Rural Health Information Hub Latest News

Union Community Care’s COVID-19 Story Spotlighted

HRSA’s new Health Center Stories webpage provides examples of health centers’ creative and inspiring efforts to boost vaccine confidence and connect with their communities. HRSA chooses stories to highlight in its Digest publication. Union Community Care’s work to get COVID-19 tests to people experiencing homelessness and residents of public housing was spotlighted in the COVID-19 section of the Feb. 22 edition of the Digest. Read the full story on the Health Center Stories webpage, as the first story under the COVID-19 Response Efforts section.

Hamilton Health Center Chief Medical Officer Serves as Role Model

PennLive is following up their report on the historic increase in Black students in medical school and why that’s important with a series of profiles of Black health care professionals in central Pennsylvania who have paved the way and now serve as role models for future doctors and nurses. Dr. Bolanle Limann, chief medical officer for Harrisburg-based Hamilton Health Center, is the subject of the first profile in the series. Dr. Limann oversees clinical operations for the health center’s six locations in Dauphin and Perry counties, bringing to bear both her skills as a physician and her knowledge of business. Read more.

Race Gap in Maternal Mortality Grows

The U.S. maternal mortality rate — already high compared to other wealthy countries — has increased, with Black women faring far worse than their White peers, according to new data. In 2020, 861 women died of maternal causes in the U.S., up from 754 in 2019, according to a new report released by the U.S. Centers for Disease Control and Prevention. That puts the 2020 maternal mortality rate at 23.8 deaths per 100,000 live births, a figure that is more than double the rate in countries including the U.K., Canada and France.

Mask Mandates Dropped in Every State but One

As COVID-19 cases continue to decline across the country, all states but one — Hawaii — have dropped their mask mandates or have made plans to do so in the coming weeks. This week, Target and Apple stores joined other retailers in pulling back their own mandates. In recent days, some cruise lines said they are relaxing mask requirements for vaccinated passengers after putting stricter rules in place during the omicron surge. But how to handle masks in schools remains a point of contention in many districts.

Pennsylvania COVID-19 Death Rate Plummets

Pennsylvania’s seven-day average of daily COVID-19 deaths fell to 84 as of Sunday, about half the level of late January, according to tracking by SpotlightPA. Sunday’s level is the lowest since early December. The commonwealth’s all-time peak average of 222 daily deaths came in mid-January of 2021. Based on data from the Department of Health, Pennsylvania’s COVID-19 death toll stood at 42,789 as of Monday. Data indicate the level of new infections also has plunged, with Pennsylvania averaging 2,478 new infections per day as of Monday, down from an average of about 28,000 new infections per day in mid-January. Across the country, new cases have plummeted 90% from five weeks ago, although it’s important to note that the data generally doesn’t capture positive home test results

Child Care Costs Exceed College Tuition in 34 States

The annual expense of child care for an infant exceeds the annual cost of in-state tuition at a public four-year university in 34 states, according to the most recent data from the Economic Policy Institute. The cost of child care can be a key influencer in decisions about entering or leaving the workforce, and especially in health care where women make up the majority of the front-line workforce (66%) and managers (59%), according to research from McKinsey. In Pennsylvania, infant care costs as a share of public college tuition are 81.5%. Average annual cost of infant care is $11,842, while Pennsylvania’s in-state tuition for four-year public college is $14,534, one of the highest tuition rates in the country. Infant care costs as a share of median family income is 17.5% with a median family income: $67,828.

Centers of Excellence Changes and Impact on Federally Qualified Health Centers

Ten Pennsylvania FQHCs are substance use disorder Centers of Excellence (COE). Recent changes to the program have raised some questions, including the question PACHC posed to Department of Human Services (DHS) on whether, under the state plan amendment DHS is submitting to CMS, case managers will be considered as eligible FQHC providers. We want to ensure that, due to the uniqueness of FQHCs and FQHC billing methodology, our health centers are being compensated fairly for the services they are providing to patients.

 

Per DHS: In short, the answer is that, because the FQHC-COEs bill for the G9012 procedure code under the 13-digit MPI associated with their 232 Opioid Center of Excellence provider specialty enrollment, rather than their MPI associated with the FQHC enrollment, and they are paid the $277.22 PMPM rather than their PPS for G9012 code services, case managers may perform the G9012 service that is billed under the 232 provider number, regardless of whether those case managers are considered eligible FQHC providers for PPS purposes.

 

You either bill as an FQHC or a COE, which are two different entities. For enrollment purposes, the provider specialty codes are different, and you are not “an FQHC that is also a COE.” If acting and billing as an FQHC, then the eligible practitioner SPA page and Appendix E handbook/PPS rules apply. If acting and billing as a COE, then the case manager policies and G9012 payment methodology apply.

 

PACHC is hosting a call on March 2 for FQHC-COEs to meet with DHS on the changes to COE payment methodology and have the opportunity to ask any additional questions. Please contact Amy Williams, PACHC’s Program Specialist for Behavioral Health and Substance Use Disorder, with questions.

Looking for Vendor Resources and Savings?

As an extension of PACHC’s benefits to health centers, we partner with Commonwealth Group Purchasing (CPG), a group purchasing organization developed by and for Community Health Centers. CPG provides vetted vendors and cost savings leveraged through group purchasing. There is a no-obligation service to help you assess your current purchasing from medical and business suppliers to current needs in telehealth and recruitment solutions. To learn more, click here or contact Julie Korick, PACHC Chief Operations and Finance Officer

Registration Open for NACHC Financial Operations Training

NACHC’s training workshop, Financial Operations Management 2 (FOM2), is an intermediate-level workshop that provides insight and understanding of the core qualities needed to approach the business aspects of financial operations, management, and service delivery. This is an intermediate-level seminar approved for up to 11.4 CPE credits. The FOM2 training agenda is packed with the essential financial management tools and techniques to help empower health center CFOs, CEOs, COOs and managers to maximize financial performance, engage in contract negotiations and leverage technology for better decision-making. Learn more and register for this May 25-26 virtual training. Early bird registration ends May 11, 2022.

COVID-19 Vaccine Payment Bulletin

The PA Department of Human Services (DHS) has finally released the long-awaited Medical Assistance Bulletin outlining payment for administration of COVID-19 vaccine during a vaccine-only visit in which no other services are provided on the same date. The bulletin announces DHS is implementing an alternative payment methodology (APM):

  1. To pay the MA Program Fee Schedule rate for the administration of the vaccine on or after Dec. 1, 2020
  2. To pay the enhanced MA Program Fee Schedule rate for the administration of the vaccine to homebound MA beneficiaries during a vaccine-only visit for dates of service on or after April 1, 2021

It is important to note that the bulletin applies to fee-for-service only; providers rendering services to MA beneficiaries in the managed care delivery system (HealthChoices) must utilize the COVID-19 vaccine administration codes for DHS tracking purposes but must contact the managed care organization (MCO) with billing questions. The bulletin outlines the procedure codes for administration of the vaccine, which are distinct to each COVID vaccine and the specific dose in the required schedule. In order to bill under this new APM, a request to opt in to the APM as of Dec. 1, 2020, must be submitted by the FQHC/RHC chief financial officer (CFO) via email to DHS at financialgatekeeper@pa.gov within 30 days of issuance of the bulletin (by March 26, 2022) and must include both the FQHC/RHC nine-digit service location number for which the opt-in is to be applied. The email should indicate the FQHC/RHC is accepting the APM. Claims submitted within 60 days of the issuance of the bulletin (April 25, 2022) will not be subject to the time frames for submission of claims in 55 Pa. Code §1101.63(b). Read the full bulletin.