Rural Health Information Hub Latest News

Study Adds New COVID-19 Symptoms

Researchers analyzed nearly 12,000 visits by adult patients to emergency departments at five New York City hospitals. They found COVID-19 in 57.5 percent of patients who went to the hospital because of weakness, falls or altered mental status; 55.5 percent of those who came in because their blood sugar was out of control; and 51.4 percent of patients whose chief complaint was a gastrointestinal problem. Read more.

FDA Approves First COVID-19 Home Test

The U.S. Food and Drug Administration has issued an emergency use authorization (EUA) for the first COVID-19 diagnostic test for self-testing at home and that provides rapid results. The Lucira COVID-19 All-In-One Test Kit is a molecular (real-time loop mediated amplification reaction) single use test that is intended to detect the novel coronavirus SARS-CoV-2 that causes COVID-19. It is approved for self-collected nasal swab samples in individuals age 14 and older who are suspected of COVID-19 by their health care provider. It is also authorized for use in point-of-care (POC) settings (e.g., doctor’s offices, hospitals, urgent care centers and emergency rooms) for all ages but samples must be collected by a healthcare provider when the test is used at the POC to test individuals younger than 14 years old. The test is currently authorized for prescription use only. Read more here.

Vaccine Administration Interim Final Rule Published

The Centers for Medicare and Medicaid Services (CMS) has issued an interim final rule establishing vaccine-related coverage provisions for Medicare, Medicaid, CHIP and private insurance. The new interim final rule, published Nov. 6 in the Federal Register, states that providers can receive free vaccines from the federal government but will be prohibited from charging consumers for the administration. Under Medicare there would be no cost-sharing for COVID-19 vaccines. For individuals without health coverage, providers can be reimbursed through HRSA’s COVID-19 Claims Reimbursement Program. NACHC believes vaccine administration requirements could present costs to health centers and that state Maintenance of Effort requirements could adversely impact FQHC reimbursements and will be submitting comments. NACHC has written this memo in response to the rule. CMS issued toolkits aimed at State Medicaid Agencies, providers who will administer the vaccine and health insurance plans. The deadline for comments on the rule is Jan. 4, 2021.

HRSA Puts 340B Dispute Resolution Final Rule in Motion

HRSA sent a final rule to create a binding administrative dispute resolution (ADR) process for the 340B program to the White House for approval. Congress, more than 10 years ago as part of the Affordable Care Act (ACA), required U.S. Department of Health and Human Services (HHS) to publish a regulation establishing a binding 340B ADR system, to replace 340B’s then 14-year-old, informal dispute resolution process. Congress wanted the job done in 180 days. HRSA published an advanced notice of proposed rulemaking in Sept. 2010 and a proposed rule in Aug. 2016. The Trump administration withdrew the proposed rule, written by the Obama administration, in Aug. 2017, and HRSA never advanced a final rule, until now. HHS’s failure to do so and the impact of not having an ADR process in place to respond to the recent attacks on the 340B program are the basis of the NACHC 340B lawsuit. The final rule’s contents remain unknown for now so it is unclear whether or how much the final rule differs from the proposed version HRSA sought comment on more than four years ago.

Pennsylvania Announces Week-Six Rapid Antigen Test Card Distributions

The Pennsylvania Department of Health this week began distribution of the sixth allotment of COVID-19 antigen test kits provided by the federal government to Clinical Laboratory Improvement Amendments (CLIA)-certified institutions in Bedford, Cambria, Franklin, Lancaster and Lehigh counties. Last week, 139,200 tests were distributed to 70 facilities in Armstrong, Dauphin, Delaware and Indiana counties. Additional tests will be provided to healthcare providers in those counties in the coming weeks. Archived lists of distributions since week one can be found on the Department of Health’s Coronavirus Symptoms & Testing webpage under the Antigen Tests subhead.

Pennsylvania House and Senate Announce Leadership Changes

The Pennsylvania Senate and House Republicans and House Democrats recently held leadership elections. Here are the results:


Senate Republicans (Majority Party)

Interim President Pro Temp: Jake Corman (Centre)

Majority Leader: Kim Ward (Westmoreland)

Whip: John Gordner (Columbia)

Caucus Chair: Bob Mensch (Montgomery)

Caucus Secretary: Ryan Aument (Lancaster)

Appropriations Chair: Pat Browne (Lehigh)

Caucus Administrator: TBD

Policy Committee: TBD


Senate Democrats (Minority Party)

Minority Leader: Jay Costa (Allegheny)

Whip: Anthony Williams (Philadelphia)

Caucus Chair: Wayne Fontana (Allegheny)

Caucus Secretary: Maria Collett (Montgomery)

Appropriations Chair: Vince Hughes (Philadelphia)

Caucus Administrator: TBD

Policy Committee: Katie Muth (Montgomery)


House Republicans (Majority Party) 

Speaker: Bryan Cutler (Lancaster)

Leader: Kerry Benninghoff (Centre)

Whip: Donna Oberlander (Clarion)

Caucus Chair: Mike Reese (Westmoreland)

Caucus Secretary: Martina White (Philadelphia)

Appropriations Chair: Stan Saylor (York)

Caucus Administrator: Kurt Masser (Northumberland)

Policy Committee Chair: Marty Causer (Franklin)


House Democrats (Minority Party) 

Leader: Joanna McClinton (Philadelphia)

Whip: Jordan Harris (Philadelphia)

Caucus Chair: Dan Miller (Allegheny)

Caucus Secretary: Tina Davis (Bucks)

Appropriations Chair: Matt Bradford (Montgomery)

Caucus Administrator: Mike Schlossberg (Lehigh)

Policy Committee Chair: Ryan Bizzarro (Erie)

White House Signals Acceptance to Full-Year Spending Bill

For the last few weeks, Congressional leadership, including Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Nancy Pelosi (D-CA), have indicated a desire to pass a full-year omnibus appropriations bill ahead of the December 11, 2020, funding cliff rather than another short-term continuing resolution. Last week, Senate Republicans released their spending package which has helped kickstart negotiations on the full-year spending package. Following meetings between Republican leadership and White House Chief of Staff Mark Meadows this week, Roll Call has begun reporting that the President Trump is open to signing a full-year package. Negotiations are ongoing, and NRHA will keep members apprised of developments via NRHA Connect.

For more timely updates, follow @NRHA_Advocacy on Twitter! If you have any questions, comments, or suggestions, NRHA wants to hear them.

The Nation’s Attention Turns Towards Rural America as Concerns with COVID-19 Vaccine Distribution Rise

Large urban hospitals are rushing to buy expensive ultra-cold freezers to store what’s likely to be the first approved COVID-19 vaccine. But most rural hospitals can’t afford these high-end units, meaning health workers and residents in those communities may have difficulty getting the vaccines. “Hundreds of rural, small towns all across the U.S. have a higher percentage of elderly, low-income [residents], a higher percentage of the community with multiple chronic health issues,” says NRHA CEO Alan Morgan. “In this financial environment, you can imagine that there is simply no consideration of rural hospitals purchasing storage equipment for this ultra-cold distribution.” In an interview that aired on CBS This Morning, NRHA member Tim Size spoke to the need for equitable vaccine access in rural America. He stated, “If, basically, rural is getting the message, ‘We will start with urban,’ even it is for reasonable logistical reasons, it’s bad optics. I don’t think anybody wants to give the message that rural America, rural Wisconsin is second-class.”