Religious Non-Medical Health Care Institutions (RNCHIs)
RNHCIs furnish only nonmedical nursing services and items to people who choose to rely solely on obtaining a religious method of healing and for whom the acceptance of medical services would be inconsistent with their religious views. Such nonmedical services are performed by nonmedical nursing personnel and include activities such as assistance in moving, comfort and support measures, and general assistance in performing day-to-day activities. (The nonmedical nursing personnel must be experienced in caring for the physical needs of nonmedical patients.) RNHCIs do not perform any medical screenings, examinations, diagnoses, or treatments, including the administration of drugs. Each beneficiary who wishes to receive services in an RNHCI must make a valid and formal written statement (or “election”) to do so. (The specific election requirements are discussed in 42 CFR §403.724 and CMS Pub. 100-07, chapter 2, section 2054.1B.)
CMS’s Boston regional office has primary responsibility over the approval and certification of RNHCIs. RNHCIs are not certified by the State, but must meet all of the conditions of coverage outlined in 42 CFR §403.720, as well as all conditions of participation outlined in 42 CFR §403.730 through 403.746. For purposes of provider enrollment, the three most important conditions are that the provider:
1. Must not be owned by, under common ownership with, or have an ownership interest of 5 percent or more in, a provider of medical treatment or services.
2. Must not be affiliated with a provider of medical treatment or services or with an individual who has an ownership interest of 5 percent or more in a provider of medical treatment or services. (Permissible affiliations are described in 42 CFR §403.738(c)).
3. Must be a non-profit organization per subsection (c)(3) of §501 of the Internal Revenue Code of 1986, and exempt from taxes under subsection 501(a).
To this end, the contractor shall: (1) examine Sections 5 and 6 of the CMS-855A, and (2) verify the provider’s non-profit status to ensure that the aforementioned conditions are met.
For more information on RNCHIs, refer to:
• Section 1861(ss)(1) of the Social Security Act
• 42 CFR Part 403, subpart G
• Pub. 100-07, chapter 2, sections 2054, 2054.1, 20541A and 2054.1 (State Operations Manual)
• Pub. 100-04, chapter 3, sections 170 - 180 (Claims Processing Manual)
• Pub. 100-02, chapter 1, sections 130 – 130.4.2 (Benefit Policy Manual)
For guidance on the appropriate contractor jurisdiction for incoming RNCHI applications, please see Pub. 100-04, chapter 1, section 20.
RNHCIs furnish only nonmedical nursing services and items to people who choose to rely solely on obtaining a religious method of healing and for whom the acceptance of medical services would be inconsistent with their religious views. Such nonmedical services are performed by nonmedical nursing personnel and include activities such as assistance in moving, comfort and support measures, and general assistance in performing day-to-day activities. (The nonmedical nursing personnel must be experienced in caring for the physical needs of nonmedical patients.) RNHCIs do not perform any medical screenings, examinations, diagnoses, or treatments, including the administration of drugs. Each beneficiary who wishes to receive services in an RNHCI must make a valid and formal written statement (or “election”) to do so. (The specific election requirements are discussed in 42 CFR §403.724 and CMS Pub. 100-07, chapter 2, section 2054.1B.)
CMS’s Boston regional office has primary responsibility over the approval and certification of RNHCIs. RNHCIs are not certified by the State, but must meet all of the conditions of coverage outlined in 42 CFR §403.720, as well as all conditions of participation outlined in 42 CFR §403.730 through 403.746. For purposes of provider enrollment, the three most important conditions are that the provider:
1. Must not be owned by, under common ownership with, or have an ownership interest of 5 percent or more in, a provider of medical treatment or services.
2. Must not be affiliated with a provider of medical treatment or services or with an individual who has an ownership interest of 5 percent or more in a provider of medical treatment or services. (Permissible affiliations are described in 42 CFR §403.738(c)).
3. Must be a non-profit organization per subsection (c)(3) of §501 of the Internal Revenue Code of 1986, and exempt from taxes under subsection 501(a).
To this end, the contractor shall: (1) examine Sections 5 and 6 of the CMS-855A, and (2) verify the provider’s non-profit status to ensure that the aforementioned conditions are met.
For more information on RNCHIs, refer to:
• Section 1861(ss)(1) of the Social Security Act
• 42 CFR Part 403, subpart G
• Pub. 100-07, chapter 2, sections 2054, 2054.1, 20541A and 2054.1 (State Operations Manual)
• Pub. 100-04, chapter 3, sections 170 - 180 (Claims Processing Manual)
• Pub. 100-02, chapter 1, sections 130 – 130.4.2 (Benefit Policy Manual)
For guidance on the appropriate contractor jurisdiction for incoming RNCHI applications, please see Pub. 100-04, chapter 1, section 20.
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