- Ways and Means Members Put Forth Solutions to Strengthen Telehealth Access and Improve Health Care for Rural Communities
- In Rural Texas, ERs Are Facing a Growing Mental Health Crisis
- Sage Memorial Hospital in Navajo Nation Constructs New Facility to Improve Health Care
- How the State, Tribes and Federal Government Are Working to Curb SD's Syphilis Epidemic
- Rural Children Struggle to Access Hospital Services, Say Researchers
- RPHARM Program Fulfills Need for Rural Pharmacists
- A Pilot Program in Rural Vermont Hopes to Build a Blueprint for Substance Abuse Recovery
- Farmers Don't Do Mental Health
- Biden-Harris Administration Announces Critical More Than $1.5 Billion State and Tribal Opioid Response Funding Opportunities
- Outlining the Intersection between Health Care and Missing and Murdered Indigenous People
- USDA Rural Development Seeks Input to Improve Access to Grants and Help More Communities Thrive
- Rural Telehealth Extension Reintroduced in Congress
- The South Was the Center of Rural Population Growth Last Year
- Students From Across the State Emphasized the Need for Mental Health Resources in Rural Alaska During a Conference
- How HHS SUD Confidentiality Regulations Will Impact Rural Providers
FY 2024 Budget Period Progress Report Noncompeting Continuation for June 1 Budget Period
HRSA released the fiscal year (FY) 2024 Budget Period Progress Report (BPR) Non-Competing Continuation (5-H80-24-006) for Health Center Program award recipients with a June 1 budget period start date. These award recipients have a BPR submission available for completion in EHBs with a deadline of 5:00 pm on Friday, Dec. 29. Technical assistance materials and deadlines for all FY 2024 BPRs are available on the BPR TA webpage.
Marriage and Family Therapists and Mental Health Counselors: Enroll in Medicare Now
CMS will implement two new provider types on Jan. 1: marriage and family therapist and mental health counselor. These provider types must enroll in Medicare to submit claims and get paid for covered items or services. Enroll now. Find out how to become a Medicare provider, and take these steps to enroll:
- Review the application: electronic version in PECOS or paper CMS-855I (PDF)
- Gather your supporting documents
- Find your Medicare Administrative Contractor’s website
- Sign up to get CMS’ weekly MLN Connects newsletter
The effective enrollment date won’t be earlier than Jan. 1. More Information is available at Physician Fee Schedule final rule, Medicare Enrollment for Providers & Suppliers webpage, and FAQs (PDF).
Court Decision on 340B “Patient Definition” Causing Reassessment of Policies – By Both Covered Entities and Manufacturers
The November 3 court decision regarding how a “patient” should be defined under 340B is continuing to reverberate through the 340B world. Some media reports are hailing it as a “major victory” for covered entities (CEs), and many CEs are re-examining their current policies to determine if/how they can safely fill more prescriptions with 340B drugs. On the other hand, manufacturers are reportedly very concerned about the decision, pointing to a recent study suggesting that it will cause the program to expand by 50 to 100 percent. It is expected that many manufacturers will respond by further tightening restrictions on the program (e.g., contract pharmacy restrictions) and increase their efforts to convince Congress to address the program. These slides will help explain the decision and its impacts on Community Health Centers. If your health center intends to review your 340B patient definition considering the ruling, this template policy and procedure will help you address what types of services qualify an individual as a patient and how recently an individual must be seen at the health center to retain their “patient” status.
Many Americans Can’t Afford Health Coverage
According to a new Commonwealth Fund survey, having insurance doesn’t guarantee access to affordable care. More than half of all working-age Americans reported they struggle with health care costs, and more than one of three are saddled with medical debt. The respondents to the survey represent those insured for a full year and some who spent all or part of the year uninsured. Large shares of insured working-age adults surveyed said it was very or somewhat difficult to afford their health care. Nearly two of five working-age adults reported delaying or skipping needed health care or a prescription drug in the past year because they couldn’t afford it.
Read the full article here: Paying for It: How Health Care Costs and Medical Debt Are Making Americans Sicker and Poorer
Ensuring Medicare Beneficiary Access: A Path to Telehealth Permanency
The Senate Finance Health Subcommittee held a hearing on extending access to telehealth services for Medicare beneficiaries. In 2022, Congress extended certain key telehealth flexibilities instituted during the public health emergency (PHE) through December 31, 2024, as part of the Consolidated Appropriations Act, 2023.
- Telehealth emerged as a vital connection for health centers and their patients during and after the COVID-19 pandemic. In 2022, 100% of Pennsylvania health centers offered telehealth services, compared to just 23% in 2019. Virtual visits increased to more than 565,000 in 2022 compared to only 3,400 virtual visits in 2019. Almost half of these virtual visits in 2022 were for behavioral health services at the patients’ discretion.
- Forty-eight percent (48%) of Pennsylvania health centers are in rural communities. Telehealth programs are especially critical in rural areas, where many residents can face long distances and significant commute time between home and health providers, particularly specialized providers. Telehealth remains an integral part of health center operations, even after the end of Public Health Emergency.
Read the testimony from the hearing or watch the live stream here.
Pennsylvania Governor’s Administration Requires Autism Coverage
This month, Pennsylvania Gov. Shapiro announced a new requirement that all commercial insurers in Pennsylvania provide coverage for autism benefits starting on Jan. 1, 2024, in compliance with mental health parity laws. This follows a notice issued by the Pennsylvania Insurance Department in the PA Bulletin last week. While most commercial carriers operating in Pennsylvania already treat autism as a mental health condition, this action seeks to make that standard universal.
Read the full article here: Shapiro Administration Directs Insurers to Meet Obligations for Autism Coverage Under Mental Health Parity Laws, Removing Barriers to Care and Expanding Access to Services for Pennsylvanians
New Telehealth Privacy Resources Released
The Office for Civil Rights (OCR) released two resource documents for providers and for patients to help explain to patients about privacy and security risks to their protected health information (PHI) when using telehealth services and ways to reduce these risks.
New Read: Report on Health Workers’ Mental Health
A recent report from the Centers for Disease Control and Prevention (CDC) documents the ongoing mental health challenges for health workers. From 2018 to 2022, health workers reported an increase of 1.2 days of poor mental health during the previous 30 days (from 3.3 days to 4.5 days) and the percentage who reported feeling burnout very often also increased (11.6% to 19.0%). Improving management and supervisory practices might reduce symptoms of anxiety, depression and burnout. Health employers, managers, and supervisors are encouraged to implement the guidance offered by the Surgeon General (see page 8 of the report) and use CDC resources (see page 20 of the report) to include workers in decision-making, provide help and resources that enable workers to be productive and build trust, and adopt policies to support a psychologically safe workplace.
Fall 2023 State Telehealth Laws and Reimbursement Policies Report Released
The HRSA-supported National Telehealth Policy Resource Center released a report that provides an overview of state telehealth policies as of September 2023. The report covers Medicaid reimbursement, private payer laws, and professional requirements.
Expanded Medicare Reimbursement for FQHCs/RHCs Effective in 2024
On Nov. 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule announcing finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after Jan. 1, 2024. CMS is finalizing conforming regulatory text changes to implement:
- Extending payment for telehealth services furnished in FQHCs/RHCs through Dec. 31, 2024.
- Delaying the in-person requirements under Medicare for mental health visits furnished by FQHCs/RHCs.
- Including marriage and family therapists (MFTs) and mental health counselors (MHCs) as eligible for payment.
- Aligning enrollment policies so that addiction, drug, or alcohol counselors who meet all of the requirements of MHCs to enroll with Medicare as MHCs will also apply for FQHCs/RHCs.
- Medicare coverage and payment for intensive outpatient program (IOP) services furnished by an FQHC/RHC.
- Extension of the definition of direct supervision to permit virtual presence in FQHCs/RHCs through Dec. 31, 2024.
- A change to the required level of supervision for behavioral health services furnished “incident to” a physician or NPP’s services in FQHCs/RHCs to allow general supervision, rather than direct supervision, consistent with the policies finalized under the PFS during last year’s rulemaking for other settings.
- Inclusion of Remote Physiologic Monitoring and Remote Therapeutic Monitoring in the general care management HCPCS code G0511 when these services are furnished by FQHCs/RHCs.
- Inclusion of Community Health Integration (CHI) and Principal Illness Navigation (PIN) services in the general care management HCPCS code G0511 when these services are provided by FQHCs/RHCs. RHCs and FQHCs that furnish CHI and PIN services will be able to bill these services using HCPCS code G0511, either alone or with other payable services on an RHC or FQHC claim, for dates of service on or after Jan. 1, 2024.
- A change in the methodology to calculate the payment rate for the general care management HCPCS code G0511 that takes into account how frequently the various services are utilized.
- A clarification that obtaining beneficiary consent for chronic care management and virtual communications services is required, but the mode of obtaining the consent can vary and direct supervision is not needed.
Review the CMS press release on the PFS, a summary table, Expanded Medicare Reimbursement for FQHCs Starting Jan. 1, 2024, and a one-pager on the new Intensive Outpatient Program benefit.