- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- CMS: Request for Information; Health Technology Ecosystem
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- State: 60-Day Notice of Proposed Information Collection: J-1 Visa Waiver Recommendation Application
- Public Inspection: CMS: Request for Information: Health Technology Ecosystem
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
- VA: Solicitation of Nominations for the Appointment to the Advisory Committee on Tribal and Indian Affairs
- GAO Seeks New Members for Tribal and Indigenous Advisory Council
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
Why Does Insulin Cost “An Arm and a Leg”?
There has been a lot of false news circulating on insulin pricing lately, indicating that Biden Administration policies have caused the surge. Find out the facts on the history of insulin, why it is so expensive and why there is no generic version. In “An Arm and a Leg: Revisiting Insulin: How the Medicine Got So Expensive,” Kaiser Health News recounts the history and gives us the current status of this lifesaving drug. Listen to the podcast or read the transcript here.
Top Businesses Partner to Bolster Vaccination Messaging
Business Roundtable, the voice of America’s top CEOs, last week launched “Move the Needle,” a campaign to support President Biden in rolling out COVID-19 vaccines, increasing vaccine uptake and encouraging masks. In the announcement, Business Roundtable president and CEO Josh Bolten said, “Masks and vaccines are working. Now is the time to keep at it, overcome pandemic fatigue, and double down on the measures that will end this public health and economic crisis.” Pushing the hashtag #IGottheShot, the campaign aims to ramp up engagement with employees, suppliers and customers to advance wider and consistent adoption of COVID-19 safety practices and vaccines. The White House also announced alliances with top business groups, including the U.S. Chamber of Commerce, Business Roundtable, National Association of Manufacturers, and leaders in Hispanic, African American and other minority business organizations to help organizations provide accurate and up to date information to their employees and customers.
94% of Medicaid-Covered Children Are in Managed Care Plans
News Medical Life Sciences reported on March 1, 2021, that the proportion of Medicaid-eligible children enrolled in managed care plans increased from 65 percent in 2000 to 94 percent in 2017, according to a study published in the journal Academic Pediatrics. The study also pointed to opportunities for Medicaid plans to improve quality by encouraging more preventive care visits for children. Read More.
Updated HAN on Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19
The Pennsylvania Department of Health (DOH) is releasing the updated guidance for making decisions about return to work for healthcare personnel (HCP) with confirmed COVID-19, or who have suspected COVID-19 (e.g., developed symptoms of COVID-19 but did not get tested for COVID-19). These updates are consistent with those published by the CDC on Feb. 16, 2021 and available for review here. This HAN replaces PA-HAN-516. These changes include HCP who are severely immunocompromised could remain infectious more than 20 days after symptom onset. Click here to access all the 2021 Health Alerts, Advisories and Updates.
Tax Surprise Due To COVID-19 for Some May Mean Pay Back
The vast majority of people who sign up for a marketplace plan are eligible for a tax credit to reduce their monthly premium. But the tax credits are based on estimated annual income, which may be especially hard to predict during such financially uncertain times. People whose income fluctuated significantly during the year may be in store for a tax season surprise: having to pay back part of their premium tax credit if they earned more than they expected. Read more.
PA Launches Project Firstline
PA Project Firstline is an exciting new educational effort created by the Department of Health’s healthcare-associated infection prevention team in the Bureau of Epidemiology and funded by CDC. The Bureau launched a new text messaging program for frontline workers as part of this education effort. The program allows individuals to receive simple and direct messages with images and links to infection prevention and control information. PA Project Firstline aims to reach all healthcare workers, in all roles, in all facility types to provide them foundational knowledge on infection prevention and control in a way that is easily accessible, immediately applicable to their work, and even entertaining. The first of the project’s activities is a poster campaign that provides reminders of precautions to combat COVID-19. The first four posters in printable and web-friendly formats are available here. To sign up for the text messaging program, text JOIN to IPC4U (47248).
Timetable for Adequate Vaccine for All Adults Across America Moves Up to May
President Biden this week said the U.S. will have enough COVID-19 vaccines for all American adults by the end of May, two months earlier than he had previously stated and after regulators authorized the one-shot Johnson & Johnson (Janssen) vaccine and Merck & Co. agreed to help produce it. Mr. Biden also called on states to give priority to teachers, school staff and child-care workers for vaccinations, as virtual learning continues for many students across the country. Pennsylvania is among the states that have responded to the call to do so (see related article under Harrisburg Update).
NRHA Secures Big Wins for Rural Health in Latest COVID-19 Relief Package
On March 11, 2021, President Biden signed into law a $1.9 trillion COVID-19 relief package. Thanks to the advocacy of NRHA and its members, the package includes a number of provisions to protect and promote rural health.
Most notably, NRHA has secured the infusion of $8.5 billion for rural providers, a key provision which NRHA worked closely with Senator Manchin’s office on. The $8.5 billion for rural providers will be provided through a fund called the Health Care Heroes Sustainability Fund (HCHSF), which will be similar to the Provider Relief Fund (PRF) but specific to rural providers. After months of advocacy, NRHA and its members are proud to have secured this much-needed relief on behalf of rural providers.
Additional rural health provisions of note include:
- Additional funding for the Paycheck Protection Program (PPP) with language increasing eligibility for rural providers. Previously, rural hospitals affiliated with a larger health system were deemed ineligible for the PPP if their affiliation brought them above the program’s 500-employee threshold, even if the rural hospital itself only had 100 or so employees. The new bill will waive the affiliation provision, which will enable many more rural providers to participate in the program. NRHA has advocated for this change since the PPP was created last March.
- $500 million for the creation of an ‘Emergency Grants for Rural Health Care’ program through the United States Department of Agriculture. This program will support rural hospitals’ efforts around COVID-19 response and vaccine administration, as well as telehealth services.
- $7.66 billion in funding for the public health workforce to carry out activities related to establishing, expanding, and sustaining public health at the state, local, and territorial levels.
- Supplemental appropriation allocation for the National Health Service Corps ($800 million) and the Nurse Corps Loan Repayment Program ($200 million), bringing $1 billion dollars of additional funding to health care workforce programs. NRHA has advocated for additional funding for the health care workforce in each COVID-19 relief bill, and we are pleased that Congress has decided to provide resources to rural and underserved communities.
- An additional $55 billion in funding for COVID-19 vaccine deployment, vaccine awareness programs, testing, tracing, and mitigation programs.
- $1 billion in funding to support vaccine confidence activities throughout the country.
- Additional funds for mental health support for rural and underserved areas, including $80 million towards Mental Health training, and $40 million in funding to support the Mental Health professional workforce.
How 18 Million Americans Could Move Into Rural Areas – Without Leaving Home
From Route Fifty
COMMENTARY: A pending proposal would reclassify dozens of communities from metropolitan to rural, potentially affecting their eligibility for certain federal funding and programs.
About 46 million Americans – 14% of the nation’s inhabitants – are currently classified as living in rural areas. That number could jump to 64 million – an increase of nearly 40% – without anyone moving into a new home. That could actually hurt small cities and rural communities across the country.
The federal government classifies communities’ characteristics based on their populations, according to a definition created by the federal Office of Management and Budget. The criteria haven’t substantially changed since the 1940s. Since then, the U.S. population has more than doubled, from 152 million in 1950 to more than 328 million in 2019.
The main dividing line is between communities – which include both towns and cities and their surrounding counties – with more than 50,000 people and those with fewer than that number. Over the past 70 years, the number of areas with at least that many people has increased from 168 to 384 as small towns have grown into small cities. For example, from 1950 to 2010, the population of Lawrence, Kansas, grew from 23,351 to 87,643.
Under the current definition, Colbert County, Alabama – population 54,428 – is in the same category as Los Angeles County – population over 10 million. As the Trump administration ended, federal officials decided some more nuance would be useful in understanding American communities. They proposed to change the dividing line to populations of more than 100,000 – and the effort appears to be continuing under the Biden administration.
That change would effectively move everyone who lives in places with 50,000 to 100,000 from urban to rural life, because their cities, including San Luis Obispo, California, and Battle Creek, Michigan, will no longer be considered large enough to count as metropolitan.
Redefining Rural
The government doesn’t specifically use this system to label places as “urban” or “rural.” Instead, there are three government categories – “metropolitan,” “micropolitan” and “outside a core based statistical area.” However, most government agencies, researchers, advocates and media outlets use these classifications to sort communities into two groups – equating “metropolitan” with “urban” and the other two categories together as “rural.”
Making the proposed change would mean 144 areas with populations between 50,000 and 100,000, and the 251 counties they occupy, would no longer be classified as “metropolitan,” but rather as “micropolitan” – and therefore effectively rural – including Flagstaff, Arizona, and Blacksburg, Virginia. The change would leave Wyoming without any metropolitan areas at all.
The Office of Management and Budget is accepting comments about this proposed change until March 19.
Looking at the Numbers
Changing how rural areas are defined could change Americans’ understanding of rural life.
For instance, the current data reveal that rural areas have less access to broadband internet and health care services.
But if the homes and communities of 18 million more Americans are added to those rural statistics, the numbers could look better. That rosier picture – which would not be the result of any actual changes to Americans’ lives – could reduce public and political pressure to improve life in rural communities.
It’s also not clear whether 100,000 is the right boundary for urban living – or of there is an exact number at all. To people in major cities, a community of 80,000 like Santa Fe, New Mexico, may be more similar to the 22,000-person Roseburg, Oregon, than to Chicago or Miami. To a rancher on the Plains, with fewer than one person per square mile, though, Santa Fe may qualify as a “big city,” with chain stores, hospitals and government offices.
More than a Statistical Shift
Though the government’s proposal says it’s meant as a statistical change only, the classifications are commonly used by government agencies, charities and other organizations to determine which communities are eligible for their funding or programs.
The change could make many small American cities, which would be newly identified as rural, ineligible for money to help community planning and public transit – even if they currently get that money.
Communities currently designated as rural may be hurt, too. If Congress and states don’t allocate more funds to serve the increased number of people classified as living in rural areas, the money that is available – like rural health grants – would be spread more thinly.
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Check Out the New CMS OMH COVID-19 Vaccine Resources for Vulnerable Populations Webpage
The COVID-19 pandemic has disproportionately impacted minority and vulnerable populations. The COVID-19 vaccine can reduce the spread of the virus and help end the public health emergency. Community partners working with racial and ethnic minorities, people with disabilities, people with limited English proficiency, sexual and gender minorities, and rural populations are critical in helping consumers understand how and when they can receive the vaccine, vaccine safety and confidence, and the important ongoing precautions to slow the spread of COVID-19.
To assist our partners, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) has developed a COVID-19 Vaccine Resources website of the many Federal resources and organized them for health care professionals, partners, consumers, and for assistance in additional languages.
To view the page, visit: go.cms.gov/omhcovid19vaccine.
We encourage you to visit the website regularly, as we will continue to update the page with new resources. You can also share this page within your networks to prepare others to get the vaccine as soon as it’s available to them.
For additional COVID-19 information, visit our general COVID-19 website for Federal resources focusing on vulnerable populations: go.cms.gov/omhcovid19 and From Coverage to Care COVID-19: go.cms.gov/c2ccovid19 webpage.