Among the changes mandated in the Affordable Care Act is the expansion in the next few years of Medi-Cal eligible patients. As part of the implementation of California’s Medi-Cal program, Medi-Cal managed care will be arriving in the 25 counties not currently using the plan. This now goes into effect on September 1, 2013. For those already enrolled in managed care plans, there are significant changes in the annual reporting.
Author Archive
Healthcare Reform Impacts FQHCs and RHCs in California
Tuesday, May 14th, 2013CDPH Conducting RHC Recertification Surveys
Monday, February 11th, 2013The California Department of Public Health district offices have been conducting RHC recertification surveys for a select number of rural health clinics throughout the state. CMS has required that the CDPH local offices, acting as their agent, conduct surveys on at least 5 percent of the state’s RHCs.
Up until this recent mandate, RHC re-certifications had been a lower priority for the district offices, and many RHCs had not been surveyed in years. As a result, we’ve noticed that many sites have become a bit lax in their adherence to RHC requirements. We are aware of one RHC that received a 42-page Plan of Correction for deficiencies after having a surprise re-certification site visit. (more…)
MDS 3.0 Update
Monday, August 13th, 2012Version 1.08 was implemented on April 1, 2012, and with it comes new additions to the MDS. It is now 40 pages long and has several additions, some of which help in the overall completion of the assessment. In Section A, we now have A0050, which was moved from Section X, Correction Request. Also in Section A, an explanation of the type of discharge, planned or unplanned, will be reported. We’re sure this will be used later in any quality reporting. Lastly, in Section A, we now report on the PASRR information, a helpful addition. (more…)
HFS Staff Participate in Habitat for Humanity Build Day
Thursday, May 10th, 2012On a cloudy, rainy April morning, eight volunteers from HFS gathered at the Habitat for Humanity San Francisco Chapter’s Mission Street project for a day of pounding nails, walking scaffolding and laying plywood along a roofline. The sun came out in the late morning and it turned into a superb day with great views from the top of the 4 story structure. There was a lunch run to a Wendy’s up the street that included volunteers from other companies joining the crowd.
Habitat for Humanity Greater San Francisco’s premier construction project, the most advanced Habitat development west of New York City, is a group of condominiums that will become home to 36 local working families. The site is located at 7555 Mission Street in Daly City, just 1 block from the Colma BART station.
The four-story structure built on a podium garage is Habitat Greater San Francisco’s most ambitious development to date and is a cornerstone of the Grand Boulevard Initiative, exemplifying the revitalization that is underway along El Camino Real to provide compact, urban design and construction in a pedestrian-friendly, transit-oriented corridor.
Clients and others are invited to join us for staff volunteer days such as HFH. Contact us at 510-768-0066 for information on upcoming events.
Clinic Code 19 Billing for Healthy Families
Wednesday, February 29th, 2012
The California Department of Health Care Services (DHCS) began receiving claims on July 1 for the newly established Code 19 rate. Similar to the Code 18 rate for Medi-Cal Managed Care services, Code 19 will be imbedded into the prospective payment system (PPS) rate for services provided by FQHCs and RHCs to beneficiaries of the Children’s Health Insurance Program(CHIP). The Code 19 rate equals the difference between what the clinic receives for Healthy Families services and their Medi-Cal PPS rate.
DHCS is requiring that clinics submit a request form to the Audits & Investigations department to establish an initial Code 19 rate. If you have not yet submitted the request form for payment, your rate will be automatically set at $1. Any amount due to your clinic above this payment will not be refunded to your clinic until after you submit your year-end PPS reconciliation forms, causing a delay in reimbursement.
DHCS Tries to Recoup Medi-Cal Payments
Tuesday, February 14th, 2012The Centers for Medicare & Medicaid Services (CMS) approved the State Plan Amendment (SPA) for California on May 23, 2011. In the process, CMS approved the elimination of Medi-Cal payments to FQHCs and RHCs for certain “optional benefits” including adult dental, podiatry, and chiropractic services. (more…)
Glide Memorial Visit
Wednesday, November 23rd, 2011
Several members of the Social Responsibility group at HFS Consultants served a meal at the Glide Memorial this week. Vanessa, Joaquin and I did the seasonal serving yesterday.
Joaquin and I combined with a variety of volunteers behind the counter to load up the serving trays. Joaquin deftly handled the scooper for rice and then later mashed potatoes, while I threw down the breaded chicken breasts, all the while arguing about the worst disco songs of all time coming over the radio speaker in “Mo’s Kitchen”. Of course, Joaquin had to put up with my singing….
We served approximately 750 meals in 2 hours flat. The kitchen ran out of chicken breasts, so we served meatballs, then breaded fish, then back to some chicken.
So it’s a good reminder about all that you have in your own life. As first timer Vanessa said, “It was an amazing experience that really makes you grateful for everything that you have. I must say I had a lot of fun, the people were great and I will definitely do it again.
By Bill Deane
Adopting Electronic Health Records:
Saturday, November 12th, 2011The Answers to Participate in the Incentive Program
The Health Information for Economic and Clinical Health Act (HITECH) portion of the ARRA provides incentives and regulations for the use of electronic health records (EHR) by all Medicare enrolled practitioners, whether a single physician or a multiple site clinic group. These incentives will assist groups in updating their current systems to meet all electronic patient data reporting requirements of “meaningful use,” which are being implemented over the next four years. (more…)
CMS Requires Provider Revalidation
Thursday, October 27th, 2011In accordance with regulations listed in the Patient Protection and Affordable Care Act (“PPACA”), CMS has authorized the Fiscal Intermediaries (FI) to request revalidation of provider information currently on file. This requires the completion and submission of new Medicare enrollment applications (CMS-855A, 855B, 855I or 855R) depending on the type of healthcare provider.
Safety Net Provider Statistics
Wednesday, August 10th, 2011HRSA and CMS have always placed emphasis on the ability of Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) to act as the safety net providers across the nation. These clinics provide access to primary care services for the working poor, low income families and the indigent populations. (more…)