Congress Releases Draft FY2023 Omnibus Text
New RHC Providers, Medicare Telehealth Through 2024, and Much More
Late Monday night Congress released draft text of the Consolidated Appropriations Act of 2023, also known as the yearly “Omnibus” package which will fund the federal government for the remainder of Fiscal Year 2023. Omnibus bills are often referred to as the “Christmas tree” bill because of the number of provisions tacked on to it like ornaments, and FY23 is no exception.
Of exciting note for RHCs, Congress has expanded Medicare coverage to include Marriage and Family Therapists (MFTs) and Mental Health Counselors. These providers in the RHC setting can now generate a Medicare encounter, reimbursable at the RHC’s All-Inclusive Rate (AIR) beginning January 1, 2024.
“The past several years have seen historic changes to the Rural Health Clinic program. 2022 will close with a nice gift, which is better described as the fruit of our labor. For the first time in decades, Congress has expanded the definition of RHC eligible providers. Mental Health Counselors and Marriage/Family Therapists are now eligible providers in RHCs and FQHCs” said Charles James, NARHC President. “It is a huge deal. I am deeply proud of the work RHCs provide to at-risk patient populations. This will allow us to provide urgently needed services to patients in crisis. NARHC and our allies in the Rural Health community worked hard to make this change.”
Another important provision to note from this year’s Omnibus package is the two-year waiving of a 4% “pay as you go” or “PAYGO” Medicare reduction which had previously been set to kick in January 1, 2023.
Congress also extended several Medicare telehealth provisions through December 31, 2024 (if the Public Health Emergency ends before 12/31/2024), including current RHC and FQHC telehealth policy. If passed as released, this bill would also delay in-person requirements for mental health services done via telehealth until January 1, 2025 (or the end of the PHE, if later). While this offers providers more confidence in the continuation of telehealth, it does not fix the payment/coding challenges of current G2025 policy.
“NARHC will continue to advocate for normal payment and normal coding rules pertaining to telehealth visits in RHCs, like was granted for mental health telehealth” said Nathan Baugh, NARHC Executive Director. “However, we hope this extension offers providers continued confidence that telehealth is here to stay.”
Beginning January 1, 2024, RHCs will be eligible to bill, under a special payment rule, for a new service category, “intensive outpatient services.” These treatment programs are intended for patients with needs less severe than would require residential programs but more involved care than occasional treatment. We expect further details in the Medicare Physician Fee Schedule proposed rule next summer.
On the Medicaid front, Congress will be separating the Medicaid continuous eligibility policy from the PHE, allowing states to begin the so called “Medicaid redetermination” process as soon as April 2023. States will need to re-determine eligibility for all current beneficiaries. RHCs can visit our previous article on the topic for resources that can be used to educate your patients on the upcoming process to ensure they don’t unnecessarily lose coverage.
Finally, we are disappointed to share that the grant funding for the RHC Behavioral Health Initiative, proposed in the President’s budget and included in draft appropriations report language, was struck from the text.
“While there are other grants for which RHCs are eligible, it is frustrating that Congress elected not to fund an RHC specific grant for behavioral health, a need so significant in our rural communities” said Sarah Hohman, NARHC Director of Government Affairs. “We will seek future opportunities for RHC-specific grant funding in the next Congress.”
More details to come on all of these provisions, with any questions please email Sarah Hohman at Sarah.Hohman@narhc.org.
Sincerely,
National Association of Rural Health Clinics
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