NARHC-News: published quarterly                   Your RHC News Source                                      Spring 2015 Edition
Rural Health Clinics

Stage 3 Meaningful Use

On March 20th, 2015, CMS released a notice of proposed rulemaking (NPRM) for Meaningful Use Stage 3, which is the final stage in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.


In addition, the Office of the National Coordinator for Health IT (ONC) has announced the proposed 2015 Edition Certification Criteria for health IT products. These NPRMs were  published in the Federal Register on March 30 and are now available online. Together, these proposed rules focus on making the EHR Incentive programs more flexible, simplifying and reducing burden of providers participating in the program, driving the interoperability of health IT across systems and between providers, and improving patient outcomes.   read more

Biosimilars Approved

A biosimilar is a biologic medical product which is copy of an original product that is manufactured by a different company.


On Friday, March 6, 2015, the U.S. Food and Drug Administration, using the authority provided in the Affordable Care Act, approved the first biosimilar product in the United States. Since the introduction of biosimilar products to the market could yield measurable cost savings & greater access to therapeutic treatment for chronic conditions, the following information may be relevant to the patients and populations you serve.  


Biosimilars are a type of biological product that is licensed (approved) by the FDA because they are highly similar to an already FDA-approved biological product, known as the biological reference product (reference product) and have been shown to have no clinically meaningful differences from the reference product.     read more 
Funding Opportunities
BROADBAND: The Federal Communications Commission (FCC) recently released the 2015 Broadband Progress Report that provides the latest data on broadband deployment in the U.S. The report finds that rural areas are failing to keep pace with today's advanced, high-quality voice, data, graphics, and video offerings.


NAT'L HEALTH SERVICE CORPS (NHSC) SITE:   The 2015 National Health Service Corps Site application cycle is now open!  The NHSC is dedicated to developing the primary care workforce in underserved areas through providing loan repayment and scholarships to providers in return for service in underserved communities.


INITIATIVES: The US Department of Agriculture (USDA) has announced several initiatives around addressing rural poverty, economic development and the social determinants of health  read more

PQRS Penalities

There continues to be some confusion with regard to the applicability of PQRS and Rural Health Clinics.  NARHC asked CMS to clarify the policy and they have done so...


On March 6, 2015, MLN Matters® Special Edition Article #SE1508, "Guidance on the Physician Quality Reporting System (PQRS) 2013 Reporting Year and 2015 Payment Adjustment for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs)," was released.


This article is designed to provide education on the PQRS 2013 reporting year and 2015 payment adjustment for RHCs, FQHCs, and CAHs. If you believe that providers in your RHC were inappropriately identified as being subject to a PQRS related negative payment adjustment, there is no longer a way to appeal for reporting year 2013. Requests for informal reviews had to be submitted by February 28th, 2015.   read more 

PQRS: How to Register

Group Practice Reporting Option in 2015

Thursday, April 16; 1:30-3pm ET


Space may be limited, register early. This MLN Connects National Provider Call provides a walkthrough of the Physician Value (PV) - Physician Quality Reporting System (PQRS) Registration System, an application that serves the Value Modifier (VM) and PQRS programs. Groups can register via the PV-PQRS Registration System from April 1 through June 30, 2015, using an Individuals Authorized Access to the CMS Computer Services (IACS) user ID and password. A question and answer session will follow the presentation.

read more  
Has the ACA Improved Health Outcomes?


Most experts say there is not enough data yet on the entire population to determine whether the Affordable Care Act is improving the nation's health.


The best early data is on young people, and it suggests that the law is benefiting that group by allowing them to stay on their parents' insurance. The share of 19- to 25-year-olds without health insurance declined to 21 percent in the first quarter of this year, from 34 percent in 2010, a reduction of about four million people.   Young college graduates were far more likely to report excellent health, to have a primary care doctor and to go to the doctor regularly than before the law.    read more

Ron Nelson Award

NARHC Members are invited to submit NOMINATIONS for a worthy recipient of the Ron Nelson Award. This award recognizes and honors an outstanding leader and promoter of Rural Health Clinics. Please nominate an individual who has dedicated their time and talent to advancing the health and well being of others through the RHC program.


Persons doing the nominating do have to be NARHC members but award recipients do not. This sign of our appreciation and national distinction will be awarded at the NARHC Annual Meeting at the Fall Institute in St. Louis in October. Nominations will be accepted until May 31st. If you know of someone worthy of our recognition, please take a moment to fill out the nomination form.   read more

NARHC 2015 Fall Institute
ST. LOUIS -- Oct. 27-29 (Tues.-Thurs)

The conference "for and about" RHCs 

This conference will be held in the Renaissance St. Louis Grand Hotel and is a boot camp of all things RHC. Topics will include a legislative update, ICD-10 billing, cost reports, HIPAA, MU, CHOWS + so much more! 


Personnel who would benefit from attending include: Hospital CEOs, CFOs, Clinic Administrators, Physicians, PAs, NPs, RNs, Billers, Coders, & any RHC staff involved with the business end of a rural health clinic. Room rates begin at $160/night.   read more  


Sports Physicals in the RHC



During this time of year and on into the summer months, one of the questions being asked is how do we handle "sports physicals"? With all that is dependent upon the sports physical, RHCs need to consider doing the annual physical at this time.


Most insurance companies pay for an annual physical as well as State Medicaid pays for the annual physical if all the components of a physical are completed. Many times this is the only time these kids come to the clinic for services and the Clinic should address many other concerns with the kids and use this time as a "teaching moment" for these kids.   read more  

Is Your RHC Running on Auto Pilot?


We work hard to obtain our initial RHC certification. Our policies and procedures are

perfectly organized in a binder. You could eat off our floor. Our patient forms-

registration forms, financial policy disclosure, privacy & security notice, HIPAA

disclosures--are newly created and crisply printed. Our HR and credentialing files

are immaculate. Our MSDS sheets are in a new red binder above the eye wash station clothed in sheet protectors arranged in alphabetic order. (Insert here any other things that we totally obsessed about until nary a surveyor one could find a deficiency.)


Then, a year or two or five or more goes by. It's is easy to let things fall by the wayside, right?    read more  

Top 10 ICD-10-CM Documentation Deficiencies


1)    Does your EHR allow copying/pasting of medical record information from previous visits? This is the problem we see the most. It results in documentation that does not convey medical necessity for the frequency and intensity of services being claimed, and it creates inconsistencies within the note-especially with diagnoses. Typically, the history and exam components are pasted from a previous note. When other issues are addressed in the current visit, those pasted sections do not support the new diagnosis.


2)    Is the diagnosis or "assessment" simply generated from the provider's ICD code "smart list" of most common diagnoses? If so, you probably have ICD codes "coming out of the blue" or that are nonspecific-taboo in the ICD-10 world. We find that "assessments" that simply list the diagnosis (based on the ICD code description) don't sufficiently tell the story of how the provider arrived at the diagnosis nor does it provide information such as a "differential" diagnosis, which can support the reason for tests.

read more 

Novitasphere Portal!


Novitas Solutions' free, web-based portal Novitasphere will allow Medicare Part B providers in Jurisdiction H or Jurisdiction L access to Eligibility, Claim Information and Remittance Advice, Claim Submission with File Status, Electronic Remittance Advice (ERA), Claim Correction, and a MailBox. Eliminate the need to call Novitas for this information, resulting in time savings for your office! Novitasphere is also a great alternative to using dial-up or Secure File Transfer Protocol (SFTP) for your EDI transactions.


Join us for educational webinars on the many components of Novitasphere.  read more 
In This Issue
Quick Links
Upcoming Events
NARHC Fall Institute
Oct. 27-29, 2015
Renaissance Grand
St. Louis, Missouri
Click here for  more info.
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