Rural Health Information Hub Latest News

HHS/DOD Release Vaccine Distribution Plan

The U.S. Department of Health and Human Services (HHS) and Department of Defense (DOD) have released their joint vaccination plan ‘From the Factories to the Frontline.’ The plan mentions their commitment to rural America saying:

“HHS is also committed to ensuring rural populations can receive the vaccine, and has decades of experience working with public health partners addressing the needs of hard-to-reach populations. The Centers for Disease Control and Prevention (CDC) will work with local communities, governments, and other partners to identify the best places and times to reach this population and utilize strategic distribution points via community health centers, schools, workplaces, mobile clinics, and pharmacies.”

Coming Soon: Appalachia Nonprofit Resource Center

Recognizing COVID-19’s impact on the Region, and particularly to the nonprofit community, ARC will soon launch a new Nonprofit Resource Center offering training to help nonprofits navigate through the pandemic to greater organizational sustainability. Via a competitive application process, cohorts from selected nonprofits will receive technical assistance in four key areas: short-term financial management, long-term financial management, mission and operations, and fundraising. A highly curated online resource guide is also planned as an additional resource.

Applications for this free training will open Tuesday, September 22. For more information, contact

Learn more about ARC’s support for our communities during the COVID crisis.

Rural Hospitals Teeter on Financial Cliff as COVID Medicare Loans Come Due

Note to Readers: Sarah Jane Tribble spent more than a year and half reporting on a small town in Kansas that lost its only hospital. This month, KHN and St. Louis Public Radio will launch “Where It Hurts,” a podcast exploring the often painful cracks growing in America’s health system that leave people vulnerable — and without the care they need. Season One is “No Mercy,” focusing on the hospital closure in Fort Scott, Kansas — and what happens to the people left behind, surviving the best way they know how. You can listen to Episode One on Tuesday, Sept. 29.

David Usher is sitting on $1.7 million he’s scared to spend.

The money lent from the federal government is meant to help hospitals and other health care providers weather the COVID-19 pandemic. Yet some hospital administrators have called it a payday loan program that is now, brutally, due for repayment at a time when they still need help.

Coronavirus cases have “picked up recently and it’s quite worrying,” said Usher, chief financial officer at the 12-bed Edwards County Medical Center in rural western Kansas. Usher said he would like to use the money to build a negative-pressure room, a common strategy to keep contagious patients apart from those in the rest of the hospital.

But he’s not sure it’s safe to spend that cash. Officially, the total repayment of the loan is due this month. Otherwise, according to the loan’s terms, federal regulators will stop reimbursing the hospitals for Medicare patients’ treatments until the loan is repaid in full.

The federal Centers for Medicare & Medicaid Services has not yet begun trying to recoup its money, with the coronavirus still affecting communities nationwide, but hospital leaders fear it may come calling for repayment any day now.

Hospital leaders across the country said there has been no communication from CMS on whether or when they will adjust the repayment deadline. A CMS spokesperson had not responded to questions by press time.

“It’s great having the money,” Usher said. “But if I don’t know how much I get to keep, I don’t get to spend the money wisely and effectively on the facility.”

Usher took out the loan from Medicare’s Accelerated and Advance Payments program. The program, which existed long before the pandemic, was generally used sparingly by hospitals faced with emergencies such as hurricanes or tornadoes. It was expanded for use during the coronavirus pandemic — part of billions approved in federal relief funds for health care providers this spring.

A full repayment of a hospital’s loan is technically due 120 days after it was received. If it is not paid, Medicare will stop reimbursing claims until it recoups the money it is owed — a point spelled out in the program’s rules. Medicare reimburses nearly $60 billion in payments to health care providers nationwide under Medicare’s Part A program, which makes payments to hospitals.

More than 65% of the nation’s small, rural hospitals — many of which were operating at a deficit before the pandemic — jumped at the Medicare loans when the pandemic hit because they were the first funds available, said Maggie Elehwany, former vice president of government affairs for the National Rural Health Association.

Read the full article here.

ARC Announces Launch of Revised Website

The Appalachian Regional Commission (ARC) is excited to announce the unveiling of their refreshed logo and a new look for!

With clean navigation, upgraded search functionality, and easy-to-access resources and data, they are making it faster for you to find the information you need.

Some upgraded features include:

  • Quick links to ARC’s available funding opportunities;
  • Spotlight on each ARC investment priority;
  • Searchable database of ARC’s latest research and reports;
  • State profiles for each one of Appalachia’s 13 states;
  • Stories about many of ARC’s investments in action;
  • And much more!

Although has a new look and an enhanced experience, they still have the same commitment to the Region’s future.

Hope you like it!

CDC Says Don’t Expect Broad Vaccine Availability Until Mid-2021

Centers for Disease Control and Prevention (CDC) director Robert Redfield warned Congress this week that it could take six to nine months after approval to get enough people vaccinated to control the pandemic. President Trump has promised a vaccine fast, but Redfield said the U.S. will struggle to distribute an eventual vaccine. Redfield also offered a bridge between now and vaccine availability:

  • “[F]ace masks are the most important, powerful public health tool we have.”
  • “[W]e have clear scientific evidence they work, and they are our best defense.”
  • “I might even go so far as to say that this face mask is more guaranteed to protect me against COVID-19 than when I take a COVID-19 vaccine, because the immunogenicity might be 70%, and if I don’t get an immune response, the vaccine’s not going to protect me. This face mask will.”
  • “I do want to keep asking the American public to take the responsibility — particularly the 18- to 25-year-olds. … because we haven’t got the acceptance of personal responsibility that we need for all Americans to embrace this face mask.”

DHS Issues MA Bulletin on Behavioral Health Group Therapy in an FQHC/RHC

The Pennsylvania Department of Human Services (DHS) released a Medical Assistance (MA) Bulletin that addresses Behavioral Health Group Therapy provided in FQHCs and Rural Health Clinic (RHC) settings. MA Bulletin 08-20-03 applies to FQHCS and RHCs who are MA enrolled and provide services to MA beneficiaries in a fee-for-service (FFS) or through managed care delivery systems. DHS has added the HQ modifier to procedure code T1015 to identify behavioral health group therapy encounters provided by FQHCS and RHCs. This is effective beginning Sept. 15, 2020 and the T1015 code is to be billed when a behavioral health group therapy session is led by a psychiatrist, licensed clinical psychologist, licensed clinical social worker (LCSW), licensed professional counselor (LPC) or licensed marriage and family therapist (LMFT).

DHS Releases MA Bulletin for Vision Services Provided by FQHCs/RHCs

The Pennsylvania Department of Human Services (DHS) released a Medical Assistance Bulletin implementing a separate PPS encounter rate for vision services provided by FQHCs and RHCs. The separate vision PPS rate can be billed by an ophthalmologist or optometrist and is effective with dates of service on and after Oct. 1, 2020. DHS indicates:

  • FQHCs and RHCs may bill for a vision encounter in addition to a physical health, behavioral health and dental encounter on the same day
  • To receive a separate vision PPS encounter rate and be eligible to bill for vision encounters, FQHCs and RHCs must submit a Medicaid FQHC Cost Report to DHS
  • For billing, the U3 pricing modifier with the T1015 code must be on the claim

For more details, access the Bulletin here.

Waived and Suspended Licensure Regulations

The Pennsylvania Department of State offers a consolidated list of licensure regulations that have been impacted by the COVID-19 pandemic. The list includes all pandemic actions taken by the state’s licensure boards and includes:

  • Buprenorphine Treatment. Suspension of the initial medical history and physical examination requirement for Buprenorphine treatment extended for the duration of the disaster declaration
  • CE Credits for Poll Work. Nursing Home Administrators, Physical Therapists, Social Workers, Marriage & Family Therapists, Professional Counselors, Speech-Language Pathologists and Audiologists can earn up to 2 hours of CE for serving as poll workers for the election

For a complete list of the licensure board actions during the pandemic, click here.

Guidance for Patients Under Quarantine After Exposure to COVID-19

The Pennsylvania Department of Health released Health Alert 525-09-14: Guidance for Patients Under Quarantine After Exposure to SARS-CoV-2. If PA DOH or the local health department identifies that someone is a close contact to a person with COVID-19, the close contact must quarantine for 14 days from last contact, even if the person remains asymptomatic. A negative test result obtained while a close contact is under quarantine does not release the person from quarantine. Because infection can develop up to 14 days after exposure, persons with negative test results must still quarantine for the full 14 days. Patients being tested for SARS-CoV-2 infection must be instructed to isolate at home until results are received. Click here to access all of the 2020 health alerts, advisories and updates.

340B Update: Request a Meeting with OMB

HRSA has drafted an Interim Final Rule (IFR) that would implement the President’s Executive Order on insulin and EpiPens. This IFR is currently being reviewed by OMB, which is the last step before it is published. (No draft has yet been released to the public.) Once published, it will go into effect almost immediately, before any opportunity for public comment. However, OMB is legally required to hold “listening sessions” with any groups who request one before they finalize their review. Therefore, PACHC and NACHC encourage health centers to reach out to OMB ASAP to request a meeting, as follows:

Requesting a meeting will allow FQHCs to share their concerns with the proposal and help to slow down the approval process.