Bill Finerfrock, NOSORH Legislative Liaison, reports that the starting budget number for 2014 that the Senate is operating from will be different than what the House is working from. The House adopted a budget with less money than the Senate put in their budget; working from different topline numbers will be difficult, Finerfrock said. It could be late this year when we find out what will happen and it is possible another continuing resolution will come on October 1st. Regardless, appropriations will probably be reduced, he said. 

Health Insurance Marketplaces

Marketplaces are in the process of being set up. In most rural areas, there will only be a statewide plan available. Finerfrock suggests that SORHs keep an eye on exchanges and market plans in their states, and not get caught in total number but look at availability in rural areas. CMS is trying to take care of consumer information so they are focusing on providers who would benefit. In addition, CMS is creating toolkits for consumers and providers. 

ICD10 Conversion

On October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. The transition to ICD-10 is required for all providers covered by the Health Insurance Portability Accountability Act. According to Finerfrock, who also serves as president of National Association of Rural Health Clinics, it has been estimated that that the conversion to ICD10 will add five minutes to each visit. The longer it takes, the more the provider will see a financial reduction. Finerfrock says that small providers are going to be experiencing problems because of software and staffing issues, but there are organizations that can provide some training to help providers get ready.