Accreditation
Joint
Commission on Accreditation of Healthcare
Organizations (JCAHO) – Ambulatory
Care Accreditation home page for information
related to the accreditation process for
health centers (not a Government Web
site)
Behavioral
Health (includes Mental Health and Substance
Abuse):
1.
Behavioral Health - 2004 HRSA Partial
Update to State by State Profiles
VIEW
TABLE ON WEB (Since the table is wide,
it's divided in two parts.)
VIEW
TABLE AS EXCEL FILE
2. Behavioral Health - Reimbursement
Reimbursement of Mental Health Services in Primary Care Settings (PDF - 1.6MB) – This report highlights key action steps that would help to reduce existing barriers to reimbursement for mental health services in primary care settings. Recommendations focus on a variety of stakeholders, including primary care providers, state Medicaid officials, and others billing for mental health services in the public sector. The report was jointly funded by SAMHSA and HRSA, with the technical expertise of CMS
Examples of State Billing Codes for Mental Health Services – SAMHSA has posted a set of tools on mental health billing codes and Medicaid – by provider type.
3.
Behavioral Health - State by State
Profiles
"State
Profiles, 2000, on Public Sector Managed
Behavioral Health Care"
(Produced for SAMHSA - Substance Abuse
and Mental Health Services Administration)
4. Primary Care Mental Health Integration
Issue Brief: Serving the Needs of Medicaid Enrollees with Integrated Behavioral Health Services in Safety Net Primary Care Settings (PDF - 163KB) – This Issue Brief identifies important partnerships that have developed to address the need for behavioral health services. It highlights ways in which safety net providers such as Federally Qualified Health Centers, Ryan White Programs, Maternal and Child Health Clinics, and Rural Health Providers work with Community Mental Health Centers and State Medicaid Programs across the Nation to deliver high-quality behavioral health care services to those most in need and least able to afford such services.
5.
State Profiles of Mental Health
and Substance Abuse Services in Medicaid
On
SAMHSA's National Mental Health Information
Center web:
State
Profiles of Mental Health and Substance
Abuse Services in Medicaid
Benchmarks:
Practice Management - PDF,
Word,
web
page
Medical
Group Management Association www.mgma.com
(not a Government Web site)
Billing
& Collections Manual - Table
of Contents (with links to three sample
policies)
Buildings
and Equipment
Capital
Link – Buildings and Equipment capital financing
resource
www.caplink.org
(not
a Government Web site)
Business
Plan Template
You
must have Excel software to use the Excel
files. Save the Excel files on your
computer and then open the files you've
saved.
-
Business Plan - Case Data - revised January
2003 (Excel - 58KB)
-
Business Plan - Blank
- revised January 2003 (Excel - 53KB)
Modified
version of the business plan for SBHCs:
- SBHC
Business Plan - Case Data (Excel - 68KB)
- SBHC
Business Plan - Blank
(Excel - 60KB)
CMS
Open Door Forums
CMS
Open Door Forums were established to
interact with beneficiaries, providers,
and stakeholders interested in the delivery
of quality healthcare for the nation’s seniors.
Low Income Health Access Open Door Forum – addresses the concerns of the beneficiary advocates, providers, and information intermediaries throughout the country interested in improving access to Medicare and Medicaid for lower income Americans. CMS co-hosts this forum with the Health Resources & Services Administration (HRSA). Timely announcements and clarifications regarding important rulemaking, agency program initiatives, and other related areas impacting the lower income beneficiaries are also included in the forums.
CMS
Provider Manuals Pertaining to HRSA Grantees
The
Medicare Rural Health Clinic and Federally
Qualified Health Center Manual – Contains
operating instructions, policies and procedures
based in statues and regulations, guidelines,
models and directives
The
Provider Reimbursement Manual - Part 1
– Contains operating instructions, policies
and procedures.
The
Provider Reimbursement Manual - Part 2
– Contains operating instructions, policies
and procedures. Click on Chapter 29 to download.
Medicare Benefit Policy Manual (PDF - 216KB) (Chapter 13 – RHC/FQHC Services) – contains information on the types of services covered as a RHC/FQHC service.
Medicare Claims Processing Manual (PDF - 258KB) (Chapter 9 – RHC/FQHC) – describes policy applicable to Medicare fee-for-service claims.
Community
Toolbox
Community
Toolbox makes available practical information to support your
work in promoting community health and development.
(not a Government Web site)
Costing
Tool
Technical
Assistance Costing Tool (TACT) to Identify
Cost in Providing HIV/AIDS Care. For webcast
and supporting materials, go to: TACT
web
Cultural
Competence
Disabled
Serving
Persons with Disabilities in Medicaid Managed
Care: Assuring Continuity, Quality and Cost
Effectiveness - Conference Proceedings
Electronic
Data Interchange
Workgroup
for Electronic Data Interchange - WEDI
(not a Government Web site)
Evaluation
and Management (E&M) Coding
Federal
Medical Assistance Percentages (FMAP)
- Federal share or match to State expenditures
Federal
Medical Assistance Percentages
Federal
Poverty Guidelines - sometimes inaccurately
refered to as "Federal Poverty Level"
(FPL)
Federal
Poverty Guidelines
Financing
and Reimbursement Strategies for Children
with Special Health Care Needs
The
Development of Financing and Reimbursement
Strategies for Children with Special Health
Care Needs: Volume
I: Narrative (PDF - 475 KB) and
Volume
II: Appendices (PDF - 278 KB) is
a report by the National
Center on Financing for Children with Special
Health Care Needs in the Institute for
Child Health Policy at the University of
Florida. (not a Government Web site)
Fiscal
Intermediary for FQHC's
National Government Services – NGS
is the fiscal intermediary for FQHC Medicare
nationally. NGS works with FQHC’s on provider
enrollment, cost report preparation and
audit, and FQHC Medicare claims processing.
Site includes Medicare cost report and instructions,
provider notices, Medicare Memos, and the
Appeals process. (not a Government Web site)
Health Disparities Collaboratives
HRSA’s Health Disparities Collaboratives Website – Collaborative areas of focus include clinical, financial, and operational.
Health Information Technology
HRSA’s Office of Health Information Technology
Health Insurance Portability and Accountability Act (HIPAA)
- HRSA's
HIPAA Web Site
HRSA
Grants Information
Department
of Health & Human Services (DHHS)
www.dhhs.gov/grants/
Health Resources Services Administration
(HRSA)
www.hrsa.gov/grants/
IRS
Forms
Instructions
- Form 990 for Not-for-Profit Organizations
www.irs.gov/pub/irs-pdf/i990-ez.pdf
Form
990 – Not for Profit Organizations
www.irs.gov/pub/irs-pdf/f990.pdf
Medicaid
Primer -
Opportunities
to Use Medicaid in Support of Access to
Health Care Services
On
this web, view fact sheets which assist
state and local health officials in understanding
how Medicaid works and how it can assure
access to health services for underserved
populations.
Medicaid
Prospective Payment System (PPS)
"Health
Centers and Rural Clinics: State and Federal
Implementation Issues for Medicaid's New
Payment System" on Government Accountability
Office (GAO) web.
Understanding the Medicaid PPS for FQHCs, NACHC Issue Brief #69 – Explains the Prospective Payment System
statute for Medicaid as it relates to FQHCs
and RHCs (not a Government Web site)
Status of the Medicaid PPS in States, NACHC State Policy Report #17 (not a Government Web site)
Medicaid
- State by State
State
Medicaid Agencies listed at National
Association of State Medicaid Directors
(not a Government Web site)
State
Health Facts by Kaiser Family Foundation
(not a Government Web site)
Descriptions
of State Programs by Centers for Medicare
and Medicaid Services
Medicare
- Medicare
Modernization Act of 2003 and Medicare Prescription
Drug Program
Medicare Provider Enrollment
The State Operations Manual – Chapter 2 – contains the Medicare certification process for Federally Qualified Health Centers (Section 2825) and Rural Health Clinics (Section 2240).
Medicare Provider Supplier Enrollment provides Medicare enrollment information for providers, physicians, non-physician practitioners, and other suppliers. Available download of CMS Form 855A CMS 855A - Medicare Enrollment Application
Mental
Health - see
Behavioral
Health
OMB
Circulars
OMB Circulars are instructions or information issued by the Office of Management and Budget (OMB) to Federal agencies.
Of Note:
OMB Circular A-110 – Uniform Administrative Requirements for Grants and Other Agreements with Institutions of Higher Education, Hospitals and Other Non-Profit Organizations
OMB Circular A-122 – Cost Principles for Non-Profit Organizations
OMB Circular A-133 – Audits of States, Local Governments, and Non-Profit Organizations
Policy
Information Notices (PINs) and Program Assistance Letters (PALs) from the Bureau of Primary Health Care (BPHC)
www.BPHC.HRSA.GOV/policy/default.htm
Of Note:
PIN 08-01:- Defining Scope of Project and Policy
PIN 04-05:- Medicaid Reimbursement for Behavioral Health Services
Practice
Management - The ACMPE Guide to the Body of Knowledge for Medical Practice Management (not a government
Web site)
Purchasing
Specifications - View
model contracting language for states and
managed care organizations:
Sliding
Fee Scales
Substance
Abuse - see
Behavioral
Health
Uniform Data System (UDS) – Health Centers report to HRSA annually. These reports include demographic clinical information about patients, plus staffing and financial data.
UDS
Overview
Search
for HRSA Publications |
