In a move that should surprise no one, the Office of Information and Regulatory Affairs (OIRA) announced that the 340B Program Omnibus Guidelines, aka the 340B Mega Guidance, was withdrawn on January 30th. The proposed rule, which was released in draft form in August 2015, was widely expected to be finalized last December. As a unit of OMB, OIRA speaks directly for President Trump's executive branch.
I don’t care who you are – You should be scared of Zika. And, by scared, I don’t mean that you should panic. That doesn’t help anyone. But this virus needs to be taken seriously - And I'm not alone here, even public health experts are sounding the alarm. There is still so much that is unknown about it’s transmission and the possible long-term effects for those infected.
Here at FQHC Associates, we get many inquiries about starting or becoming a Federally Qualified Health Center (FQHC). We hear from a wide range of individuals and organizations, but most inquiries come from existing health care organizations who see the benefits in transitioning to an FQHC model of care, both to the community-at-large and to the organization itself.
The 340B Program has become an important source of revenue for many Federally Qualified Health Centers. Many fear that without 340B, their programs will not survive. With a draft Mega Guidance under consideration by HRSA and new CMS rules governing Medicaid reimbursement, 340B is going to change. The extent to which this will affect FQHCs is currently a matter of speculation. Meanwhile, in order to understand where this crucial program is likely headed, it is important to know where we are now, and how we got here.
Besides not dying young, one of the advantages of being around for a long time is that you gain perspective.
The chronically ill account for a huge percentage of the population. In fact, as of 2012, approximately one half of all adults had one or more chronic health conditions, and one in four adults had two or more chronic health conditions. Additionally, heart disease and cancer—both chronic diseases—together accounted for almost half of all deaths in 2010. Given these facts, is it any surprise that, in 2010, eighty-six percent of all health care spending was for people with one or more chronic medical conditions? (CDC website)
As of January 1st, 2016, Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) are able to bill for Chronic Care Management (CCM) services provided to Medicare patients using CPT code 99490. CCM refers to the non-face-to-face coordination of care for chronically ill patients.