Join OKPCA for a Free Training on Virtual OSVs
Oklahoma Primary Care Association is hosting a virtual operation site visit (VOSV) training on Wednesday, January 20 from 10:00 AM – 11:30 AM and Thursday, January 21 from 10:00 AM to 12:30 PM. This training will be recorded and is free to attend, but registration is required.
The training will be broken down as follows:
- Part one will be devoted entirely to the new VOSV methodology for performing compliance reviews. The presentation lays out the process from start to finish. Trainers will go through document submission expectations, file naming conventions, preparation tips, and they will walk participants through the various steps of the review including the next steps. That session is 90 minutes long and includes a question and answer session.
- Part two will be a review of the OSV protocol. The presentation lists every question in the protocol, with discussion centered on the elements of each chapter that most often pose compliance challenges for health centers. The sessions will be taught by subject matter experts, including a physician, an administrative/governance reviewer, and a finance expert.
Register now!
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Health Centers Receive Mandatory and Discretionary Funding in Consolidated Appropriations Act
Community health centers received three years of mandatory funding through FY2023 at $4 billion per year and approximately $1.7 billion per year in discretionary funding through FY2023. The discretionary funding amount represents a $57 million annual increase from FY2020.
Teaching Health Centers with graduate medical education (GME) programs also received appropriations of $126.5 million per year for three years, and National Health Service Corps (NHSC) was funded at $310 million per year for three years.
HHS General Counsel Issues Opinion Stating 340B Discounts Apply to Contract Pharmacies
While advisory opinions do not carry the force of law, they convey official agency opinions. On December 30, U.S. Health and Human Services Department (HHS) Office of General Counsel Robert Charrow issued an opinion, writing that the 340B statute’s “core requirement” is that “manufacturers must ‘offer’ covered outpatient drugs at or below the ceiling price for ‘purchase by’ covered entities.”
“This fundamental requirement is not qualified, restricted, or dependent on how the covered entity chooses to distribute the covered outpatient drugs,” he wrote. “All that is required is that the discounted drug be ‘purchased by’ a covered entity. In this setting, neither the agency nor a private actor is authorized by section 340B to add requirements to the statute.” He continued, “No amount of linguistic gymnastics can ordain otherwise,” and where the drugs are delivered “is irrelevant.”
Despite the HHS opinion, several drug manufacturers including Eli Lilly and Sanofi appear unwilling to change their current policies. An Eli Lilly representative told Modern Healthcare this week, "We've reviewed the statement from HHS and we disagree with their conclusion. We continue to believe our 340B distribution program complies with all applicable laws and regulations, and we will continue to advocate for fixes to 340B that will help people access affordable medicines instead padding the bottom lines of hospitals and contract pharmacies that pocket discounts for themselves." Read more.
Insulin and EpiPen Pricing Rule Implementation May Be Delayed
The final regulation on insulin and EpiPen pricing for community health centers was published on December 23, 2020, and is scheduled to go into effect on Friday January 22, 2021, two days after Joe Biden is sworn in. The President-Elect’s transition office has publicly announced that he plans to issue a memo on the afternoon of January 20 blocking “midnight regulations” including regulations that the Trump Administration finalized but that have yet to go into effect. That delay—which will probably be at least 60 days—would give HRSA time to officially rescind the regulation.
Second Round of PPP Loans Available
A second round of loans for first-time and second-time applicants have been authorized under the Paycheck Protection Program (PPP), which offers low-interest, forgivable loans guaranteed by the Small Business Administration (SBA) for small businesses and other entities to keep workers on the payroll during the COVID-19 crisis.
The PPP was open to businesses and 501(c)(3) nonprofits with 500 or fewer employees, as well as self-employed workers and some companies that are part of food or hotel chains, among others. Eligibility requirements have been modified in this COVID-19 relief package for second-time loan applicants.To qualify for a second loan, entities would have to:
- Employ 300 or fewer workers, instead of the current 500-employee threshold.
- Demonstrate that they had at least a 25% reduction in gross revenue during a quarter in 2020 compared with the same period in 2019, with some exceptions.
- Exhaust their first loan before receiving a second one
Read new guidance from SBA.
Insulin and EpiPen Pricing Rule Implementation May Be Delayed
The final regulation on insulin and EpiPen pricing for community health centers was published on December 23, 2020, and is scheduled to go into effect on Friday January 22, 2021, two days after Joe Biden is sworn in. The President-Elect’s transition office has publicly announced that he plans to issue a memo on the afternoon of January 20 blocking “midnight regulations” including regulations that the Trump Administration finalized but that have yet to go into effect. That delay—which will probably be at least 60 days—would give HRSA time to officially rescind the regulation.
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HHS Secretary Azar extends the PHE: On January 7, 2021, Secretary Azar declared the extension of the public health emergency (PHE) related to the COVID-19 a pandemic effective January 21, 2021. The Public Health Emergency Act is renewed every 90 days while the PHE exists. It was last renewed on October 23, 2020.
BKD Revenue Cycle Management Boot Camp: BKD is hosting a boot camp for health center finance professionals from January 25-29. Upon completion of this program, participants will be able to:
- Evaluate key revenue cycle areas
- Discuss charge structure development, analysis, and related information
- Describe Medicare and Medicaid federally qualified health center (FQHC) reimbursement
- Explain Medicare FQHC cost reporting basics
- Evaluate billing compliance
Learn more and register today.
Free Training Dental Implications in Treatment of HIV Positive Patients: The OUHSC Infect ious Diseases Institute and College of Dentistry is hosting a webinar on January 26, 2021 from 8:00 AM to 12:00 PM. Register here or contact Jill Coleman (jill-coleman@ouhsc.edu) for more information.
Raising the Grade on Oral Health in Oklahoma Webinar Series: The Oklahoma Oral Health Coalition (OOHC) invites you to join us for "Raising the Grade on Oral Health in Oklahoma", a 5-part webinar series that will focus on specific aspects of the 2020 Oklahoma Oral Health Report Card. Each 90-minute, interactive webinar will feature an expert panel, and will explore different actionable steps towards improving oral health and wellness for all citizens across our state. The dates and topics for the series can be found here.
MyHealth Stakeholders Meeting: MyHealth held a briefing for all MyHealth participants and stakeholders on Friday to discuss the recently announced State Health Information Exchange (HIE) Award from the Oklahoma HealthCare Authority and how it may affect MyHealth and MyHealth participants going forward. Last month, the Oklahoma Health Care Authority (OHCA) awarded a contract to Orion Health to support the OHCA State HIE project. MyHealth submitted a bid and was not selected. MyHealth is currently considering filing a formal bid protest. MyHealth has been assured by state leadership that its participants can use MyHealth as a bridge to participate in the state system and will be deemed to be connected to a statewide HIE. Participation in the Orion-awarded Oklahoma Statewide Health Information Network and Exchange (OKSHINE) will not be free.
OHCA Names Chief Quality Officer: Oklahoma Health Care Authority Chief Executive Officer Kevin Corbett has named Dr. Nathan Valentine as the OHCA’s chief quality officer. “I am passionately committed to improving health for the underserved,” said Dr. Valentine. “I am particularly excited about my new role because I will be able to directly engage OHCA staff and community partners in a concerted effort to measurably improve health outcomes for all SoonerCare members.” Dr. Valentine was previously the Chief Medical Officer at Variety Care. Read more in The Journal Record.
COVID-19 Vaccine Updates: Oklahoma health center staff are scheduled to receive COVID vaccines beginning in January. They have been included in Phase 2 of the state distribution plan. Phase 1, with distribution beginning next week, is limited to inpatient settings.
Phase 2 (which is anticipated to initiate in January 2021) will include workers in urgent care, outpatient facilities, primary care, federally qualified health centers, community health centers, rural health centers, pharmacies (not involved in the federal allocation plan), home health, hospice, rehabilitation services, occupational/physical therapy, etc., and teachers. View the COVID-19 Priority Population Framework for Oklahoma.
Information about the COVID-19 Vaccination Program Provider enrollment is below:
COVID-19 Vaccine Safety: Monitoring vaccine safety is a vital part of the nation’s response to the COVID-19 pandemic. This week, The Centers of Disease Control and Prevention (CDC) Clinician Outreach and Communication Activity (COCA) presented information for clinicians on how they can educate their patients about what to expect after COVID-19 vaccination. This includes encouraging patients to enroll in v-safe, a new smartphone-based, after-vaccination health checker for people who receive COVID-19 vaccines, and to use v-safe to report how they’re feeling. Clinicians also will learn how to report adverse events (possible side effects) to the Vaccine Adverse Event Reporting System (VAERS). View the recording, slides, fact sheets, and posters here.
OHCA Clarification on Medicaid Telehealth Billing: OKPCA has received the clarification on telehealth billing from the Oklahoma Health Care Authority. When submitting telehealth claims, FQHC providers can bill either T1015 GT or a CPT code with GT but not both. If the claim has GT modifier on both lines, the system logic will pay the CPT code on the detail line fee for service.
For example, here is what happens under various scenarios:
- Bill T1015GT and 99212: T1015GT pays encounter and 99212 pays 0.00
- Bill T1015GT alone: pays encounter
- Bill T1015GT and 99212GT: 99212GT pays FFS and T1015GT encounter denies
- Bill T1015 and 99212GT; 99212GT pays FFS and T1015 encounter denies.
Apply by January 21 for Funding to Expand the Behavioral Health Workforce: HRSA released a funding opportunity to increase the supply and distribution of behavioral health professionals in high need areas. Award recipients will train students to work with children and adolescents at risk for behavioral health disorders. Check eligibility and apply by Thursday, January 21, 2021.
Workforce Survey: Oklahoma Primary Care Association, alongside the Health Resources & Services Administration Bureau of Health Workforce (HRSA BHW) and Primary Care Associations across the country, are working to increase provider recruitment and retention. HRSA’s new Health Professions Education and Training (HP-ET) Initiative will enhance health centers’ capabilities to recruit, develop, and retain their workforce by exposing health and allied health professions students, trainees, and residents to education and training programs conducted at health centers. The HP-ET Initiative will use the Readiness to Train Assessment Tool (RTAT) to help health centers assess and improve their readiness to engage in health professions training programs. Ideally, a key contact at each health center will provide the RTAT survey link to all employees of the health center for completion. Access the link for the RTAT survey here.
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- Oklahoma Again Sets Affordable Care Act Enrollment Record (Oklahoma Watch)
- ‘A very difficult process’: More vaccines arriving in Oklahoma as COVID-19 surge persists (The Frontier)
- Confusion after Oklahoma State Department of Health rolls out vaccine registration portal (KFOR)
- Oklahoma health department taps Microsoft to build COVID-19 vaccine scheduling app (Becker's Health IT)
- Oklahoma State Health Information Exchange Targets Fall 2021 Launch (EHR Intelligence)
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