RHC Updates

CMS released a new 2024 Information for Rural Health Clinics Medicare Learning Network (MLN) Booklet

Considerable content changes are in dark red. Including the clarification of how care management services can be billed with multiple G0511 codes per claim.

Additional topics addressed:

● Marriage and family therapists and mental health counselors as practitioners (page 4)

● Remote physiologic monitoring (RPM), remote therapeutic monitoring (RTM), community health integration (CHI) and principal illness navigation (PIN) (page 5)

● Intensive outpatient program services (pages 5 and 7)

● All-Inclusive Rate (AIR) per visit for CY 2024 (page 7)

● Social determinants of health (page 8)

● Table of general care management services HCPCS/CPT codes (pages 9-10)

● Rural health reports and publications as a resource (page 14)

Change Healthcare Cybersecurity Outage- CMS has taken steps to assist providers.

The U.S. Department of Health and Human Services has made announcement for several assistance programs for health providers affected and not able to have their medical payments processed electronically.

Key Actions:

On March 5, HHS announced that CMS had taken steps to assist providers to continue to serve patients. Specifically, CMS announced that they had streamlined the process for providers to change clearinghouses to ensure continuity of payments, encouraged insurance plans to remove or relax prior authorization requirements in both Medicare and Medicaid, and directed MACs to be prepared to accept paper claims submissions during the course of the outage.
On March 5, HHS announced hospitals paid under Medicare Part A may submit accelerated payment requests to their respective servicing MACs for individual consideration.
On March 7, HHS officials participated in a roundtable with the American Medical Association to discuss the impact of the breech on physicians and ensured that leadership from UHG attended to hear the providers’ concerns.
On March 7, at the urging of HHS, UHG announced steps that they are taking to restore services for providers to ensure that they are able to submit claims.
On March 9, CMS announced that applications are being considered for advance payments for Part B suppliers. These applications are available on all of the MACs’ websites.
On March 9, CMS provided instructions to MACs about how to consider applications for accelerated payments from Medicare Part A providers and for advance payments from Part B providers and suppliers
On March 8, HHS staff briefed Congressional staff on the scope of the incident and the Department’s response.
On March 10, HHS Secretary Becerra and Acting Labor Secretary Su sent an open letter to health care leaders urging the private sector, especially other insurance companies, to work with the government to address the impacts on the cyberattack on health care providers.
On March 12, HHS Secretary Becerra and Deputy Secretary Palm hosted a roundtable with health care leaders, including UHG, other insurance companies, and provider associations to discuss direct actions taken by these leaders to address the impact of the cyberattack.
Contact your respective MAC for assistance https://www.cms.gov/mac-info