Rural Health

Rural Americans face different health disparities than urban Americans requiring the need for different rules and programs. National Rural Health Association’s Policy Institute helps facilitate state offices with their individual rural communities to remove barriers to healthcare access. The purpose is to ensure enough healthcare access and healthcare delivery systems to promote a healthy rural America.

All state Medicaid programs are required to recognize RHC service
RHC is exempt from the Merit-Based Incentive Payment System (MIPS)
RHCs are in non-urbanized areas
For policy and advocacy issues: National Association of Rural Health Clinics (NARHC) Telephone: 866.306.1961
For RHC reimbursement questions: Contact your state Medicare Administrative Contractor(MAC).

Resources

Additional Links and Resources

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Dec 27th, 2022

Leveraging Hierarchical Condition Category (HCC) Coding to Improve Overall Healthcare

by Kem Tolliver, CMPE, CPC, CMOM

Diagnosis code usage is a major component of optimizing HCCs to improve overall healthcare. Readers will gain insight into how accurate diagnosis code usage and selection impacts reimbursement and overall healthcare.

Oct 24th, 2022

End-Stage Renal Disease Risk Model Updates for 2023

by Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

For the first time, ESRD Medicare beneficiaries were permitted to enroll in Medicare Advantage plans beginning in 2021. Since that time, CMS has been working to revise the program to reduce costs, improve quality, and drive benefits. Effective January 1, 2025, one such change will include a definition change for "oral-only drugs." Why is Medicare changing the definition of these drugs and how will that be a driving force in advancing care models for ESRD in the future?

Jul 28th, 2022

Calendar Year 2023 Medicare Physician Fee Schedule Proposed Rule

by Amanda Ballif

The Centers for Medicare and Medicaid Services (CMS) is soliciting public comments on proposed changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues effective on January 1, 2023 and thereafter. The Calendar Year (CY) 2023 PFS proposed rule is one of several proposed rules aimed at increasing equity in health care.

Apr 21st, 2022

2022-03-03-MLNC - 2022 Payment, Quality, & Policy Changes

by CMS - MLNConnects

News - Ambulance Prior Authorization Model Expands April 1 - Nutrition-related Health Conditions: Recommend Medicare Preventive Services - Claims, Pricers, & Codes - HCPCS Application Summaries & Coding Decisions: Drugs and Biologicals - Events - ICD-10 Coordination & Maintenance Committee Meeting — March...

Dec 8th, 2020