Rural Health Clinics


Background

A Rural Health Clinic (RHC) is a clinic certified to receive special Medicare and Medicaid reimbursement. The purpose of the RHC program is improving access to primary care in underserved rural areas.

Designated Rural Health Clinics (are reimbursed based on a reasonable cost formula for Medicare visits, and on a modified cost-based formula or prospective payment for Medicaid visits. Many rural providers find that their reimbursement is significantly enhanced under this system.

For more information about Rural Health Clinics check out:

Rural Assistance Center – Rural Health Clinic Information Guide |

Centers for Medicare and Medicaid Services – Rural Health Clinics Fact Sheet


Rural Health Clinics must be located in rural areas with current health care shortage designations.

Any area that is not in a U.S. Census-designated "urbanized area" is considered rural.
      To see if your location is in a rural area you can use the Rural Assistance Center´s Am I Rural?

Eligible clinics must be in a rural area designated or updated within the last four years by the U.S. Health Resources and Services Administration. There are four types of shortage areas that qualify:

•    Geographic-based HPSA (Health Professional Shortage Area)

•    Population-based HPSA

•    MUAs (Medically Underserved Area), or

•    Governor Designated medically underserved area.

To see if your location is in a federally designated Health Professional Shortage Area or Governor-Designated medically Underserved Area go to:

KDHE´s annual Primary Care Health Professional Underserved Areas Report |

Or the Bureau´s Shortage Designation webpage

The final determination of eligibility is made by your state agency responsible for RHC certification and the CMS regional office. For information on RHC eligibility, contact KDHE´s Bureau of Community Health Systems at BCHS@kdheks.gov or (785) 296-1200.

 

Requirements for Rural Health Clinics

Rural Health Clinics must comply with Medicare regulations to meet conditions of certification.

Rural Health Clinics are required to use a team approach of physicians and midlevel practitioners such as nurse practitioners, physician assistants, and certified nurse midwives to provide services. The clinic must be staffed at least 50% of the time with a midlevel practitioner.

Rural Health Clinics are required to provide out–patient primary care services and basic laboratory services.

To view Medicare´s RHCs regulations and interpretative guidelines go to the:

National Association for Rural Health Clinics – Rules and Guidelines webpage |

Centers for Medicare and Medicaid Services – Rural Health Clinic Center webpage

 

Becoming a Rural Health Clinic

To receive special Medicare and Medicaid reimbursement; a clinic must gain Medicare certification as a Rural Health Clinic. This process first begins by applying for Medicare certification through Kansas Department of Health and Environment, Bureau of Child Care and Health Facilities. For more information or questions about the application process for RHC certification, contact Tamara Wilkerson at twilkers@kdheks.gov or (785) 296-1263.


Links

Map of Rural Health Clinics in Kansas

Kansas Health Care Provider Directory