A seemingly small omission from the 2009 economic stimulus law could spell big trouble for the country's thousands of rural health clinics.
The problem? If you're billing the Centers for Medicare & Medicaid Services on an HCFA 1500 form, you're eligible for meaningful use incentive payments; if you're billing on a UB-04 form—which certified rural health clinics are required to do—you're not.
"They've simply been left out because they're billing on a different form," Aric Sharp, CEO of Quincy, IL-based Quincy Medical Group, said in an interview. "That's a pretty big oversight. There's about 3,700 rural health clinics across the country."
Now, Quincy Medical Group, which has rural affiliates throughout Illinois and Missouri, is spearheading an effort to make what Sharp calls a "technical correction" to the bill.
"We're trying to change the law so that physicians that practice in rural health clinics are able to participate in these quality programs," he says.
Sharp says Quincy Medical Group began its effort to change the law by reaching out to other stakeholders who were affected by the oversight. Now, he says there's a formal coalition made up of players such as the National Rural Health Association, the American Medical Group Association, and various rural health clinics and associations from around the country. In advocating for the change, the coalition has discovered lots of receptivity from people on Capitol Hill, including Congressman Greg Walden (R-OR).
In addition, the coalition has already developed a draft of the language that they want to attach to a bill.
"We're hoping to attach it as a part of the SGR [sustainable growth rate] bill when and however that moves," Sharp says, adding that they've heard that it may move with the debt ceiling negotiations.
Sharp says that his coalition believes that the omission was an oversight, not intentional. But it still leaves rural health clinics at a major disadvantage.
"No one wants to discriminate against rural health clinics," he says. "They have their work cut out for them as it is in the challenges that they face, and it's vital that they're able to participate in these programs."
He says healthcare's transformation is going to be built on information technology and the ability to report, track, and improve quality metrics is based upon having electronic records.
"It's a very simple technical correction to allow rural health clinics to participate in these programs," he says.
Still, even the simplest things aren't always guaranteed, and Sharp says he's "cautiously optimistic" about getting the language changed. In the meantime, he urges rural stakeholders to lobby their own representatives in Washington about the oversight, raise awareness about the issue among their peers, and join the coalition to be sure that rural healthcare doesn't get left behind.
"We're really advocating for all of those quality programs that, regardless of what form you bill on, that those physicians the providers involved would be able to play on an equal playing field with their urban counterparts," he says. "But I don't think it will happen without this change."
E-mail Sharp at asharp@quincymedgroup.com to learn more about the coalition and its efforts.
Alexandra Wilson Pecci is an editor for HealthLeaders.
