CMS Rules Changes
Jul 1, 2011
To: RHC Community and Friends
From: Bill Finerfrock
Re: Regulatory Update
Yesterday, we conducted an RHC TA call updating the RHC community on various regulatory issues affecting or potentially affecting federally certified Rural Health Clinics. We know that many were unable to listen in so we wanted to pass along some of the information presented on the call so that everyone would be up-to-date.
1. CMS failed to meet the statutory deadline of June 27th to issue RHC rule changes proposed by CMS in a June 27, 2008 Notice of Proposed Rulemaking (NPRM). By law, CMS must issue a final rule in response to a proposed rule, within 3 years of the publication of the proposed rule. Failure to adhere to this timeline means that the rule must be withdrawn.
This means that the most controversial proposal - decertification of RHCs no longer located in rural areas or underserved areas - will not be implemented. In addition, proposed changes to how the beneficiary co-pay and deductible is calculated when the Medicare patient is seen in an RHC will also not be implemented.
It is not clear what the next steps will be but we do not expect that CMS will move quickly to reissue a new proposed rule. NARHC will continue to work with CMS and Congressional leaders to ensure that the RHC program remains a viable option for improving and maintaining access to healthcare in rural underserved areas.
2. CMS rescinds lab signature rule. Late in 2010, CMS announced that all requisitions for laboratory services for Medicare beneficiaries would have to be signed by a physician, PA, NP or other qualified health professional as a condition for payment. There was great concern amongst the provider community that this requirement would slow down the process for getting necessary lab work ordered and completed and represented an unwarranted administrative burden.
In response to stakeholder complaints, CMS announced early in 2011 that they were suspending the policy and now, CMS has announced that they are going to rescind the lab signature policy. Although it will likely be September before the policy can be officially rescinded, CMS has said that they will continue to suspend enforcement of the requirement until the rescision process can be completed.
An audio recording and transcript of the call should be posted on the Federal Office of Rural Health Policy (ORHP) website in the near future:
You are encouraged to download either the audio recording or transcript when they are available so you can hear the entire presentation. Gail Nickerson provided a very informative presentation on efforts by the federal government to change the methodology for how medically underserved areas and health professional shortage areas are designated. Although no final decisions have been made, you might want to listen to Gail's remarks so you can better understand some of the options that are under consideration.
A notice announcing the availability of the transcript and recording will be sent out via this listserve when they are up and ready for download.
Please contact me at the National Association of Rural Health Clinics if you have any questions about yesterday's presentations or the issues raised during yesterday's call. My email address is: info@narhc.org
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