise the U.S. Secretary of the Department of Health and Human Services (HHS) and CMS concerning strategies for developing and implementing outreach and enrollment programs for individuals enrolled in, or eligible for, Medicare, Medicaid, CHIP, the Health Insurance Marketplace and other CMS programs. Tia Whitaker, PACHC’s Statewide Director for Outreach and Enrollment, was appointed to the panel in 2019 representing Community Health Centers. The APOE met on March 31 to discuss COVID-19 therapies, Medicare COVID-19 research and outreach and new cost savings available to consumers accessing healthcare coverage through the Federal and State-based Marketplaces from the American Rescue Plan Act. Presentations from Meredith K. Chuk, MD, lead for the COVID-19 Therapeutics Team, HHS Office of Assistant Secretary for Preparedness and Response, Chris Koepke, Ph.D., Director of the Strategic Marketing Group, Office of Communications, CMS, and Laura Salerno, Deputy Director of the Strategic Marketing Group, Office of Communications, CMS, focused on messaging, branding, outreach tactics, strategies and target populations to educate consumers and market COVID-19 therapies, reduce vaccine hesitancy and make consumers more aware of the availability of health insurance through the state and federal marketplaces.
New Guidance to Pennie Enrollment Assisters
Pennie’s Board of Directors approved a COBRA Special Enrollment Period (SEP) for those who are eligible for the COBRA subsidy under the American Rescue Plan Act (ARPA) and will receive 100% subsidy for their COBRA premium from April 1, 2021 to Sept. 30, 2021. The SEP will be available after the COBRA subsidy comes to an end.
- When the ARPA COBRA subsidy for a qualified individual runs out on Sept. 30, 2021, they can contact Pennie and open a COBRA special enrollment period (SEP) with a cost-sharing reduction (CSR), providing them with 60 days to secure coverage. The customer can begin reviewing plans Aug. 2nd in accordance with the SEP.
- Under the COBRA SEP, a customer will qualify for the maximum advance premium tax credit (APTC) as provided under ARPA for those claiming unemployment for at least one week, regardless of whether they collect unemployment compensation benefit payments. The exception – a person who has been discharged from their employer and ineligible for unemployment.
- If the customer transitions from the COBRA SEP to 2021 coverage with Pennie and seeks to continue coverage through Pennie for Plan Year 2022, enhanced subsidies due to unemployment in 2021 will NOT continue in 2022; however, the general ARPA subsidies will apply in 2022.
Bipartisan Bill Introduced to Allow NAP funds to Be Used for Mobile Vans and Facilities
On Thursday, March 25, Senators Jacky Rosen (D-NV) and Susan Collins (R-ME) introduced the Maximizing Outcomes through Better Investments in Lifesaving Equipment for (MOBILE) Health Care Act. This bipartisan legislation would allow New Access Point (NAP) funding to be used to acquire, expand, or renovate mobile medical equipment or vehicles, particularly to establish new delivery sites in areas that lack the population base to support a full-time CHC site. It would also allow NAP funds to be used for leasing, expanding, or renovating an existing health center building or constructing a new one. NACHC has endorsed the bill.
Several Key HHS Appointments Still Pending
Since Department of Health and Human Services (HHS) Secretary Xavier Becerra was confirmed by the Senate on March 18, nominations for several other key HHS officials have been confirmed: The Senate voted to confirm Vivek Murthy, MD, as Surgeon General on March 23 and former Pennsylvania Health Secretary Rachel Levine, MD, was confirmed on March 24 as Assistant Secretary of Health. However, there is no new information on when the Senate will hold a confirmation for Ms. Chiquita Brooks-LaSure, who has been nominated to serve as CMS Administrator. There is also no word on who will be nominated for the position of HRSA Administrator.
Harry Gottlieb and Kiran Singh Sirah on Everywhere Radio
This special episode of Everywhere Radio features two contributors to the upcoming Rural Assembly Everywhere virtual event. Don’t miss Harry and Kiran as they discuss solving problems and telling stories with host Whitney Kimball Co.
Analysis: The Connection Between Race and Opportunity in Rural Parts of the 5th Federal Reserve District
By Surekha Carpenter and Sonya Ravindranath Waddell, Federal Reserve Bank of Richmond
More than a quarter of the nation’s rural Black population lives in the five-state region covered by the Federal Reserve Bank of Richmond. The region’s history has a big impact on the economic conditions these communities face today.
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Tribal Efforts to Preserve Languages Get Boost from Covid Relief Funds
By Nancy Marie Spears/Gaylord News, Cronkite News
The American Rescue plan designates $20 million for Tribal efforts to preserve their native languages and culture.
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