CMS response to the provider-based facilities restriction

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) proposed severe restrictions on the ability of Critical Access Hospitals to operate certain provider-based facilities. Specifically, CMS proposed a policy that any CAH that operates a provider-based facility, such as a Rural Health Clinic, acquired on or after January 1, 2008, must comply with the distance requirement of a 35-mile drive to the nearest hospital or CAH (or 15 miles in the case of mountainous terrain or in areas with only secondary roads.) The proposal went on to further stipulate that if a CAH with a necessary provider designation enters into a co-location arrangement on or after January 1, 2008, or acquires or creates an off-campus facility on or after January 1, 2008, that does not satisfy the CAH distance requirements CMS would terminate that CAH's provider agreement.

CMS received numerous comments on this policay and recommened that RHC's owned and operated by a CAH be exempt from this policy.

Below is CMS' response to those comments:

Comment:

 Numerous commenters requested that rural health clinics (RHCs) be excluded from the category of provider-based entities that must comply with the proposed change. Some commenters stated that operating an RHC is the only way to provide healthcare to the medically underserved population in their service area. One commenter stated that if CMS does not exempt RHCs from the proposed policy, CMS should allow grandfathered CAH/provider-based RHCs to move the location of the RHC without jeopardizing the CAH status of the parent provider. 

Response:

To be certified as an RHC, the clinic must be located in an area designated, either by population or geographic area or location, as a Medically Underserved Area (MUA) or Health Professional Shortage Area (HPSA). In addition, State governors are allowed to designate areas with a shortage of professional health services through the use of statewide shortage designation plans approved by HRSA’s Bureau of Health Professions. Because RHCs have their own location requirements and because, unlike other provider-based clinics, a provider-based RHC is a separate entity which undergoes a separate certification process and has a unique provider identification number from the base provider, we believe that our concerns leading to our provider-based proposal do not apply to CAH provider-based RHCs. Accordingly, in this final rule with comment period, we are excluding RHCs from the list of provider-based facilities at  §413.65(a)(2) that must comply with this requirement.

Green is the New Color of Health Care

Sustainable Compositions focuses on techniques, technologies, behaviors, and decisions that Pennsylvania health care providers and businesses can feasibly adopt to save money, energy, and resources while promoting a healthy and healthful environment.

Recording powering by solar and wind energy. Sustainable Compositions is a collaboration of the Penn State University's Center for Sustainability and PennTAP, the Pennsylvania Technical Assistance Program. To download the podcasts click here. This link also includes several other online resources and information on Green Health Care.

Save the Dates

November 14, 2007 - TASC 90 Conference Call

TASC will be holding a TASC 90 Conference Call on Wednesday, November 14th from 2:00 p.m. to 3:30 p.m. Central Time (3pm Eastern, 1pm Mountain, 12 pm Pacific). An agenda with call-in information as well as other materials will be sent out soon.

January 28 - 30, 2008 - National Rural Health Policy Institute

Registration is now available for the National Rural Health Policy Institute held January 28 - 30, 2008 in Washington, D.C. To register go to http://www.nrharural.org/conferences/sub/PI.html.

June 2 - 3, 2008 - Getting on TRAC with Telehealth

The Great Plains Telehealth Resource and Assistance Center will be holding Getting on TRAC with Telehealth Conference June 2 - 3, 2008 in Sioux Falls, SD. For more information contact contactus@gptrac.org.

July 1-2, 2008 - National Conference of State Flex Programs

The 2008 Flex Conference will be held July 1-2 at the Westin Crown Center in Kansas City, MO. More information coming soon!