RHC Legislative and Regulatory Links

On Sunday, March 21, 2010 the House of Representatives voted 219 to 212 to approve the Patient Protection And Affordable Care Act, the Senate healthcare reform bill (the “Senate Reform Bill”) and 220 to 211 to approve its companion reconciliation bill (the “Reconciliation Bill”) amending the Senate Reform Bill. The cost of these changes is expected to be $940 Billion over the next ten (10) years and it is expected to reduce the Federal deficit by $138 Billion over the same time period.

The bill imposes financial penalties for employers (with 50 or more employees) who do not offer insurance and for those individuals who do not acquire insurance coverage (with exemptions for low-income individuals) and places restrictions on physician ownership of hospitals; and requires disclosure of physician ownership or investment interest in a pharmaceutical or device manufacturer or nursing home.

RHCs will benefit from the largest expansion of the Medicaid program since its inception. Current uninsured patients may well be covered by Medicaid and with most rural health clinics having Medicaid as their best payer per visit it certainly should benefit RHCs financially.

Federally funded health clinics are set to play an even larger role under the health-care overhaul, which expands Medicaid and other insurance coverage and sharply increases funding for the clinics.

Medicaid will have to raise fees paid to primary-care doctors to the same level the federal government sets under Medicare. Beginning in 2014 anyone with an income of up to 133 percent of the federal poverty level, or $29,300 for families of four, will be eligible for Medicaid. As a RHC, building your Medicaid base now before other providers become aware of these requirements makes good business sense.

Co-pay limitations under Medicare - Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

The health reform bill is the most significant legislation affecting healthcare since the inception of Medicare in 1966. The bill will have profound effects on your clinic in the future and will cover the potential impact in our upcoming RHC Update Seminars. There is still plenty of room (although Indianapolis is limited) and time to register for any of our seminars. This information will be more valuable and timely than ever; so take the time to look at our seminar schedule or order the materials if you can not attend. If you would like for us to schedule a seminar closer to you let us know and if we get enough interest; we will certainly schedule a seminar in your area.

February 22, 2010: President Obama released his plan for Healthcare reform today. To view the summary of his proposal; please follow the link:

Here is an article on the President's budget as it relates to rural health. There is $5 million in grants to states to help federally qualified health centers and rural health clinics transition to a prospective payment system for the Children's Health Insurance Program and certification funding is increased so as to allow the surveyors to inspect clinics on a 6 six year cycle instead of the current every 11.5 year funding.

Extension of the 2009 Poverty Guidelines until at Least March 1, 2010

On December 19, 2009, the President signed the Department of Defense Appropriations Act, 2010 (Pub. L. 111-118), which included a provision affecting the poverty guidelines. Section 1012 of the law states that:

Notwithstanding any other provision of law, the Secretary of Health and Human Services shall not publish updated poverty guidelines for 2010 under section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 U.S.C. 9902(2)) before March 1, 2010, and the poverty guidelines published under such section on January 23, 2009, shall remain in effect until updated poverty guidelines are published.

The 2009 Poverty Guidelines for the 48 Contiguous States and the District of Columbia
Persons in family	Poverty guideline
1	$10,830
2	14,570
3	18,310
4	22,050
5	25,790
6	29,530
7	33,270
8	37,010
For families with more than 8 persons, add $3,740 for each additional person.

2009 Poverty Guidelines for Alaska
Persons in family	Poverty guideline
1	$13,530
2	18,210
3	22,890
4	27,570
5	32,250
6	36,930
7	41,610
8	46,290
For families with more than 8 persons, add $4,680 for each additional person.

2009 Poverty Guidelines for Hawaii
Persons in family	Poverty guideline
1	$12,460
2	16,760
3	21,060
4	25,360
5	29,660
6	33,960
7	38,260
8	42,560
For families with more than 8 persons, add $4,300 for each additional person.

Legislative and Regulatory

This page will include information on legislative, regulatory, and health reform as it specifically relates to rural health clinics.

Extension of the 2009 Poverty Guidelines until at Least March 1, 2010