Policy Update, September 27, 2016
-Essential Community Provider List
-BPHC Program Compliance Manual
-BPHC PAL on 2017 UDS Changes
State Updates in This Issue
-Three Star Health Task Force
-Recently enacted state legislation
Essential Community Provider List
CMS has released its draft 2018 Essential Community Provider list, the list used by Qualified Health Plans in the Marketplace to meet the ECP contracting requirement. Take a look at the CMS petition to find out how to determine if your health centers are on the list and, if not, how they can complete the petition process to get on the list. Please note, if you want to submit a petition, you must do so before the October 7, 2016, deadline.
BPHC Program Compliance Manual
BPHC recently released a Program Compliance Manual; the comment period is open until November 22. The Health Center Compliance Manual serves as a web-based policy resource to assist in understanding and demonstrating compliance with Health Center Program requirements.
BPHC PAL on 2017 UDS Changes
This Program Assistance Letter (PAL) provides an overview of proposed changes to the Health Resources and Services Administration's (HRSA) calendar year (CY) 2017 Uniform Data System (UDS) to be reported by Health Center Program grantees and look-alikes in February 2018. Additional details regarding these changes will be provided in the forthcoming 2017 UDS Manual.
Three Star Health Task Force
The Three Star Health Task Force continues to work on a plan to expand health coverage to individuals and households that fall under 138 percent of the Federal Poverty Level. It is expected that the Task Force will submit their plan to CMS this week. Following CMS approval, the Tennessee General Assembly will also need to approve the plan before it can be enacted. The plan outlines a two-stage phase-in process. Phase One would focus on individuals with behavioral health diagnoses and some veterans; Phase Two would focus on the population under 138 percent of FPL. TPCA will update members as soon as the plan is made available for review.
Recently Enacted State Legislation
Public Chapter 1046
Task Force to explore physician and APRN scope of practice
Effective April 2016
Status: Task Force has had two meetings and will meet again in October
Creates a scope of practice task force to make recommendations to the General Assembly for the improvement of Tennessee residents' health by providing access to quality and cost-effective care.
Public Chapter 918
Effective July 1, 2016
Status: Awaiting rules to be promulgated by the Board of Dentistry
Authorizes the practice of "teledentistry" to facilitate evaluation and treatment of the patient outside of a real-time or in-person interaction. Any and all services provided via teledentistry shall be consistent with the in-person provision of those services. Any and all services provided via teledentistry shall be provided in accordance with the rules of the board of dentistry. Teledentistry shall not alter or amend the supervision requirements or procedures authorized for licensed and registered dental hygienists or registered dental assistants. Any licensed and registered dental hygienist who, under the supervision of a dentist, assists the dentist in providing dental health services or care using teledentistry is only authorized to perform those services that the dental hygienist is authorized to perform during an in-person patient encounter under general supervision.
Public Chapter 0968
State Oral Health Plan
Effective April 2016
Status: TDH will complete this plan by the end of March 2017
Authorizes the Commissioner of Health to develop a comprehensive state oral health plan. The plan may be used to direct skilled personnel and funding decisions in order to reduce the prevalence of oral disease.
Public Chapter 990
Effective January 1, 2017
Health insurance entities shall reimburse a healthcare services provider for the diagnosis, consultation, and treatment of an insured patient for a healthcare service covered under a health insurance policy or contract that is provided through telehealth without any distinction or consideration of the geographic location or any federal, state or local designation, or classification of the geographic area where the patient is located. A health insurance entity shall provide coverage for healthcare services provided during a telehealth encounter in a manner that is consistent with what the health insurance policy or contract provides for in-person encounters for the same service, and shall reimburse for healthcare services provided during a telehealth encounter without distinction or consideration of the geographic location, or any federal, state or local designation or classification of the geographic area where the patient is located.
Public Chapter 942
Pharmacists and hormonal contraceptives
Effective April 27, 2016
Status: Awaiting rule promulgation by Board of Pharmacy, Board of Medical Examiners, and Board of Osteopathic Examination
Authorizes pharmacists to provide hormonal contraceptives according to a valid collaborative pharmacy practice agreement containing a non-patient-specific prescriptive order and standardized procedures developed and executed by one (1) or more authorized prescribers. The Board of Pharmacy, in collaboration with the Board of Medical Examiners and the Board of Osteopathic Examination, shall adopt rules to establish standard procedures for the provision of hormonal contraceptives by pharmacists.