The CMS has issued a proposed rule that would update certification and participation regulations, as well as payment provisions, for rural health clinics and federally qualified health centers.
In addition to establishing location requirementssuch as clinics being located in nonurbanized areas defined by the U.S. Census Bureauand exception criteria for rural health clinics, the rule would also require rural health clinics to establish a quality assessment and performance-improvement program. It would also revise the payment methodology to be consistent with statutory requirements that set Medicare payment at 80% of reasonable costs after application of deductibles. And it would clarify circumstances in which a rural health clinic and a Medicare Part B physician practice, or a Medicaid fee-for-service practice, could operate simultaneously.
This is not the first time the CMS has tried to update the rural health-clinic program. The agency proposed a rule that addressed participation, payment and quality-assessment issues in February 2000, and issued a final rule in December 2003. That rule was suspended in September 2006 to comply with 2003s Medicare Prescription Drug, Improvement and Modernization Act, which said there could not be more than three years between when a proposed and final rule were published. The CMS will accept comments on the rule until Aug. 27. -- by Jessica Zigmond