CMS issued a proposed rule June 27, 2008 that would establish a number of new standards for RHCs and FQHCs participating in the Medicare program. Among other things, the rule would: establish location requirements and quality assessment and performance improvement program requirements for RHCs; clarify policies regarding “commingling” of an RHC with another entity; revise the RHC and FQHC payment methodology to implement statutory requirements; revise payments for services furnished to skilled nursing facility (SNF) patients; allow RHCs to contract with RHC nonphysician providers under certain circumstances; modify regulations regarding waivers of staffing requirements; update infection control requirements; and update the requirements under the emergency services standard and patient health records condition for certification to reflect advancements in technology and treatment. Finally, CMS solicits comments on payment for high cost drugs and the appropriateness of a mental health specialty clinic as an exception to the location requirements. CMS will accept comments on the proposed rule until August 26, 2008.