RHC Technical Assistance Call

RHC Technical Assistance Call
November 20

The next RHC TA call will be held on Tuesday, November 20 at 1:00pm CST. The call is entitled “Meeting the RHC Civil Rights Requirements.” Provider–based (hospital-based) RHCs are being asked to demonstrate their compliance with the federal civil rights requirements and, in the future, it is thought that independent (free-standing) RHCs may be expected to meet the federal civil rights requirements.

The speaker will be Robin Veltkamp from Health Services Associates, Inc. (HSA). Robin will cover the federal civil rights requirements and what it takes to demonstrate compliance.

The call-in information is: (888) 606-9802, Pass code 7197682

The presentation will last about 45 minutes allowing time for some questions after the subject matter presentation. A copy of the slides of the program will be available prior to the call and instructions will be made by email as to the web address where you can go to download the slides.

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Health Resources and Services Administration Webinar

Health Resources and Services Administration Webinar
November 16
There will be a free HRSA webinar on patient charting and documentation in the electronic health record for nurses and allied health professionals. The webinar will begin at 1:00pm CST. Register for the call here.

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Celebrating the Power of Rural

November 15th is National Rural Health Day – Celebrating the Power of Rural!

Why are rural health clinics important? Tell me in two or three paragraphs why you think RHCs are important…and if you can give me an example of how the RHC benefited one of your patients in your clinic, kindly include that also! Please send your response to Ramsey Longbotham.

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Texas Legislature – Important Dates to Keep in Mind

Texas Legislature – Important Dates to Keep in Mind

Monday, November 12, 2012
Pre-filing of legislation bills for the 83rd Legislature

Tuesday, January 8, 2013
83rd Legislature convenes at noon

Friday, March 8, 2013
Deadline for filing bills and joint resolutions other than local bills

Monday, May 27, 2013 (140th day)
Last day of 83rd regulation Session, corrections only in house and senate.

Sunday, June 16, 2013 (20th day following final adjournment )
Last day governor can sign or veto bills passed during the regular legislative session.

Monday, August 26, 2013 (91st day following final adjournment)
Date that bills without specific effective dates (that could not be effective immediately) become law.

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New Manager at the Texas RHC Survey and Certification Office

Kaimy (pronounced KIMMY) Chappell has been selected as the manager of the Texas Department of State Health Services’ (DSHS) survey and certification office for rural health clinics. She replaced Chuck Peck, who accepted a transfer to the HHSC Office of the Inspector General’s (OIG) Fraud Investigation Team.

This health facility licensure and complaints office handles several healthcare provider type entities besides rural health clinics. They are: outpatient therapy clinics; portable x-rays; CORF rehab facilities and community mental health centers.

All RHC survey and certifications are handled out of this one office located in Austin. All RHC questions about initial survey applications, re-certifications, changes of ownership (CHOW), operational regulatory criteria in the State Operations Manual, request for waivers when your physician assistant or nurse practitioner leaves employment in your RHC, etc., can be directed to them. Please don’t ask them about billing questions since they do not have anything to do with the finance end of the business.

Their contact info is: Texas Department of State Health Services
P.O. Box 149347 (MC 1979)
Austin, Texas 78714-9347

Kaimy Chappell, Supervisor
RHC Survey and Certification
Phone (512) 834-6650, ext 2639

Brenda Butler, Administrative Assistant
RHC Survey and Certification
Phone (512) 834-6650, ext 2470
Fax (512) 834-6653

 

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TrailBlazer Announces Final Posting of Medicare Part A Claims Input

Effective October 29, 2012, the Jurisdiction 4 (JH4) Medicare Part A “facilities” (i.e. RHCs workload) will transition to Novitas Solutions, Inc. as part of the JH implementation.

Due to the transition, Trailblazer will no longer be posting any Medicare Part A information on their website as of October 26, 2012. TrailBlazer will continue to update their website with any required Medicare Part A information through the close of business October 25, 2012.

The TrailBlazer Part A toll-free numbers and Interactive Voice Response (IVR) will no longer be in service after 4:00 pm Central Time, October 26, 2012. Novitas will observe a “dark day” on October 29, 2012, to complete cutover transition activities and offers a single toll-free customer service line to be effective October 30, 2012.

Effective October 29, 2012, providers will need to access the Novitas Solutions website www.novitas-solutions.com to obtain all Medicare Part A information.

Medicare Part B claim transactions for the physician fee-for-service reimbursement will transition over to Novitas from TrailBazer on November 19, 2012.

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New CMS Region VI Rural Health Coordinator

Becky Peal-Sconce has notified us that instead of retiring as she had planned on doing in January 2013, she will continue working but in another job role. On October 7, she transferred to the CMS division responsible for Medicare Advantage (MA) and Medicare part D prescription drug plans. Becky said that after working in rural health for most of her 38 years with CMS, she wanted to do something different. Her new job will be working with provider complaints and appeals and bringing rural providers’ perspectives to the monitoring of the MA plans.

Her replacement is Kaleigh (pronounced KAY-LEE) Emerson, who is transferring from the Philadelphia Regional Office where she worked with CMS for two years, primarily in the areas of Medicare Secondary Payer and Accountable Care Organizations. Kaleigh is already familiar with Texas, because she grew up in South/Central Texas. She reports to her new role as the CMS Region VI Rural Health Coordinator on October 22 and will begin acquainting herself with the specific policies that cover providers in the rural area. Her CMS Rural Health Coordinator’s phone number can be reached at (214) 767-6444 or via e-mail. Kaleigh studied global health in graduate school and has a background in public health. She started her career at CMS as a Presidential Management fellow at CMS. We look forward to working with Kaleigh in the future. We extend an invitation for her to visit with our RHCs at the NARHC Conference in San Antonio and at the TARHC Conference in Austin next year.

Good luck, Becky, on your new adventure! Welcome back to Texas, Kaleigh!

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Upcoming Texas RHC Training

Healthcare Horizons has scheduled two training days in Texas to present a newly created intensive five-hour RHC Update and Review Workshop. Cost $99 per person. The dates and locations are:

  • San Antonio – Thursday October 11, 2012 – 11:00 AM to 4:00 PM (eat lunch before program)
    Holiday Inn west of downtown at 318 W. Cesar Chavez
  • Dallas – Friday December 7, 2012 – 11:00 AM to 4:00 PM. (eat lunch before program begins)
    Wyndham Hotel at Love Field

For more information or to register contact Jim Estes, 800-399-0874 or visit their web site.

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The National Advisory Committee on Rural Health and Human Services is Coming to Texas

On Wednesday September 26, 2012, the National Advisory Committee on Rural Health and Human Services will conduct a day-long public meeting in Austin at the Radisson Hotel & Suites, located downtown at 111 E. Cesar Chavez Street. The meeting will begin at 9:00am with a welcome by the Committee Chair, former Mississippi Governor Ronnie Musrove, and followed up with a Health and Human Services update by the CMS Regional VI Director Majorie McColl Petty. Linda Jones, the Texas State Office of Rural Health Director, will conclude the update session with an overview of the transfer of Texas’ rural health agency to the Texas Department of Agriculture’s Office of Rural Affairs. Download the agenda here.

Beginning at 10:00am will be the start of a series of Infrastructure Panels lasting though the day that will cover healthcare concerns, rural workforce and workforce opportunities. At 4:00pm, the committee will conduct an open discussion of the issues presented and conclude the day with an overview of the next day’s site visits to Llano, Lulling and Bastrop by selected committee members who will take community public comments in those rural towns.

On Thursday September 27, health care issues addressed by the general public (this is the time for nearby local RHC staff to attend and make public comments on their access issues that will be accepted by the committee site visit meetings at the Scott and White hospital in Llano and also at the Seton Edgar B. Davis hospital in Lulling. Public workforce issues will be accepted by a committee in Bastrop at the Workforce Solutions’ office of Bastrop County. In the afternoon the community site visit committee members will reconvene in Austin at 4:00pm to discuss and begin drafting their comments on rural health infrastructure, hospitals, and rural workforce ideas.

On Friday morning, September 28, the committee will continue going over their subcommittee notes and drafting the outline of their White Papers; and at 9:30am they will review their findings and highlight their subcommittee key points and timelines. Their business will be concluded during a meeting at 10:00am with a call for any public comment at 10:30am, after which they will adjourn their official visit to Texas.

The National Advisory Committee on Rural Health and Human Services is a 21-member citizens panel of nationally recognized rural health experts that provides recommendations on rural issues to the Secretary of the Department of Health and Human Services.

The committee was chartered in 1987 to advise the Secretary of Health and Human Services on ways to address health care problems in rural America. Each year the Committee selects one or more topics upon which to focus during the year. The Committee then produces a report with recommendations on that issue for the Secretary by the end of the year. In addition to the report, the Committee may also produce white papers on select policy issues.

The Committee meets three times a year. The first meeting is held during the winter months in Washington. The Committee then meets twice in the field (in June and September). The field visits include ongoing work on the yearly topics with some time devoted to site visits and presentations by the host community. I have been in contact with Nathan Nash, a Truman-Albright Fellow at the Office of Rural Health Policy, who has asked that Texas Rural Health Clinics participate in the community site visits on Thursday September 27, and are invited to appear before the subcommittee panels in Llano and Lulling. That day in Austin the Committee will break up into subcommittees of approximately 6 – 8 members, then each subcommittee will travel to a rural hospital, one to Scott& White’s hospital in Llano and the other to Seton’s Edgar B. Davis Hospital in Lulling. At each site, the Committee will engage in a constructive dialogue with two panels of administrators in rural health care; one in the morning (about 10 am –noon) and the one in the afternoon (about 1-3 pm). Each panel generally lasts 1:5 – 2 hours and consists of 4 – 5 administrators from the area discussing the innovations and challenges they have experienced in rural health care and offering an on-the-ground perspective to the ideas being considered by the Committee. At this session, the Committee will be focusing on coordination across the continuum of care and integrated care networks as well as the traditional distinction between hospital and clinic, and the services they can provide. After the site visits, the subcommittee will return to Austin and start outlining the recommendations they want to make to the Secretary on these issues.

Nathan is looking for voluntary participation from RHCs near Llano: Brady Medical Clinic, Brady; Junction Medical Clinic, Junction; Family Medicine Rural Health Clinic, PA, Lampasas; Scott & White Hoerster Clinic–San Saba, San Saba; Scott & White Hoerster Clinic, Kingsland; Scott & White Hoerster Clinic, Horseshoe Bay; Scott & White Hoerster Clinic, Marble Falls; Seton Burnet Healthcare Center, Burnet; and Seton Lampasas Health Center; Lampasas. He is looking for panel volunteers from these RHCs near the Lulling area: Sievers Medical Clinic, Gonzales; Waelder Medical Clinic, Waelder; Wagner Medical Clinic , Shiner; Moulton Health Clinic, Moulton; Four Oaks Medical Clinic , Columbus; Seton Lockhart Family Health Center RHC /Children’s Care-a-Van RHC, Lockhart; Yoakum Family Practice, Yoakum; Cuero Medical Clinic, Cuero; Parkside Family Health Clinic, Cuero; and Bohman Clinic, Cuero.

If you or someone in your RHC is interested in visiting the subcommittee panel programs on Thursday September 27 (morning or afternoon) and would consider making comments about your clinic’s access to care or other issues you want to address, contact Nathan Nash to get more info. His direct phone is (301) 443-4043 or via email.

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The Texas Medicare Administrator Contractor Changes

The Texas Medicare Administrator Contractor changes from TrailBlazer to Novitas (formerly Highmark Medicare Services). For many years, TrailBlazer Health Enterprises, LLC (TrailBlazer) was both the fiscal intermediary (Part A) and carrier (Part B) for providers located in Texas. TrailBlazer was responsible for the fee-for-service Medicare payments, local coverage decisions and physician enrollment into the Medicare program. However, beginning the summer of 2012, some things will change.

In November 2011, the Centers for Medicare and Medicaid Services (CMS) announced that Highmark Medicare Services will become the Medicare Administrator Contractor (MAC) for a large region of the country that includes Texas. The contract is for one year, with the option of four annual renewals. Effective January 1, 2012, Diversified Service Options, Inc, a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida Inc, acquired Highmark Medicare Services from its parent company, Highmark Inc. As a result, Highmark Medicare Services changed its name to Novitas Solutions, Inc. Novitas is currently the A/B MAC for Delaware, New Jersey, Pennsylvania, Maryland, the District of Columbia, and the Part B MAC for certain areas within Virginia.

Effective July 2012, Texas will be part of Jurisdiction H, along with Arkansas, Colorado, Louisiana, Mississippi, New Mexico, and Oklahoma. CMS consolidated two former MAC jurisdictions – Jurisdiction 4 comprised of Colorado, New Mexico, Oklahoma, and Texas, and Jurisdiction 7 comprised of Arkansas, Louisiana, and Mississippi. Novitas will also process Indian Health Service facility claims for the entire country and serve as the designated A/B MAC to support centralized billing for Mass Immunizers. CMS estimates that about 4.9 million Medicare beneficiaries reside in Jurisdiction H with approximately 1,300 Medicare hospitals, and over 147,000 physicians and other practitioners that furnish health care services to Medicare beneficiaries in this jurisdiction. CMS approximated that Jurisdiction H will account for approximately 13.2% of all Medicare fee-for-service claims nationally.

Novitas recently announced the anticipated cut-over dates for the transitions, which will start in mid-August and go through November 2012 (with Part B for Colorado, New Mexico, Oklahoma, and Texas being the last to switch over). Since Novitas has prior experience as a MAC for a number of eastern states, CMS anticipates that the transfer to a new MAC will go smoothly, with few disruptions for Medicare beneficiaries or providers. However, providers should prepare for possible delays and implementation glitches. Providers also should be mindful of any notices sent from Novitas as well as TrailBlazer regarding updated dates and procedures under Novitas.

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