NRHA: Congress Releases FY 2022 Appropriations Package

On March 9, the U.S. House and Senate released the long-awaited compromise for the fiscal year (FY) 2022 appropriations package. The National Rural Health Association (NRHA) is pleased with the attention lawmakers have placed on rural providers throughout the pandemic. This week’s package continued that focus with significant provisions for supporting the rural health safety net the following provisions of note.

Support for Rural Hospitals  

  • $3.45 billion for the Rural Community Facilities Program and $2 million for the Rural Hospital Technical Assistance Program thru the United States Department of Agriculture Rural Development (RD) programs. NRHA is happy to see maintained funding for these critical programs and will continue advocating for additional TA funds in FY 2023. 
  • $62 million for the Medicare Rural Hospital Flexibility Grants Program, an increase of nearly $7 million over FY 2021 funding levels. The $62 million includes $21 million for the Small Rural Hospital Improvement Grant Program and $5 million to establish a Rural Emergency Hospital (REH) Technical Assistance Program. Since the REH designation was established in December 2020, NRHA has been advocating lawmakers explaining that technical assistance is needed to support providers interested in transitioning to this designation.  

Continuation of Core Rural Health Care Programs 

  • $12.5 million for State Offices of Rural Health 
  • $135 million for the Rural Communities Opioid Response Program  
  • $10.5 million for the Rural Residency Development Program 
  • $122 million for the National Health Service Corps  
  • $6 million for the Rural Maternity and Obstetrics Management Strategies (RMOMS) program, including an increase of $1 million over FY 2021 included in this package.  

Supplemental Public Health Provisions  

As an omnibus package, non-appropriations related provisions will pass along with it, including several that NRHA advocated for.  

  • Legislative text to ensure providers maintain their 340B status by waiving the DSH percentage qualification requirement during COVID-19 cost report years. We have heard tremendous concerns from providers on this issue. Congress taking this action is a tremendous victory to upholding the integrity of the program. In February, NRHA sent this letter to HHS Secretary Becerra outlining our concerns with attacks on the 340B program, and the need for this fix.  
  • Substantive maternal health legislative language. This includes training grants for health care providers in the maternal health lens, support for pregnant women to understand the true benefit of the COVID-19 vaccine, and additional support for post-partum care. Also included is the NRHA developed Rural Maternal and Obstetric Modernization of Services (Rural MOMS) Act to:  
    • Improve rural maternal and obstetric care data;  
    • Create rural obstetric network grants (authorization of FORHP’s current program); 
    • Adds rural obstetric care to the telehealth programs at HRSA; 
    • Creates a rural maternal and obstetric care training demonstration on workforce specific to rural communities.  
  • Extension of telehealth flexibilities beyond the duration of the public health emergency (PHE), including allowance for rural health clinics (RHC) and Federally Qualified Health Centers (FQHC) at their current reimbursement methodology and furnishment of audio-only telehealth services. The bill continues current Coronavirus Aid, Relief, and Economic Security (CARES) Act telehealth provisions as currently written for 151 days beyond the duration of the PHE, which is anticipated to end in July 2022. This timeframe will allow for telehealth to be continued until mid-December, where they will have another opportunity to address this issue.  

NRHA is thrilled with the number of our advocacy priorities included in this package as outlined above. They will continue advocating for delay reinstatement of Medicare sequestration, tools rural providers need to combat the remainder of the pandemic, and creation of a quality reporting program for provider-based RHCs in exchange for cost-based reimbursement moving forward.  

NRHA expects consideration of this package in the House and Senate before the deadline of March 11, with the President expected to sign it into law soon after. They will keep members apprised of developments on this important package and work we’re doing to continue improving the rural health safety net.