COVID-19 Resources for RHCs

Healthcare Business Specialists is using this COVID-19 website to provide resources for our RHCs. We have provided links to valuable information as you deal with this world-wide pandemic.

Vast amounts of ever-changing Information must be assimilated by RHCs regarding the COVID-19 Public Health Emergency (PHE) at a dizzyingly fast pace. It is difficult, even impossible, to keep up with all the changes affecting the operation of a medical clinic or hospital during this unprecedented time. Information has always been a perishable asset, but, never so much as in this time of constant change and guidance from our government. While not getting political, one can not help but be impressed by the dedication and commitment from our governmental agencies in fighting this war with COVID-19 and the government’s resolve to win this war without completely sacrificing the financial future of those that survive this war.

In order to help you process, organize, and locate information related to COVID-19 we have organized this site into Topics, so you find information much faster. If you click the links below you will find a chronological list of resources dated from the latest to the oldest. We at Healthcare Business Specialists hope this helps you find the answers you need during this difficult time.

Telehealth State Medicaid and Regulations Financial Laws and Regulations Other Resources

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November 24, 2021

The National Association of RHCs also provided a template for RHCs on the Vaccine Mandate. To download that Word document please click here and edit the document.

Here are the links to the files provided by HSA (https://hsagroup.net/) Some members in the Facebook Group had a hard time downloading them.

Sample COVID-19 Vaccine Policy
Sample Medical Exemption Form
Sample Religious Exemption Form

October 1, 2021

We are getting a lot of questions regarding monoclonal infusions, Covid vaccines, and non-rhc time in rural health clinics. We put together a quick webinar on the subject that addresses the subject. We handle the information pretty quickly so go over this information with your RHC cost report person or financial advisor when implementing any changes to your current system. Here is the link: https://youtu.be/pAxUq5KQCps

September 15, 2021:

Here is the recording of the September 15, 2021 Provider Relief Fund webinar for Rural Health Clinics: https://youtu.be/WSdVHpr0C34

Here is the link to the presentation for today’s webinar: PRF Fund Reporting Webinar Slides for 9 15 2021

Rural Health Clinic Vaccine Confidence (RHCVC) Program Grant Notice of

Award Webinar with Elizabeth Burrows, JD

In this webinar, Elizabeth Burrows, JD will review the Notice of Award information for Rural Health Clinics that received the Rural Health Clinic Vaccine Confidence (RHCVC) Program Grant. The webinar will last 45 minutes to an hour, and we will have some time for questions and answers. If you have specific questions and would like to submit them ahead of time, here is Elizabeth's contact information.

Elizabeth Morgan Burrows, JD

Principal

Burrows Consulting, Inc.

765-505-3896

elizabethburrowsconsulting@gmail.com

The session will be recorded, and a PDF will be available on our website and in the RHC Information Exchange Facebook Group.

Please register for Rural Health Clinic Vaccine Confidence (RHCVC) Program Grant Notice of Award Webinar with Elizabeth Burrows, JD on Aug 10, 2021 2:30 PM EDT at:

https://attendee.gotowebinar.com/register/5006603524036063757

Recording of the Presentation. https://youtu.be/wc74_WY1PJQ

Here is the presentation for the 8.10.2021 Webinar. (RHCVC) Program Grant Notice of Award Webinar Presentation PDF

Please find the Administrative Presentation for the 8.10.2021 webinar HERE.

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Rural Health Clinic Vaccine Confidence (RHCVC) Program Grant Payment Management System

Webinar with Elizabeth Burrows, JD

In these second of two webinars, Elizabeth Burrows, JD will review the Grant Payment Management System for Rural Health Clinics that received the Rural Health Clinic Vaccine Confidence (RHCVC) Program Grant. The webinar will last 45 minutes to an hour, and we will have some time for questions and answers. If you have specific questions and would like to submit them ahead of time, here is Elizabeth's contact information.

Elizabeth Morgan Burrows, JD

Principal

Burrows Consulting, Inc.

765-505-3896

elizabethburrowsconsulting@gmail.com

The session will be recorded, and a PDF will be available on our website and in the RHC Information Exchange Facebook Group.

Please register for Rural Health Clinic Vaccine Confidence (RHCVC) Program Grant Payment Management System Webinar with Elizabeth Burrows, JD on Aug 12, 2021 2:30 PM EDT at:

https://attendee.gotowebinar.com/register/1024681482115239693

You can find the recording of the session HERE

Elizabeth Burrows Presentation can be found here

PMS Information Sheet can be found here

Mark Lynn’s Administrative Presentation can be found here

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August 18, 2021

Hello Everyone. First check your bank account. HRSA sent a $100,000 grant payment to 360 RHCs that did not previously receive the RHC COVID Testing and Mitigation grant that was sent earlier in the year.

Secondly, we are having a webinar on Provider Relief Funds today. This webinar is important to RHCs because you MUST report your PRF Fund uses by September 30, 2021 or HRSA could potentially ask for the money back. There are no extensions and currently no provision for people missing the deadline (unlike the cost reports that came in late). The reporting requirements are burdensome and will take time to prepare for and submit.

The webinar will last approximately one hour and you can find the presentation here.

Here is the recording of the session: https://youtu.be/jndkeRdhnDM

Here is a link to the Provider Relief Funds Reporting Tool: Download the Reporting Worksheets (.xls)

Click here to download our Provider Relief Funds Portal Information Request Document. This 16-page PDF explains the information that must be accumulated to complete the PRF portal submission. We also recorded a 10-minute tutorial on how to compile the information which can be viewed here: https://youtu.be/KDNdfTsvB3E

Click here to download our Excel PRF Payroll Worksheet that will help you document payroll expenses by Quarter

If you have not signed up yet, here is the information to register:

Provider Relief Fund Reporting for RHCs

In this webinar Mark Lynn, CPA (inactive), CRHCP, CCRS will update Rural Health Clinics on the Provider Relief Fund Reporting portal for RHCs and how to use the portal to report Provider Relief Funds. We will go over FAQs and resources to help RHCs report uses of Provider Relief Funds and lost revenues. There will be a 45 minute presentation and time for questions. The session will be recorded and available for viewing on the HBS Youtube channel and a link will be available at http://www.ruralhealthclinic.com/covid19 and in the Rural Health Clinic Information Exchange Facebook Group. In the meantime, RHCs should download the PRF Worksheet Excel Spreadsheet from https://prfreporting.hrsa.gov/s/ and begin accumulating information so they are ready to submit the report to HRSA by September 30, 2021.

Please register for Provider Relief Fund Reporting for RHCs on Aug 18, 2021 1:00 PM EDT at:

https://attendee.gotowebinar.com/register/1279451520076141067

Additionally, we will have a webinar with Elizabeth Burrows, JD on August 27th regarding the Rural USDA Grant opportunity for RHCs. Here is the information for this webinar.

Rural USDA Grant Update with Elizabeth Burrows, JD

Do you need funding for a new facility, a renovation, telehealth, or to provide additional services at your RHC? If so, please tune in to our webinar by Elizabeth Burrows, JD from Burrows Consulting, LLC. Elizabeth will provide an update to RHCs that are interested in applying for the USDA grant for rural areas and explain how for profit RHCs can participate in this grant opportunity.

Click here to download the presentation by Elizabeth Burrows, JD.

Click here to download the administrative presentation by Mark Lynn.

The following is a link to the recording of the webinar: https://youtu.be/CbYhfqL6y1U

Please register for Rural USDA Grant Update with Elizabeth Burrows, JD on Aug 27, 2021 11:00 AM EDT at:

https://attendee.gotowebinar.com/register/7306605927878942478

Thank you for what you are doing and stay safe.

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June 16, 2021, Just a quick reminder that the Provider Relief Fund Update webinar will be today (June 16, 2021) at 1:15 Eastern time. We have added Elizabeth Burrows, JD to the agenda for a quick update on the Rural Health Clinic Vaccine Confidence (RHCVC) Grant in addition to Shannon Chambers who will give an update on the Covid Testing and Mitigation grant money including the $100,000 distribution that most RHCs received last week.

If you have not signed up yet, here is the information to sign up:

Provider Relief Funds Reporting Update - Revised Guidance issued June 11, 2021

In this webinar Mark Lynn CPA (Inactive), CRHCP, CCRS will update attendees on guidance published June 11, 2021 on the reporting and uses of Provider Relief Funds. We will go over that Period 1 (April 10 to June 30, 2020)PRF funds must be expended by June 30, 2021 or they must be returned to HHS and these funds must be reported in the portal by September 30, 2021. We will go over Lost Revenue calculations and allowable expenses to be reported. Additionally, Shannon Chambers from the NARHC and South Carolina Office of Rural Health will provide a quick update on the Covid Testing and Mitigation Funds that many RHCs received last week. Shannon will go over what to do if you did not receive the $100,000 distribution and if or when future distributions will be made to RHCs that did not receive the initial distribution.

Please register for Provider Relief Funds Reporting Update - Revised Guidance issued June 11, 2021 on Jun 16, 2021 1:15 PM EDT at:

https://attendee.gotowebinar.com/regi.../5973498655301618444

After registering, you will receive a confirmation email containing information about joining the webinar.

Brought to you by GoToWebinar®

Webinars Made Easy®

On June 11, 2021, HHS released revised guidance on reporting and uses of Provider Relief Funds. The key takeaway from the revised guidance is that funds received during Period 1 (April 10 to June 30, 2020) PRF funds must be expended by June 30, 2021 or they must be returned to HHS and these funds must be reported in the portal by September 30, 2021. Here is a link to the HHS website announcing the changes which has links to relevant documents

https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/reporting-auditing/index.html

Here is a link to the 11 pages of revised guidance

https://www.hhs.gov/sites/default/files/provider-post-payment-notice-of-reporting-requirements-june-2021.pdf

Here is our latest newsletter with a link to a webinar on June 16, 2021: https://conta.cc/3voNKfg

Summary of Reporting Requirement per HHS as of June 11, 2021

Provider Relief Funds Reporting Update - Revised Guidance issued June 11, 2021

In this webinar Mark Lynn CPA (Inactive), CRHCP, CCRS will update attendees on guidance published June 11, 2021 on the reporting and uses of Provider Relief Funds. We will go over that Period 1 (April 10 to June 30, 2020)PRF funds must be expended by June 30, 2021 or they must be returned to HHS and these funds must be reported in the portal by September 30, 2021. We will go over Lost Revenue calculations and allowable expenses to be reported. Additionally, Shannon Chambers from the NARHC and South Carolina Office of Rural Health will provide a quick update on the Covid Testing and Mitigation Funds that many RHCs received last week. Shannon will go over what to do if you did not receive the $100,000 distribution and if or when future distributions will be made to RHCs that did not receive the initial distribution.

Please register for Provider Relief Funds Reporting Update - Revised Guidance issued June 11, 2021 on Jun 16, 2021 1:15 PM EDT at:

https://attendee.gotowebinar.com/regi.../5973498655301618444

After registering, you will receive a confirmation email containing information about joining the webinar.

Brought to you by GoToWebinar®

Webinars Made Easy®

OSHA Issues COVID-19 Emergency Temporary Standard for Healthcare

Although it may feel like COVID is in our rear-view mirror, it still poses risk to health care workers.

OSHA has determined that employee exposure to SARS-CoV-2, the virus that causes COVID-19, presents a grave danger to workers in healthcare settings where people with COVID-19 are reasonably expected to be present and has issued an Emergency Temporary Standard (ETS) to address the hazard.

The ETS requires employers to help protect healthcare workers in settings where suspected or confirmed COVID-19 patients are treated. Download the ETS summary which has a link to the full text 29 CFR 1910.502.

https://www.osha.gov/.../files/publications/OSHA4120.pdf

Go to the ETS webpage or to the FAQs.

https://www.osha.gov/coronavirus/ets

FAQS

https://www.osha.gov/coronavirus/ets/faqs

Rural Health Clinic Vaccine Confidence Grant

June 3, 2021 There is a lot of information on the RHC Vaccine Confidence Grant which is at a minimum of $50,000 and could possibly be as much as $200,000 (make sure to include in the grant application that you are willing to accept more than the $50,000 you will ask for in the grant). Because many RHCs have never applied for a grant before, we have asked an expert in grants to tell us how to apply for a grant and the webinar will be today (June 3rd) at 2:00 PM Eastern. We have included the information that will allow you to register.

RHC Grant Application Process with Elizabeth Morgan Burrows, JD

Rural Health Clinics will have the opportunity to participate in HRSA’s $1 billion Rural COVID-19 Response funding in the coming months. While some of the funds will be received without an application (ie $100,000 to each RHC), others will require an application process, and registration with such organization as Duns, SAM, and Grants.gov. Many of these organizations and processes are unfamiliar to RHCs. With this in mind, we have asked an expert in grant writing and FQHC operations to provide us some guidance on the process, pitfalls to watch for, and how to write a successful grant application. Elizabeth Morgan Burrows, JD has a proven track record of attaining grant money from both public and private sectors. She has successfully established multiple clinics as part of a thriving nonprofit health care business. Her work at Burrows Consulting, LLC involves the following:

• Partner with healthcare agencies and non-profit organizations for their consulting needs.

• Awarded millions of dollars in federal, state, and local grant funding for various clients.

• Complete program evaluations at the state and local level.

• Present at numerous conferences and meetings about federally qualified health centers, rural health

clinics, rural hospitals, and patient centered medical home accreditation.

• Draft policies and procedures for health care entities. Conducted needs assessments.

• Work with many clients on revenue cycle management, business plan development and implementation, and operational improvement.

The webinar will have about 30 to 40 minutes of presentation time and 15 to 20 minutes of time for questions. There is no charge for the webinar. Mark R. Lynn, CPA (Inactive), CRHCP, CCRS will moderate the session which is sponsored by Healthcare Business Specialists and Burrows Consulting, LLC. The session will be recorded for future viewing and the slides will be available at www.ruralhealthclinic.com and the Facebook Group called Rural Health Clinic Information Exchange.

Please register for RHC Grant Application Process with Elizabeth Morgan Burrows, JD on Jun 3, 2021 2:00 PM EDT at:

https://attendee.gotowebinar.com/register/2454055392684705808

June 3, 2021 Here is the recording of the webinar and the slides. Thank you for attending. We had 245 sign up and 170 attend.

Here are the Budget Forms that Elizabeth discussed in the meeting. The sections that must be completed for the RHC Grant Application are highlighted in Yellow.

If you need to contact Elizabeth to complete your application by the deadline (June 23rd), please do not wait. If you apply timely and completely you will be funded for most likely a minimum of $50,000 and potentially up to $200,000,

Elizabeth Morgan Burrows, JD

Principal

Burrows Consulting, Inc.

765-505-3896

elizabethburrowsconsulting@gmail.com

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Another webinar on this funding at 11:00 AM on Friday, June 4, 2021

HRSA’s Federal Office of Rural Health Policy (FORHP) invites all who are interested in the HRSA-21-142 Rural Health Clinic Vaccine Confidence (RHCVC) Program to attend a Grants.gov Applicant Overview webinar. We will review Grants.gov processes with an expert from the Office of the Assistant Secretary for Financial Resources to help you successfully submit an application for this grant opportunity.

Friday, June 4, 2021 from 11AM – 12PM ET

Zoom Link: https://hrsa-gov.zoomgov.com/j/1601489418?pwd=ZGRVZDVCOEdtbC9PdHlBSlAwaU0zZz09

Dial-in: 833 568 8864 Webinar ID: 160 148 9418 Passcode: 72456656

HRSA will record and post the webinar on this page when available.

The application deadline for the Rural Health Clinic Vaccine Confidence Program is June 23, 2021.

For questions about the program, email us at RHCVaxConfidence@hrsa.gov.

View on Grants.gov: https://www.grants.gov/web/grants/view-opportunity.html?oppId=333783

HRSA has funded the National Organization of State Offices of Rural Health to provide technical assistance to RHCs on the RHC Vaccine Confidence Program. If you have additional questions you may email rhcvaxconfidenceinfo@nosorh.org.

Please reach out to us with any questions,

HRSA Rural Health Clinic Vaccine Confidence (RHCVC) Program Team
RHCVaxConfidence@hrsa.gov

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Additionally, HRSA conducted a webinar on June 2, 2021 on this grant called A-21-142 Rural Health Clinic Vaccine Confidence Program Technical Assistance webinar recording is now available here and will soon be on the HRSA RHC Vaccine Confidence webpage. The slides for this presentation can be found here

Grant awards will be made to all eligible RHCs that apply and have a complete and acceptable application through the Rural Health Clinic Vaccine Confidence (RHCVC) Program. Interested RHCs should review the Notice of Funding Opportunity (NOFO) and start the three-step grant registration process. RHCs may use this grant funding to increase vaccine confidence, improve health care in rural areas, and reinforce key messages about prevention and treatment of COVID-19 and other infectious diseases.

Webinars

Healthcare Business Specialists is pleased to provide several webinars over the next few months or so as we strive to keep rural health clinics informed of changes to the RHC program. We are pleased to partner with other entities that have important information to share with the RHC community. More information regarding these webinars can be found at www.ruralhealthclinic.com or go to our Facebook Group called the Rural Health Clinic Information Exchange:

https://www.facebook.com/groups/1503414633296362/

Billing and Reimbursement for Mental Health Services in Rural Health Clinics

In this webinar Charles James from North American Healthcare Management Services, Dave Jolly from Rural Behavioral Health, and Mark Lynn from Healthcare Business Specialists will go over how RHCs can incorporate mental health services in their rural health clinic and how to get paid for this service in the RHC setting. This webinar will focus on the reimbursement, billing, cost reporting, and administrative aspects of mental health programs in RHCs.

Please register for Billing and Reimbursement for Mental Health Services in Rural Health Clinics on Apr 13, 2021 2:00 PM EDT at:

https://attendee.gotowebinar.com/register/7208865937856596752

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Introduction to the Rural Health Clinic Program

In this webinar, Mark R. Lynn, CPA (Inactive), CRHCP, CCRS will present information to providers interested in becoming a rural health clinic (RHC) or RHCs new to the RHC program. It will provide basic information on conditions of participation, reimbursement, billing, and cost reporting. We will discuss advantages and disadvantages of the program and identify resources to help you become RHC compliant and obtain RHC reimbursement from Medicare and Medicaid. This 45-minute webinar is designed for people new to the RHC program or have become interested in converting their medical clinic into a rural health clinic under Public Law 95-210. We will discuss the nine conditions of participation, some basics of Medicare and Medicaid reimbursement, provide a timeline for certification, and provide some basic benchmarking information from provider based and independent RHCs.

Here is the recording of the Webinar: https://youtu.be/k74iAlQr5EY

Here are the slides: Slide Presentation

Please register for Introduction to the Rural Health Clinic Program on Apr 22, 2021 1:00 PM EDT at:

https://attendee.gotowebinar.com/register/8893471683239180045

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RHC Cost Report and Provider Relief Funds Update

In this webinar, Mark R. Lynn, CPA (Inactive), CRHCP, CCRS and Dani Gilbert, CPA, CRHCP will go over changes to RHC cost reporting and provide an update on Provider Relief Funding. Cost Report information will include how to count telehealth visits and costs, COVID-19 vaccination logs for Medicare and Medicare Advantage patients, P S and R changes and an update on rate setting changes due to the increased Medicare rate for independent RHCs. The Provider Relief Funds update will include any update that HHS provides to us. Currently the last update we have is January 15th when the portal was opened for registration, but as of March 22, 2021 no changes have been made to the portal since January 15, 2021. Once there are changes, we will schedule a webinar immediately and this webinar will update that information.

If you missed the Provider Relief Funds Update Webinar here are the slides and the recording of the session. I apologize for not covering cost reporting today, but since we had Nathan Baugh from the NARHC here, I felt it was a better use of our time to have him update us on the funding opportunities for RHCs. We will have the cost report webinar in the future.

Picture of an article I wrote for the NARHC. To go to the article with working links (the above is a picture) go here.

RHC Provider Relief Funds and Cost Report Webinar on January 21, 2021

January 21, 2021 Healthcare Business Specialists, LLC will present a webinar on the updated Provider Relief Reporting requirements as of January 15, 2021 and provide an update on RHC cost reporting including the increased capped rates and cost reporting extensions due to Covid. Here is the registration information, presentation slides, and a recording of the webinar once the webinar has been completed.

In this Webinar Mark Lynn, CPA (Inactive), CRHCP, CCRS, RHC Consultant with Healthcare Business Specialists, LLC will update RHCs on announcements by HHS on January 15, 2021 regarding the Provider Relief Funds Reporting portal including how to register for the portal and the delay in the reporting deadline to a later unannounced date in the future. Please register for Provider Relief Funds Reporting Portal Update on Jan 21, 2021 12:00 PM CST at:

https://attendee.gotowebinar.com/register/5521667541781514511
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Historic Day for RHCs

December 22, 2020: Congress passed the Consolidated Appropriations Act, 2021 (CAA) and the 5,593 page document is going to the President for signature. This $900 Billion bill includes Section 130 Improving Rural Health Clinic Payments which increases the Medicare cap for independent RHCs to $100 per visit and increases the rate until the maximum rate is up to $190 per visit in 2028 and the rate will be increased by the Medicare Economic Index thereafter. This does not mean RHCs will get these higher rates. If the RHCs rate is less than the cap, then the clinic is paid the lessor of the two. There is a cost to getting this higher rate. Provider-based RHCs (less than 50 beds) certified after 12/31/2019 that were not subject to a cap will now be subject to this cap. Provider-based RHCs (less than 50 beds) certified on or before 12/31/2019 are grandfathered and will not be subject to these limitations. Here are some links to help you understand the rules and to save you a lot of time, we put together an 18 page document with just the information related to RHCs and lost revenues.

HBS Update Newsletter on December 22, 2020 on Historic changes to the RHC program (5-page PDF)

The CAA again changed the definition of lost revenue. This weeks definition reverts back to the June 2020 definition of lost revenue which includes the used of budgeted income and expenses as long as the budget was approved prior to March 27, 2020. As a refresher here is the June 2020 FAQs:

Provider Relief Funds FAQ from June 2020 (the new Lost Revenue Definition)

Updated Provider Relief Fund Guidance from HHS

December 11, 2020 HHS released a document called Provider Relief Fund (PRF) Allowable Expenses Overview which can be found here. The Overview references final reporting requirements which are dated November 2, 2020. In this document it lists the types of expenses that are allowable as well. Additionally, on December 11, 2020, HHS updated their FAQs and there are now 22 FAQs on the use of funds with 6 being added or modified on December 11, 2020 including an FAQ that indicates additional taxes paid due to Provider Relief Funds are an allowable use of Provider Relief Funds. The FAQs can be found here. We prepared a document going over the changes and guidance on allowable expenditures as well as computations of lost revenue and recorded a 15 minute webinar on the changes. The document and the recording are included below:

Recording of 15 minute webinar on Provider Relief Funds webinar on December 14, 2020

Provider Relief Funds Cheat Sheet for Expenses and Lost Revenue on December 14, 2020 (11 page PDF)

COVID-19 Vaccination Plans by State as of December 8, 2020

December 8, 2020: The Urgent Care Association released a summary by state of COVID-19 vaccination plans which can be found here.

Tennessee RHCs - Increased Payments for RHCs

December 7, 2020: Great news for Tennessee RHCs - RHCs to get a 28.51% increase in payments for the period January, 2020 to February, 2020 (I am not sure why it is only for that period of time, I am thinking this is a test to see how it works and hopefully more will come in the future - but that is just a guess). Here is the announcement:

https://www.tn.gov/.../docum.../PCPCOVID19Payments111320.pdf

“The approved $12.4 million in state and federal funding represents a portion of the total PCP claims paid to TennCare’s managed care organizations (MCOs) during a set period prior to the COVID-19 pandemic. Each TennCare MCO will review the PCP payments made through June 2020 to its PCPs for services performed during January 2020 and February 2020, and those PCPs will receive payment equal to 28.51% of the claims paid for services performed during January 2020 and February 2020. Each MCO will be posting communication to its Provider Website concerning:

How to know if I am eligible for COVID-19 Primary Care Provider (PCP) targeted payments?
How to know if I am included in the MCO’s PCP network?
If I am eligible, do I have to do anything to obtain these funds?
What mechanism will be used to issue the COVID-19 PCP targeted payments?
What is the timeline for issuing the COVID-19 PCP targeted payments?

Important information about how to report this on the Tenncare Quarterly Reports

“The increased amount will be reflected as a one-time payment in the form of a reconciliation check that will be distributed by the MCOs to FQHC and RHCs. In order for FQHCs and RHCs to experience the intended benefit of the payment, providers should not report these additional funds as payments received from the MCOs on prospective payment system (PPS) quarterly settlement reports to the Comptroller’s office. All other aspects of PPS settlement reporting, including visit counts and other funds received from the MCOs (including the original base claims reimbursement) should remain unchanged.

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November 20, 2020: Healthcare Business Specialists will conduct a webinar on Provider Relief Funds & Cost Reporting Requirements for RHCs. Please find the Slide presentation and links to resources cited in the Presentation.

Here is the recording of the Provider Relief Funds Webinar on November 20, 2020

Provider Relief Funds Reporting Requirements Powerpoint Slides for November 20, 2020 (PDF)

RHC Cost Reporting Update for 2020 Webinar

In this webinar, Mark Lynn, CPA (Inactive), CRHCP and Dani Gilbert, CPA, CRHCP will go over Rural Health Clinic Cost Reporting and the information requirements, timing of the filing, and steps to take before year-end to maximize reimbursement as well as why so many RHCs are having to pay back Medicare monies as a part of settlements.

Please register for RHC Cost Reporting Update for 2020 on Dec 10, 2020 12:00 PM CST at:

https://attendee.gotowebinar.com/register/7605161811737073166

October 8, 2020: Healthcare Business Specialists will conduct a webinar on Provider Relief Funds Reporting Requirements for RHCs. Please find the Slide presentation and links to resources cited in the Presentation.

Provider Relief Funds Reporting Requirements Powerpoint Slides for October 8, 2020 (PDF)

NRHA Questions regarding Provider Relief Fund Guidance on October 8, 2020 (3-page PDF)

October 5, 2020: Please click here for the latest edition of HBS Update for October 5, 2020 with information on upcoming webinars by NARHC, HBS, and new Provider Relief Funding.

Provider Relief Funds Reporting Requirements for RHCs

On September 19, 2020, the US Department of Health & Human Services (HHS) released the General and Targeted Distribution Post-Payment Notice of Reporting Requirements for the Provider Relief Fund (PRF), which was authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This webinar will go over these reporting requirements including timing & deadlines, reporting elements, guidelines for use of funds, the new more restrictive definition of lost revenues, FAQs, and forms to help RHCs gather the information for reporting the uses of these funds to HHS.

Please register for Provider Relief Funds Reporting Requirements for RHCs on Oct 8, 2020 12:00 PM CDT at:

https://attendee.gotowebinar.com/register/499132509589537804

After registering, you will receive a confirmation email containing information about joining the webinar. Brought to you by GoToWebinar® Webinars Made Easy®

July 29, 2020

COVID-19 Current Reimbursement Issues for Rural Health Clinics with Charles James of North American Healthcare Management

Here are the slides for this webinar: Slides for Current Reimbursement Issues for RHCs on July 31, 2020 (PDF)

In this thirty-minute Webinar Mark Lynn, Charles James, Patty Harper, and Douglas Swords will update RHCs on the following five issues:

1. HHS renews the Public Health Emergency (PHE) for 90 more days

2. Provider Relief Fund Reporting Requirements

3. Provider Relief Funds are Taxable

4. Exceptions to Productivity Screens for RHCs

5. Cost Reporting implications of the Payroll Protection Program

We will be going over the following document in the webinar: COVID-19 Updated Information for RHCs as of July 27, 2020 (PDF)

The webinar is designed to be just a quick update on some of the issues that are pressing for RHCs and not designed to go be an in-depth explanation of any of the issues. We will have some time for a quick Question and Answer session at the end of the webinar.

Please register for COVID-19 Current Reimbursement Issues for Rural Health Clinics with Charles James of North American Healthcare Management on Jul 31, 2020 12:00 PM CDT at: https://attendee.gotowebinar.com/register/4779006807954089486

After registering, you will receive a confirmation email containing information about joining the webinar. Brought to you by GoToWebinar® Webinars Made Easy®

July 9, 2020 On July 8, 2020 HHS conducted a webinar on the Medicaid/CHIP fund distribution. Here are our notes. Additionally, we published an HBS Update Newsletter today which can be found at this link: https://conta.cc/2ZcrRTj

July 6, 2020: CMS released a revised SE20016 memo for RHCs today. Here is the link: https://www.cms.gov/files/document/se20016.pdf The major change is that the CS modifier should be added to telehealth claims with preventive services to waive the co-pays. This revised memo does have an error in it (do not use the CG modifier with G2025 claims on or after July 1, 2020) and will be reissued to correct the guidance.

On June 25, 2020, Palmetto revised their website to instruct providers that the extended due date for filing December 31, 2019 Medicare cost reports has been revised from July 31, 2020 to August 31, 2020. Here is some more information. We still have a large number of RHCs that have not submitted their cost report information for filing. Please submit this information as soon as possible, as we need time to accurately and completely file your cost report before the revised Cost Report filing deadline.

June 11, 2020 HHS announced funding for Pediatric and CHIP clinics this week. We put together a document with information on how to apply and attest for this funding which can be found here.

Additionally, the PPP loan program has changed. The NARHC and Nathan Baugh updated RHCs here.

RHCs may be able to get the productivity standards waived when the 2020 cost report is submitted in May, 2021. Here is the form that will have to be completed if Novitas is your MAC. The form can be found here. Other MACs will develop their own form and when we get closer to the 2021 cost report filing date we will update you at that time. Here is a link that will download an Excel file to apply for the waiver.

May 27, 2020: On May 21, 2020 Charles James and Patty Harper held a webinar to update RHCs on Telehealth. The slides for this presentation can be found here.

May 20, 2020: PDF of the May 20th information can be found in this 3-page PDF. HBS Update - May 20, 2020

Hello everyone. A lot has happened today (as always). Most RHCs woke up with approximately $50,000 of new funding for COVID-19 testing and are still trying to sort out all the other tranches of stimulus funding they have received. We recorded a webinar on Monday that discussed these funds and provided tools to keep up with the funding as well as account for the payments in your accounting system as well as what we know about the reporting of the uses of these funds. We have included all the documents and recording from the webinar below.

On Tuesday we had a fantastic session with AAAASF and TCT while we conducted a virtual tour of a Rural Health Clinic. Kate Hill from TCT and Diane Bourque from AAAASF were amazing and really helped our RHCs to retrofit their RHCs in a COVID-19 world and prepare for their initial or resurvey. We have included the recording of the webinar and PDF of the slides below.

Here are the documents and recording of our Provider Relief Funds for RHCs on May 18, 2020

To Find the recording of the webinar go to the following link: https://youtu.be/AuV1v4FoVgE
To find the slide presentation for this webinar click HERE
The SBA has released the Loan Forgiveness application which can be found HERE
Updated PPP Loan FAQ from the SBA
1. Economic Relief Tracking Tool for RHCs
2. Template of Form to Report Quarterly Expenses if you received more than $150,000 in payments from the General or Rural Allocation Pool

Here are the documents related to the Virtual-Self Survey with AAAASF & TCT Webinar on May 19, 2020.

We uploaded the presentation on YouTube at the following location: https://youtu.be/hVAqVciYGko
You can find the Slide Presentation for the webinar HERE

Telehealth Webinar on May 21st at 11:30 Central Time by North American HMS & InQuiSeek, LLC

On May 21st North American HMS and InQuiseek, LLC will have a webinar on RHC Telehealth billing and how to use G2025. The webinar will be from 11:30 to 12:30 Central time. Mark Lynn will be a panelist on this session. Please find additional information below.

RHC Telehealth Coding and Documentation Webinar by North American HMS and InQuiseek, LLC updating RHCs on how to use G2025. Charles James and Patty Harper will be speaking and answering your RHC Telehealth coding and documentation questions related to G2025.

To Register: https://attendee.gotowebinar.com/register/8519481592358343950

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HHS Provides $225 Million for COVID-19 Testing in Rural Communities

The NARHC released this information related to the COVID-19 Funding:

https://www.web.narhc.org/News/28385/HHS-Announces-Details-of-RHC-COVID-19-Testing-Fund

There is a FAQ at the following address by HRSA:

https://www.hrsa.gov/rural-health/coronavirus-frequently-asked-questions

https://www.hhs.gov/about/news/2020/05/20/hhs-provides-225-million-for-covid19-testing-in-rural-communities.html

Today, the U.S. Department of Health and Human Services (HHS) through the Health Resources and Services Administration (HRSA) provided $225 million to Rural Health Clinics (RHCs) for COVID-19 testing. These investments will support over 4,500 RHCs across the country to support COVID-19 testing efforts and expand access to testing in rural communities. Rural Health Clinics are a special designation given to health care practices in underserved rural areas by the Centers for Medicare and Medicaid Services (CMS) that help ensure access to care for rural residents.

This funding is through the Paycheck Protection Program and Health Care Enhancement Act that President Trump signed into law on Friday, April 24, 2020 which specifically directed these monies to be allocated to RHCs. HRSA funded RHC organizations based on the number of certified clinic sites they operate, providing nearly $50,000 per clinic site.

“Today’s funding provides rural health clinics with resources and flexibility to boost their testing capabilities to fight COVID-19,” said HHS Secretary Alex Azar. “Further expanding testing capacity, including at RHCs, is a crucial element of safely reopening our country and helping Americans return to work and school. A safe reopening is vital for Americans’ health and well-being, and especially so for those living in rural areas, who may have struggled with access to healthcare long before COVID-19 and found care even harder to access during this crisis.”

“The funding may be used for a wide range COVID-19 testing and related expenses including planning for implementation of a COVID-19 testing program, procuring supplies to provide testing, training providers and staff on COVID-19 testing procedures, and reporting data to HHS on COVID-19 testing activities,” said HRSA Administrator Tom Engels. “Funds may also be used for building or construction of temporary structures, leasing of properties, and retrofitting facilities as necessary to support COVID-19 response.”

HRSA is also awarding $500,000 to support technical assistance efforts to the RHCs as they expand testing capabilities. This includes activities such as conducting webinars, providing resources and guidance for implementation and management of testing programs.

To view a state-by-state breakdown of this funding, visit: https://www.hrsa.gov/rural-health/coronavirus/rural-health-clinics-covid-19-testing-fy20-awards

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Provider Relief Funds for RHCs Webinar on May 18, 2020

In this webinar, Mark Lynn from Healthcare Business Specialists will provide a quick update on the Provider Relief Funds for RHCs. Mr. Lynn will go over what we know about the funds and actions RHCs need to take to regarding these funds based upon what we currently know. We will provide tools to help you keep up with the funds and reporting requirements. This 30 to 45-minute webinar will include some time for questions; however, most of the questions we have received so far are yet to be spelled out in official guidance from HHS.

Please register for Provider Relief Funds for RHCs on May 18, 2020 12:00 PM CDT at:

https://attendee.gotowebinar.com/register/5637251498092891150

After registering, you will receive a confirmation email containing information about joining the webinar. Brought to you by GoToWebinar® Webinars Made Easy®

To Find the recording of the webinar go to the following link: https://youtu.be/AuV1v4FoVgE

To find the slide presentation for this webinar click HERE

The SBA has released the Loan Forgiveness application which can be found HERE

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VIRTUAL SELF-SURVEY WEBINAR ON MAY 19, 2020

VIRTUAL SELF SURVEY WITH AAAASF AND TCT

(TOM TERRANOVA, KATE HILL, AND ELSIE CRAWFORD)

In this webinar, Mark Lynn of Healthcare Business Specialists will conduct a virtual RHC Compliance walkthrough of an RHC with AAAASF and TCT. Tom Terranova (AAAASF), Kate Hill (TCT), Elsie Crawford (AAAASF) will virtually walk through with us and will point out what an RHC Certification inspector is looking for when they tour the facility. They will point out common deficiencies and provide best practices for RHCs to undertake as they prepare for their initial RHC certification inspection or for a recertification inspection. AAAASF and TCT will provide a description of their current inspection processes in the light of COVID-19. AAAAF and TCT will update RHCs on how COVID-19 has changed the infection control processes in RHCs and what steps should be taken to protect patients, staff, and providers during the COVID-19 Public Health Emergency. If you have questions or concerns you would like addressed on this topic, please send them to Mark Lynn at marklynnrhc@gmail.com with the Subject: "Virtual Self-Survey Questions" and we will add them to our slides. This webinar will focus on the walkthrough aspects of an RHC self-survey. We plan on having a future followup Self Survey Inspection webinar addressing items such as Policies and Procedures, Emergency Preparedness, Protocols, chart reviews, program evaluations, and other paperwork aspects of a mock inspection. This particular webinar will focus on just the walkthrough aspect to keep our time and 1 hour or so. If you do have questions about the paperwork aspect of the mock inspection, go ahead and email those questions to us using the same Subject "Virtual Self-survey Questions.

Please register for Virtual Self Survey with AAAASF and TCT (Tom Terranova, Kate Hill, and Elsie Crawford) to watch the presentation using Gotowebinar below:

https://attendee.gotowebinar.com/register/627882019289589263

If you prefer, we uploaded the presentation on Youtube at the following location: https://youtu.be/hVAqVciYGko

You can find the Slide Presentation for the webinar HERE

After registering, you will receive a confirmation email containing information about joining the webinar. Brought to you by GoToWebinar® Webinars Made Easy®

Here is a PDF that has some of the information we will go over in the webinar:

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May 13, 2020: We added some documents to help you manage Provider Relief funds and the PPP loan today:

HBS Update on May 14, 2020

5/10/2020: We updated our Excel Spreadsheet of laws, regulations, articles, and guidance for RHCs which can be found here.

May 6, 2020: Many of RHCs received stimulus funds today. Here are some links related to those funds.

Two Page Summary of the information related to the $10 billion Rural Distribution including the phone number to call if you did not get the payment

May 1: We updated our website to include the following information from the webinar today. Thank you to everyone for participating

Here is the recording of the webinar on May 1, 2020

Julie Quinn from HSA - Cost Reporting and Telehealth Presentation for RHC Telehealth Billing webinar on April 22, 2020
Julie Quinn - HSA Time Study Document in Excel for keeping up with Telehealth time on the RHC Cost Report
Agenda for RHC Telehealth Webinar on May 1, 2020
To register to view the event on Gotowebinar follow this link: https://attendee.gotowebinar.com/register/7880974299054011662

TeleHEALTH Billing for RurAL Health CLINICS Webinar

mAY 1, 2020

Just a quick email to let you know about important changes to the RHC program announced today and about how to bill Telehealth in RHCs. We are working on understanding all the changes now and have planned a webinar for tomorrow at Noon, CENTRAL Time. SE20016 includes the statement "effective March 1, 2020, these services include CPT codes 99441, 99442, and 99443, which are audio-only telephone evaluation and management (E/M) services. RHCs and FQHCs can furnish and bill for these services using HCPCS code G2025. To bill for these services, at least 5 minutes of telephone E/M service by a physician or other qualified health care professional who may report E/M services must be provided to an established patient, parent, or guardian. These services cannot be billed if they originate from a related E/M service provided within the previous 7 days or lead to an E/M service or procedure within the next 24 hours or soonest available appointment.

Obviously, this is what we were hoping for, so it is very exciting for our RHCs that have been providing a number of telephone only visits. We will know tomorrow when we do the webinar, but for now HOLD YOUR MEDICARE TELEHEALTH CLAIMS

On April 30, 2020 CMS released a revised SE20016 (https://www.cms.gov/files/document/se20016.pdf) addressing Telehealth Billing for RHCs fundamentally changing the guidance issued on the April 17th version of SE20016. This webinar will go over the new billing guidance that includes billing for Telephone only visits with a payment rate of $92.03. There are a number of changes in the 7-page document which we will go over in this 30 to 45-minute webinar which will focus only on the changes to Telehealth Billing for RHCs. There will be time for Questions and Answers (or most like dumb looks) after the presentation.

Please register for Brand New and Changed Guidance on Telehealth Billing for RHCs including payment for Telephone Only Visits on May 1, 2020 12:00 PM CDT at:

https://attendee.gotowebinar.com/regist…/7880974299054011662

The webinar will include speakers and panelists including Nathan Baugh from the NARHC, Patty Harper from InQuiseek, LLC, Julie Quinn from HSA, Shannon Chambers from SCORH and Charles James from North American. The date and time is 12:00 Noon CENTRAL time on May 1, 2020.

After registering, you will receive a confirmation email containing information about joining the webinar.

Brought to you by GoToWebinar®

Webinars Made Easy®

April 26, 2020: We recorded a 55-minute webinar today on RHC and Telehealth billing that covers all the slides that I missed in the April 22nd webinar. With a little more time, we could explain things in a little more detail.

April 25, 2020: HHS announced several funding programs targeting healthcare and RHCs during the week ending April 24, 2020. It is rather difficult to keep up with the funds, grants, and opportunities, so I prepared a table to help me understand what is available and what RHCs can expect in the near future as far as government funding of the COVID-19 crisis. It is not all-inclusive, but just a snapshot of the major programs RHCs should be aware of. Here is the table:

RHC Summary Funding Resources Table on April 25, 2020 (1-page PDF)

April 24, 2020: Additional funding is now available from HHS to eligible providers. There are $20 billion ($30 billion has already been funded) dollars of funds to be distributed to healthcare providers in the next few weeks. If you received a check or funding from the first distribution of $30 billion, you are eligible (sorry, pediatrics is left out of this distribution) for this distribution and language implies that the funds are distributed based on net revenues. You will have to go to the portal listed in the document linked below and report your revenues from your tax return as soon as possible before the money runs out. This document will help you pull the information together to enter in the portal. The portal opened this evening for submission of 2018 revenue. The pool is finite and hospitals/organizations who submit their information are first in line. These funds are not an advanced payment and do not need to be repaid.

Provider Relief Fund and Rural Health Clinics - How to get your share of $20 Billion before it is gone

April 23, 2020: Please find the slides and recording of the RHC Telehealth Billing webinar presented on April 22, 2020. Thank you to everyone who attended. We had over 500 people at the webinar which was capacity, so we really appreciate your interest. A big thank you to Nathan Baugh, Charles James, Julie Quinn, Patty Harper, and Dani Gilbert for helping make this webinar happen. We are working on updating our FAQ with questions that were not answered during the session. We appreciate what you are doing and stay safe.

You will find below the Agenda and the slide presentation that will go over during the webinar:

Recording of the RHC Telehealth Webinar on April 22, 2020 (Youtube - 2 hours)

HBS Update on April 20th, 2020 with link to FAQ, NARHC webinar registration link, and HBS webinar

April 17, 2020

The long awaited guidance from Medicare to RHCs on billing telehealth claims was released today. We are working on the webinar explaining the rules which will be held on Wednesday, April 22, 2020 at Noon, Central Time. Here are the links to guidance and the webinar:

https://attendee.gotowebinar.com/register/345720946941958158

HBS Update Newsletter on April 17, 2020 with information about the Medicare Telehealth Guidance for RHCs and upcoming webinars

The CARES Act Provider Relief Fund Payment Attestation Portal is now open. Providers who have been allocated a payment from the initial $30 billion general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment.

April 12, 2020:

On Saturday we recorded our Telehelath webinar on Medicare Part B Fee for Service. It is rather long and includes information on Modifier 95, and new place of service guidance, the use of the CS modifier (not just for Telehealth), and new guidance for enrollment for providers working from home (spoiler, you do not have to call and add their home address to their Medicare Part B enrollment). We also have a lot of links to cheat sheets, tool-kits, and other information you need to start a Telehealth program. While this webinar goes over Medicare Part B fee for service information and is not directed at RHCs it will be helpful to RHCs that have non-RHC time or hospitals with clinics that do not have the RHC designation. We still do not have word on the new RHC billing guidance as a distant site, but as soon as we do we have a great line-up on standby to get the information to you as quickly as possible.

RHCs got a nice surprise on Friday. A check from the federal government. To help you understand the meaning of this CARES Act Relief Fund money we have produced a “pop-up: webinar that lasts 10 minutes and will explain the monies and how to account for them.

We also included links to a lot of valuable information we used to prepare the Part B Telehealth webinar include a link to cheat sheet by EMPClaims that has been particularly helpful to our clinics billing Telehelath insurance claims.

April 7, 2020

Here is some updated information:

April 4, 2020

Please find the following information that will be helpful to RHCs:

April 2, 2020

Still no word on the Medicare Telehealth Benefit for RHCs. We did get some guidance from CMS that RHCs that need to close or reduce hours during the State of National Emergency are allowed to do so. Kate Hill from The Compliance Team recommends that if you are temporarily closing or changing your hours of operation to notify the state of this change. We also have an email from Lana Dennis from CMS saying that RHCs are allowed to do this as well. Below is the link to the CMS Memorandum to State Surveyors with the section on RHCs highlighted.

Guidance for Infection Control and Prevention of Coronavirus Disease (COVID19) in Outpatient Settings: FAQs and Considerations

Last week’s Interim Regulations fundamentally changed the way Medicare pays Telehealth services during the State of National Emergency. Here is a slide presentation that will help you and we will go over the changes in our RHC webinar as well:

Telehealth Slide Presentation from Amerisource Bergen

March 31, 2020

Good Morning. Last night CMS published regulations affecting the way healthcare is delivered during this state of emergency and we are going over them today. As far as RHCs go the G0071 code has been expanded to include many other things and will be paid at a blended rate of $24.75 up from the previous $13.69 (2019 fee) and the code encompasses many other services. Also, RHCs can now use visiting nurses during the pandemic and these visits will be paid at the RHC rate is our understanding. These are my first impressions from reading the rules, but I am spending the day looking closer and will revise this section of the webpage to correct anything I misunderstood on my first reading last night. Here are the links so you can read for yourself. There are about 10 pages regarding RHCs starting on page 82.

March 30, 2020

Good Afternoon. We are anxiously awaiting guidance from CMS on how RHCs can bill as a distant site, but as of 5 PM Eastern time, we have not seen any guidance. The NARHC did send out a letter today listing and describing provisions in the CARES Act that will benefit RHCs. I have included it below as well as an Excel Spreadsheet with a sortable list of 42 documents that relate to COVID-19, Telehealth, and RHCs.

NARHC Letter detailing RHC Relief Options in Recently Signed CARES Legislation on March 30, 2020

Small Business Loans for RHCs

RHCs play many roles in communities. Healthcare Provider, Emergency Responder, Community Leader, Business owner and Employer. As an employer here are some resources as you deal with some hard business decisions in response to COVID-19.

More helpful information from CARES. Loans that could be forgiven if borrowers maintain their payrolls after the crisis.

"The Coronavirus Aid, Relief, and Economic Security (CARES) Act allocated $350 billion to help small businesses keep workers employed amid the pandemic and economic downturn. Known as the Paycheck Protection Program, the initiative provides 100% federally guaranteed loans to small businesses. Importantly, these loans may be forgiven if borrowers maintain their payrolls during the crisis or restore their payrolls afterward. The administration soon will release more details including the list of lenders offering loans under the program. In the meantime, the U.S. Chamber of Commerce has issued this guide to help small businesses and self-employed individuals prepare to file for a loan."

Telehealth Resources

March 28, 2020

Accelerated Payments from Medicare for RHCs

Great News!!!! This will help you sleep a little better tonight. CMS has just released information on how Medicare Part A and Part B providers can receive Advanced payments. That means RHCs can receive these advance payments.

https://www.cms.gov/newsroom/press-releases/trump-administration-provides-financial-relief-medicare-providers.

"CMS is expanding the program for all Medicare providers throughout the country during the public health emergency related to COVID-19. The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers. To qualify for accelerated or advance payments, the provider or supplier must:

Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form,
Not be in bankruptcy,
Not be under active medical review or program integrity investigation, and
Not have any outstanding delinquent Medicare overpayments.

Medicare will start accepting and processing the Accelerated/Advance Payment Requests immediately. CMS anticipates that the payments will be issued within seven days of the provider’s request." There is a Fact Sheet (that is linked in the press release) which says:

"Amount of Payment: Qualified providers/suppliers will be asked to request a specific amount using an Accelerated or Advance Payment Request form provided on each MAC’s website. Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period. Inpatient acute care hospitals, children’s hospitals, and certain cancer hospitals are able to request up to 100% of the Medicare payment amount for a six-month period. Critical access hospitals (CAH) can request up to 125% of their payment amount for a six-month period.

Processing Time: Each MAC will work to review and issue payments within seven (7) calendar days of receiving the request.
Repayment: CMS has extended the repayment of these accelerated/advance payments to begin 120 days after the date of issuance of the payment.

The repayment timeline is broken out by provider type below:

Inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and Critical Access Hospitals (CAH) have up to one year from the date the accelerated payment was made to repay the balance.
All other Part A providers and Part B suppliers will have 210 days from the date of the accelerated or advance payment was made to repay the balance."

What this means for Rural Health Clinics is you can request from your MAC a check representing up to 3 months' payments from Medicare. I would look at your last complete quarter (October, November, and December) and calculate your net Medicare payment from that time period and ask Medicare for that amount. Don't use January, February, and March as RHCs are in the Negative Reimbursement season and Medicare typically actually takes money away from you during those months (crazy, huh). The easy way to compute your potential payment is to take your P S & R and divide it by 3 (the reason I used 3 instead of 4 is Medicare pays you nothing during the first quarter of each year) and claim that amount. Your MAC will start withholding your Medicare funds after 120 days until the loan is repaid up to 210 days.

We will go over this process at this week's webinar so if you hear something different or new about the process, please share with the group. Most of us thankfully (except for some of our friends in Florida, Louisiana, and Texas have never had to do this before so the process is new.

Here are the instructions and form to ask for accelerated payments from Palmetto GBA Part A - Jurisdiction JJ. If this is not your MAC go to the home page and most likely the instructions will be on the home page.

March 27, 2020:

The President signed the CARES Act (Phase 3 of the COVID-19 Emergency Stimulus Legislation) allowing RHCs to be a distant site for Telehealth purposes. The $2 trillion dollar package will impact everyone and I would take time to familiarize yourself with the package and if we become aware of provisions particularly useful or helpful to RHCs we will let you know or if you find something, please let us know and we will share the information.

NARHC Letter announcing the passage of the CARES act on March 27, 2020

As soon as CMS issues guidance on the CARES Act that the House approved and the President signed, we will have a webinar with the details of how to bill for RHCs. If CMS releases the information on Monday we will schedule it for Tuesday.

What does the Section 3704 Enhancing Medicare Telehealth Services for FQHCs and RHCs During Emergency Period Increasing mean for RHCs?

Section 3704 does five things:

Medicare will pay for telehealth services that are furnished via a telecommunications system by a rural health clinic to an eligible telehealth individual enrolled in Medicare as long as the RHC is not at the same location as the beneficiary.
Allows rural health clinics to serve as a distant site for telehealth services
Allows CMS to develop a payment method based upon payment rates that are similar to the national average payment rates for comparable telehealth services under the Medicare Part B physician fee schedule
Costs associated with telehealth shall not be used to determine the all-inclusive rate
These provisions are temporary and only in effect during the declared state of National Emergency.

Source: https://www.documentcloud.org/documents/6819239-FINAL-FINAL-CARES-ACT.html

Here is the language from Section 3704 of the Phase 3 Emergency COVID-19 Stimulus Funding Bill allowing RHCs to be distant sites during the COVID-19 National State of Emergency.

Section 3704 of the Phase 3 Emergency COVID-19 Stimulus Funding Bill allowing RHCs to be distant sites during the State of Emergency

We have prepared an FAQ for RHCs pertaining to Telehealth. We are updating the FAQ every day as we get more information and we are adding questions from last weeks’ webinar as we go. Even with process we will not get them all done because there were 130 questions at the webinar. So far we have 13 questions and answers completed. Please feel free to provide input or help to any of the FAQs as information is changing rapidly and we do our best to stay current, but it is very difficult to stay current with all the changes:

FAQ for RHCs and Telehealth updated as of March 26, 2020 (13 Questions)

We have added some additional resources for RHCs that will be helpful to may of you:

Great news for Tennessee. Tennessee can get their RHC rate as a distant site. I have included the three memos from Tenncare that were emailed to me this morning.

As information comes out, we will try to get it to you as quickly as possible. Here are some links to valuable information for RHCs related to COVID-19, Telehealth, and Billing. The first is coding guidance from CMS on COVID-19 which is the way you should code COVID-19 services. It is not necessarily the way you would bill them in a rural health clinic. Remember coding and billing are two different things. The second document is information that should be added to a chart when you conduct a telehealth visit such as the location of the provider, the patient, who was involved in the visit, how were the services performed? phone only, phone and video, etc.

March 25, 2020: FINALLY!!! The Senate bill has passed and is moving back to the House for a quick approval (hopefully today) and then to be signed by the President shortly thereafter. We still do not have the final text of the Senate bill, but as soon as it is published, we will read it and incorporate that information in our FAQ from yesterday’s webinar. Our plan is to schedule another webinar early next week (most likely on Tuesday at Noon Central) to go over the new guidance from CMS on how to bill telehealth in RHCs and to go over the FAQs created from this week’s webinar.

South Carolina Medicaid Expansion of Telehealth and Telephone Benefits from Shannon Chambers and SCORH

March 24, 2020: We are having a webinar today on Telehealth Billing for RHCs at Noon, Central Time. Here is where we will add documents related to the webinar including presentations and a recording of the session when the webinar is completed:

March 23, 2020: CMS released a Telehealth Toolkit for providers on March 20th, 2020 and it is excellent. If you want to start Telehealth services in your clinic, this is a great place to start. One word of caution, it still does not address the distant site issue in RHCs. Additionally, we have added some resources to help you as you implement Telemedicine:

Many States have relaxed Telehealth regulations as we respond to the COVID-19 Global Pandemic. We have provided a listing of the changed regulations that we are aware of here:

March 21, 2020: I wanted to share some information provided by John Waltko, CPA, Vice President, Regulatory & Financial Reporting from Quorum Health Resources, LLC addressing the surprising issue that many hospitals and clinics are facing during this global pandemic - lost revenue. As crazy as it sounds many hospitals and clinics that do not directly treat COVID-19 or rely on many other revenue streams to provide the income to pay for their operations will soon be facing closure as they have a real chance of running out of cash before long. Here is what John said about hospitals and clinics potentially being able to recoup costs of the pandemic from FEMA, other Federal agencies, or possibly but not likely your insurance carrier.

“We have been struggling with this issue: normally in a natural disaster, hospitals can file a claim against there insurance carrier for "Business Interruption" payments. Hospitals should be able to also file a claim with FEMA to recoup 75% of any direct and indirect costs associated with the epidemic...Readiness preparations etc. The rest would be claimed against your insurance carrier. I believe we will all have to work through Regional FEMA Offices and State Department of Health. I have read in news sources that insurance policies will not cover costs or lost revenues resulting from a pandemic. So, check your insurance policies. I have attached some information from the FEMA Website: I believe that as each State declares a National Emergency, Regional FEMA offices will swing in to action and start the ball rolling on the cost recovery process.”

March 20, 2020: There is going to be a webinar on Tuesday, March 24th at Noon, CENTRAL Time and it will last until 1:45. We have a number of great speakers to update you on the Telehealth and rural health clinics. Hopefully, a stimulus bill will have passed with RHCs getting paid at the All Inclusive Rate for Telehealth visits. In the meantime, you can help by lobbying your representatives on what we need as RHCs. I prepared a document on the Republican Senate bill to help you understand why getting the AIR language is so important and it is in the link below along with a draft of the Republican Senate bill. Please reach out and help RHCs during this crisis. Thank you and be safe.

HBS Update Newsletter - March 21, 2020

Informational Flyer about the Webinar on Telehealth and RHCs on March 24, 2020 (2-page PDF)

Review of the Draft of the Republican Senate Bill - Phase 3 of the Emergency Stimulus Bill (2-page PDF)

Here are links to information provided to us from March 17th to March 21, 2020 on COVID-19

Here is a list of resources and companies that we have worked with during the week ending March 21, 2020. Thanks to all that are working so hard during this difficult time. We appreciate you.

Telemedicine and Rural Health Clinics

March 17, 2020: How to treat suspected COVID-19 patients safely has increased the demand for telemedicine for our rural health clinic providers. Unfortunately, most of the law that establishes RHCs is Public Law 95-210 was first enacted in 1977. While there have been updates and modernization of the act in the last 43 years, many of the original provisions remain unchanged and create barriers to safely identify and safely treat suspected COVID-19 patients via telemedicine. This series of links and FAQS will help RHCs understand what the options are for providing Telemedicine from a rural health clinic (RHC).

HBS Update Telehealth for March 17, 2020 (PDF)

COVID-19 Infection Control Webinar Resources

March 12, 2020: Here are the resources provided in our COVID-19, Infection Control and RHCs with Southern Evals - Taylor Cottano and Patty Harper on March 12, 2020

Other Important COVID-19 rESOURCES FOR rhcS

Besides the information presented in the webinar, here is a listing of links to important information about COVID-19 and rural health clinics.