Applicants must propose to plan, develop, and operate a 12-month, full-time (24 months half-time) training program for nurse practitioners, physician assistants, health service psychologists, counselors, nurses, and/or social workers (including for individuals completing clinical training requirements for licensure) that trains practitioners to provide care for individuals in need of mental health and SUD/OUD prevention, treatment, and recovery services. 2534) represents long-needed legislation that would prevent PBMs and health insurance companies from siphoning off savings from the 340B program that were meant to help health care organizations that care for many uninsured and low-income patients. Keep 340B OPAIS information accurate and up to date. The Health Center Program Compliance Manual is the principal resource to assist health centers in understanding and demonstrating compliance with Health Center Program requirements. . In fact, Congress, in the Affordable Care Act, provided HRSA with a key oversight tool through the Administrative Dispute Resolution (ADR) process. OIG found that for 22 of the 300 sample patients, HRSA made payments for services that were either not rendered or not related to COVID-19. Tens of millions of Americans get affordable health care and other help through HRSA programs. After enrolling with the UIP, providers submitted rosters of patients who received COVID-19 related services to HRSA. PDF Respiratory Protection Program for Western - Department of Health Visit the Find Funding webpage to learn which, if either, funding opportunity is currently available. To address this misinterpretation of existing law and to prevent other courts from making the same mistake, Congress should clarify and codify protections for contract pharmacy arrangements in the federal 340B statute. Please reach out to the authors, your Foley relationship partner, or to ourHealth Care Practice Groupwith any questions. For questions about Health Center Program billing and collections, sliding fee discount program, and other requirements please contactHealth Center Program Support. This module was made possible through funding from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award to the National Association of Community Health Centers totaling $7,287,500 with 0 percent financed with non-governmental sources. In addition, please continue to ensure that you are appropriately allocating and tracking grant funds. PBMs require 340B hospitals to accept unfair terms and policies to participate in their pharmacy networks, which are needed to give hospital patients greater access to those drugs.6 This practice, widely referred to as discriminatory 340B pricing, forces hospitals to accept lower and discriminatory reimbursement rates that threaten hospitals ability to provide more comprehensive services to their patients as the law intends to ensure patient access to drugs through PBM pharmacy networks. Eligibility The defining legislation for Federally Qualified Health Centers (under the Consolidated Health Center Program) is Section 1905 (l) (2) (B) of the Social Security Act. HRSA Uninsured Program Covid-19 Services: OIG Audit Finds HRSA Paid for As the contract pharmacy issue underscores, greater oversight of drug manufactures is needed. U.S. Department of Health & Human Services, Policy Information Notices (PINs) and Program Assistance Letters (PALs), Health Center Program Uniform Data System (UDS) Data, Uniform Data System (UDS) Training and Technical Assistance, Emergency Preparedness, Response, and Recovery Resources for Health Centers, Health Resources & Services Administration, Introduccin al Alcance del Proyecto del Programa para los Centros de Salud, Updated Contact Process for Adding Temporary Service Sites in Response to Emergency Events, Health Center Program Site Visit Protocol, Health Center Program Statute: Section 330 of the Public Health Service Act (42 U.S.C. HRSA Uninsured Program Covid-19 Services: OIG Audit Finds HRSA Paid for Claims that did not Comply with Federal Requirements, PAGA Litigation Remains in Play Following California Supreme Court Decision. HRSA has already implemented a process of assessing whether providers were properly reimbursed under the UIP, including through review of provider procedures regarding identification of insurance coverage. When a health practitioner's name appears on the list, you know that they are allowed to practise. Prohibit PBMs from steering patients away from 340B pharmacies to pharmacies that they own, denying the ability of 340B entities to earn any savings. If applicable, please note that prior results do not guarantee a similar outcome. Prohibit PBMs from engaging in whitebagging or brownbagging policies that jeopardize patient safety and undermine access to 340B discounts for providers and their patients. Mandatory Training Courses In Aged Care | HCA - Healthcare Australia To submit claims to the UIP, providers had to attest that they read the programs terms and conditions and confirmed that patients did not have health insurance. ET)apexusanswers@340bpvp.com, U.S. Department of Health & Human Services, Performance Measurement & Quality Improvement, 340B Administrative Dispute Resolution Process, 340B Office of Pharmacy Affairs Information System, Health Resources & Services Administration, Section 340B of the Public Health Service Act. Apply to be designated as a Health Center Program Look-alike. A health centers scope of project defines a health centers service sites, services, providers, service areas, and target populations. Follow the application process Manage Your Grant Read COVID-19 Frequently Asked Questions and visit the Manage Your Grant page to: Attend workshops and access other training Understand administrative and financial requirements Review policies, regulations, and guidance Follow reporting requirements Become a Grant Reviewer Noncommercial use of original content on www.aha.org is granted to AHA Institutional Members, their employees and State, Regional and Metro Hospital Associations unless otherwise indicated. Learn about technical assistance provided bythese partners. Funding to establish new sites to deliver comprehensive primary health care services in. Assn v. Becerra, 596 U.S. ___ (2022) (slip op., at 13). The Audit report sheds light on the processes employed by HRSA, and its third-party contractor operating the UIP, to verify claim validity before payment. Migrant Clinicians Network (MCN) is an excellent resource to new, potential, and existing grantees wanting additional assistance or information about HRSA/BPHCs clinical requirements, especially for those who serve a migrant farmworker population. At the same time, the AHA continues to vigorously support the agencys efforts outside of the ADR process, including those by the Office of Inspector General (OIG), to enforce the law and penalize drug manufacturers who intentionally break the law. In part two of this series, to follow shortly, we analyze enforcement actions filed against providers alleging submission of false or fraudulent claims to and paid by the UIP and will provide predictions related to the likely future of enforcement in this area. (Claims for vaccination services were not included in the Audit.). This page provides an overview of NHSC eligibility requirements. HRSA provides grants and cooperative agreements to national and regional organizations that address the training and technical assistance (T/TA) needs of health centers and organizations applying to join the Health Center Program. Grants | HRSA - Health Resources and Services Administration A HRSA-funded health center and a Health Center Program look-alike share the same benefits except for Health Center Program funding. Washington, DC 20510, The Honorable Jerry Moran Employ inter-professional teams and patient-centric approaches. Congress should hold PBMs accountable as they continue to engage in policies that siphon 340B savings away from 340B hospitals and into their pockets. If you do not find what you need on this page, you may contactTheressa Lyons, Senior Program Manager, Training and Technical Assistance Coordinator for further guidance. If you have geolocation turned on, you will automatically see health centers near you. Learn about the impact of HRSAs Health Center Program and the strategic partnerships that support HRSAs efforts. Provide comprehensive, high-quality primary care and preventive services regardless of patients ability to pay. To that end, the AHA, along with other national hospital organizations, filed numerous amici briefs at the district and appellate court levels where the drug companies have challenged these enforcement efforts. Foley expressly disclaims all other guarantees, warranties, conditions and representations of any kind, either express or implied, whether arising under any statute, law, commercial use or otherwise, including implied warranties of merchantability, fitness for a particular purpose, title and non-infringement. Would The Patent Eligibility Restoration Act Strike The Right Balance? In addition to these plain language edits, there is one substantive change to align with Calendar Year 2024 Requirements for Federal Tort Claims Act (FTCA) Coverage for Health Centers and Their Covered Individuals (hrsa.gov) (PDF - 900 KB), related to risk management and obstetrical training requirements. Drug companies should not be allowed to circumvent the law and indefinitely delay the implementation of this rule. The ISTP program is designed to foster robust clinical training and augment expertise among clinicians who will see patients at access points of care and provide mental health and addiction prevention, treatment, and recovery. Mandatory training. Foley makes no representations or warranties of any kind, express or implied, as to the operation or content of the site. Question: What specific policies should be considered to establish consistency and certainty in contract pharmacy arrangements for covered entities? In fact, the most recently available IRS 990 data show that 340B hospitals alone provided nearly $68 billion in community benefits.12 HRSA requires separate reporting during its annual 340B hospital certification process including Medicare cost report information. In fact, OIG recommends that HRSA identify additional improper UIP payments, which OIG estimates to equal $783.6 million. [link to, {domain:"www.migrantclinician.org",server:"169.47.211.87"}, HRSA Health Center Program Clinical Requirements, Calculation: Farmworker patients seen outside of the clinic setting with documented BP of 140/90. For site visits conducted prior to April 13, 2023, use the 2022 version of the SVP. Grantees must report annually into the Uniform Data System (UDS) on a set of clinical and financial performance measures in an effort to collect data that will allow for the evaluation of individual and collective performance trends over time. In 2023, HRSA updated the SVP to increase consistency, improve formatting, and incorporate plain language. Our comments primarily focus on how Congress can ensure that the 340B program continues to benefit patients and communities, while acting to prevent any cuts to the program that would jeopardize patient access to care. Drug manufacturers are also permitted to conduct audits of 340B hospitals in certain instances in coordination with HRSA, but hospitals have no ability to audit drug manufacturers. Therefore, any communication or material you transmit to Foley through this blog, whether by email, blog post or any other manner, will not be treated as confidential or proprietary. The Health Center Program Compliance Manual is the principal resource to assist health centers in understanding and demonstrating compliance with Health Center Program requirements. The Health Resources and Services Administrations (HRSA) Bureau of Primary Health Care (BPHC) is responsible for effective and efficient oversight of the Health Center Program. Enter a city name, ZIP code (such as 20002), or address. Reporting requirements on workforce COVID-19 vaccination status are in place for residential, in-home and community aged care providers. See the Eligibility section of the LAL ID application instructions for the full list of eligibility criteria. Enter a city name, ZIP code (such as 20002), or address. As we will discuss further in part two of this series, we are aware of cases filed against providers who allegedly submitted improper claims to the UIP. OIG describes these procedures to verify insurance status as not effective. Moreover, OIG found that 9 patients in the sample who were determined to have insurance actually had a social security number associated with their claim but, despite this, HRSAs contractor incorrectly determined that the patients did not have insurance (and the claim was paid by the UIP). As required by federal law, the ADR process establishes a formal way for the agency to resolve disputed claims by 340B providers and drug manufacturers. Hospitals report uncompensated care, charity care and other benefits provided to the communities they serve through both the Medicare cost reports and the IRS 990 form required for tax-exempt organizations. Providers who participated in the UIP should prepare for potential audits of their claims submitted to the UIP and monitor enforcement developments in this area. Australian Health Practitioner Regulation Agency - Register of The Health Center Program Compliance Manual is the principal resource to assist health centers in understanding and demonstrating compliance with Health Center Program requirements. U.S. Department of Health & Human Services, Policy Information Notices (PINs) and Program Assistance Letters (PALs), Health Center Program Uniform Data System (UDS) Data, Uniform Data System (UDS) Training and Technical Assistance, Emergency Preparedness, Response, and Recovery Resources for Health Centers, Health Resources & Services Administration, Learn more about the Health Center Program, Technical Assistance to Support Your Journey, medically underserved areas or for medically underserved populations, Centers for Medicare and Medicaid Services (CMS), HRSA-supported training and technical assistance, State and Regional Primary Care Associations, National Association of Community Health Centers (NACHC), Other HRSA-supported national TA providers, HRSA Health Resources and Services Administration. The Bureau of Primary Health Care (BPHC), within the Health Resources and Services Administration (HRSA), administers the Health Center Program and provides ongoing oversight of both Health Center Program grantees and FQHC Look-Alikes. Unfortunately, this ADR process has been challenged in court and has never been implemented in the way Congress intended. In accordance with the terms and conditions of the HRSA COVID-19 Coverage Assistance Fund, in order to seek reimbursement, a health center must agree to the following as attested at registration: If a health center accepts reimbursement from the Coverage Assistance Fund, it may not balance bill/charge the patient. 2. Program Assistance Letters (PALs) are official HRSA documents that explain important program topics or announce new or updated program processes. REMINDER: HBF participates in AGC for all states except WA.. Program Requirements | HRSA - Health Resources and Services Administration Get Affordable Healthcare Find a Health Center Health centers provide primary medical and dental care to people of all ages, whether or not they have health insurance. There are many instances when drug companies have violated program rules and requirements such as overcharging hospitals, denying 340B pricing for certain drugs and arbitrarily placing drugs in limited distribution. These shortages are projected to be particularly acute in rural areas. The list below includes accredited qualifications, non-accredited training and courses that are endorsed by the Australian College of Nursing that meet the CPD requirements set by the Nursing & Midwifery Board of Australia. There are two ways to become a health center: AHRSA-funded health center and a Health Center Program look-alike share the same benefits except for Health Center Program funding. It is vitally important that any national data claims clearinghouse, such as the one created by the Protect 340B Act, should: Question: What specific policies should be considered to implement common sense, targeted program integrity measures that will improve the accountability of the 340B program and give health care stakeholders greater confidence in its oversight?
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