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EXECUTIVE DIRECTORS

7/15/2005 12:00:00 AM

PROPOSED PERMANENT REGULATIONS FOR PART-TIME CLINICS

M e m o r a n d u m

TO:                  Executive Directors

                        Clinic Directors

FROM:            Mike Alvaro, Associate Executive Director

DATE:             July 15, 2005

RE:                 Proposed Permanent Regulations for Part-time Clinics

At a meeting with key Department of Health (DOH) staff this morning, we received a briefing on their proposed part-time clinic regulations (attached – Please note that deleted language is in red and new language is in blue).  The Department reached out to us because of our comments and problems on the version of the regulations they issued in August 2004.

DOH has explained that it is necessary for them to promulgate new regulations before August 7 to stay in compliance with state regulations.  This latest version in fact addresses our major concerns and does not seem to present any insurmountable obstacles for us at first reading.  Also, DOH staff very clearly offered the option of waivers for any of our Affiliates that might be affected by these newly proposed regulations.

While this version does not appear to be that troublesome for us, there are two issues where we’ll need your input on how the proposed regulations may affect your part-time clinics:

g     Part-time clinics located in physician offices – The fundamental reason these regulations are being so heavily pushed by the Governor’s office and DOH is their need to cut the practice of certain hospital-operated offices from billing services at a clinic rate when in fact they should be billing at the physician rate.  DOH stated that our physician office based part-time clinics seem to be appropriately structured and that they would be able to issue waivers for them.  This includes dental services in a dentist’s office.  To ensure that ALL our Affiliates’ clinics operated in physician offices are accounted for, we ask that you please let us know of ALL your part-time clinics operated in a physician office.

g   80/20 split of services – There is an arbitrary limit placed on the percentage of part-time clinic services that are allowed.  The regulations limit part-time clinic services to 20% of your total clinic visits.  If this limit is a problem for you, please let us know as soon as possible by how much you would exceed the limit they are proposing.

Much of the rest of the proposed regulation appears fairly reasonable, but we ask that you review it and let us know as soon as possible if you have any questions or problems with any aspect of this proposed regulation.  As you can see, they have removed (red) the restriction of OT, PT, ST, Audiology in part-time clinics.

The Department’s time frame is as follow:

  • This week – mail the Codes Committee a reference that the new regulation is coming.
  • July 21 – mail the proposed regulation to the Codes Committee in preparation for a special session to be held August 4.
  • August – the proposed regulation will appear in the State register, after which we’ll then have 30 days to comment.

Overall, this is a positive first step in that the Department recognizes that changing regulations before the OMRDD/DOH Article 28 Provider Council begins its work might not be the best way to proceed.  We have been assured that they realize how important the part-time clinics issue is, and therefore it will be an agenda item at the first Provider Council meeting.    

If you have any questions or concerns, please do not hesitate to contact me.  In addition, please respond to the above questions as soon as possible.

[Attachments can be obtained by contacting the Affiliate Services Office]

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