Rural Health Information Hub Latest News

Automatic Reduction of Premiums for ACA Plans Slated for September

The American Rescue Plan Act (ARPA) temporarily increases the generosity of subsidies available on Marketplace plans for consumers earning up to 400% FPL. It also provides maximum subsidies and cost-sharing reductions to people who have been approved for unemployment for any week during 2021. At present, states using whose customers were enrolled in an ACA plan prior to April must return to request the new, higher subsidies. However, starting in September, CMS will automatically begin providing the higher premium tax credits (PTCs) amounts to consumers who have yet to update their information on However, CMS will not automatically adjust plans to reflect the larger cost-sharing reductions, so consumers are still encouraged to return to the Marketplace and access the benefits. Pennsylvania’s state-based marketplace, Pennie, has already completed automatic reduction for customers as of July 6, 2021. Pennie customers should have received information from Pennie and their current health insurance plan with the new premium tax credit calculations and lower premiums.

Cognitive Assessment: CMS Resources for Providers

Do you have a patient with a cognitive impairment? Medicare covers a separate visit for a cognitive assessment so you can more thoroughly evaluate cognitive function and help with care planning.

The Cognitive Assessment & Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam, resulting in a written care plan.

Effective January 1, 2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of primary care services in the Medicare Shared Savings Program, and permanently covers these services via telehealth.

More Information:

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Senate HELP Subcommittee Hearing on Addressing Declining Life Expectancies 

On July 21, 2021, the Senate Health, Education, Labor, and Pensions (HELP) Primary Health and Retirement Security Subcommittee held a hearing on year-end data from CDC showing life expectancy dropped 1.5 years from 2019 to 2020. The focus of the hearing was on both COVID-19 and drug overdoses. Senator Susan Collins (R-ME) pointed to the concerning number of drug overdose deaths in Maine, 504 last year alone, which were more than the deaths there from COVID-19.

USDA Seeks Applications for Rural Energy for America Program

USDA Deputy Under Secretary for Rural Development Justin Maxson announced that the department is accepting applications for loan guarantees and grants for renewable energy systems; and to make energy efficiency improvements, conduct energy audits and provide development assistance.

Funds are being made available under the Rural Energy for America Program (REAP). USDA is seeking applications for Fiscal Year 2022 funding. The deadlines to apply for grants are Oct. 31, 2021, and March 31, 2022. Applications for technical assistance grants are due Jan. 31, 2022. Applications for loan guarantees are accepted year-round.

Agricultural producers and rural small businesses are eligible applicants for loan guarantees and grants for renewable energy systems and to make energy efficiency improvements. State and local governments, federally-recognized tribes, land-grant colleges or universities or other institutions of higher education, rural electric cooperatives, public power entities, and Resource Conservation & Development Councils (as defined in 16 USC §3451) are eligible applicants for grants to conduct energy audits and provide development assistance.

Interested applicants are encouraged to contact their local USDA Rural Development State Energy Coordinator well in advance of the application deadlines to discuss their project and ask any questions about the REAP program or the application process.

Additional information on the required materials and how to apply for the REAP program are available on page 40000 of the July 26, 2021, Federal Register.

If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page.

USDA Adds Online Listening Sessions to Its Review of Racial Justice and Equity

From Xander Brown, The Daily Yonder

The U.S. Department of Agriculture (USDA) has expanded opportunities for stakeholders to comment on how the agency serves marginalized and vulnerable communities.

The department added two online listening sessions so the public can literally speak for themselves. And USDA moved the deadline for commenting from July 15 to August 14.

The goal of the effort is to gather “input on how to best engage external stakeholders and community members representing marginalized, vulnerable, or underserved communities in order to increase participation in USDA programs, services, committees and decision-making processes,” according to a notice.

The department will offer three listening sessions on Wednesday, July 28 (10 a.m.-1 p.m., 1-4 p.m., and 4-7 p.m. EST). A second day of listening will occur Thursday, July 29 (7-9 p.m. EST).

Registration guarantees that participants have a reserved spot in a queue to offer their thoughts. Each speaker will have five minutes to touch on their interactions with the USDA as well as ways the USDA can remove barriers and engage more with underserved communities. Participants are also encouraged to touch on topics like access, enrollment, and general customer service experiences.

Read more.

Resource Provides Virtual to Rural and Remote Health Care Providers

The Rural Telementoring Training Center (RTTC) supports the delivery of effective, high-quality telementoring programs that expand access to care, build cultural proficiency, and improve the quality of health care in rural America. Telementoring, or technology-enabled mentoring, is the use of telecommunication technology to deliver training, education, and support that builds healthcare capacity.

The RTTC helps rural and remote health care providers deliver compassionate, evidence-based care. The RTTC offers free training and technical assistance to organizations for designing, delivering, and evaluating telementoring programs in any of six modalities: Project ECHO, online modules and curricula, webinars, community health clubs, individual consultation, and podcasts.

Rural and remote health care providers connect with educational resources and a network of learning, mentors, and partners helps to grow skills and deliver a new level of care; receive ongoing, interactive learning; network with other professionals; collaborate across disciplines and professions; reduce isolation; and improve patient access to health services.

The RTTC helps to build the rural health care infrastructure thereby ensuring access to high quality care and is part of the movement that is transforming rural health through telementoring

For more information, visit

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U5ARH39480 and title Rural Telementoring Training Center. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

New Report: Oral Health in Patients Experiencing Homelessness

The National Network for Oral Health Access (NNOHA) and the National Health Care for the Homeless Council (NHCHC) developed a publication to bring awareness to the intersection of oral health and behavioral health concerns or cognitive impairment in people experiencing homelessness (PEH). The publication shares the impacts of behavioral health illness on oral health and how behavioral health and dental providers can work together to address this intersection in their practices.

New Payment Opportunity for FQHCs/RHCs under the DATA 2000 Waiver Training Payment Program

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, Section 6083, made $6 million available to Federally Qualified Health Centers (FQHCs) and $2 million available to Rural Health Clinics (RHCs) under the DATA 2000 Waiver Training Payment Program. The program is a collaboration with SAMHSA. HRSA is accepting applications for payment under this new program from FQHCs and RHCs employing buprenorphine waivered providers.

Watch a video on how to apply, and access FAQs.

CMS Proposed Rule Could Increase Health Insurance Coverage

The Centers for Medicare and Medicaid Services (CMS) proposed a series of provisions to expand health coverage access as a third installment of the 2022 Payment Notice. The proposed changes include extending the Health Insurance Marketplace Open Enrollment an additional 30 days to Jan. 15, 2022, and for future years after 2022. In previous years, Dec. 15 was the deadline for enrollment. At the last Pennie Board of Directors meeting, it was voted unanimously to end open enrollment for 2022 in line with, not to exceed Jan. 31. Additional proposed rules included expanding the current duties of Navigators, creating new special enrollment periods for consumers earning less than 150% of the Federal Poverty Level (about $3,313 for a family of 4), and increasing user fees used to fund the federal and state based marketplaces by 0.5% of consumer premiums.

See the press release for more.

Pennsylvania Governor Signs Bill Revising State Medical Marijuana Law

Pennsylvania Governor Tom Wolf approved new updates (HB 1024, now Act 24 of 2021) to the five-year-old law that first legalized it. Some changes will continue efforts that began during the pandemic, such as permanently allowing curbside pickup and a three-month supply. Other changes are new, such as allowing caregivers to pick up the drug on behalf of more than one patient. “It’s been five years since Pennsylvania legalized medical marijuana, and in that time the Department of Health has examined the program’s successes and challenges and made important recommendations on improving the law,” Wolf said in a statement.

The new law adds cancer remission therapy and neuropathies of the central nervous system to the list of medical conditions eligible for medical marijuana, and it expands the number of research facilities that study patient response to the drug. While the state law extends access to medical marijuana, a June 2 informational bulletin to the state from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) discusses a new condition on grant awards from SAMHSA that requires organizations receiving SAMHSA funding, in order to continue serving individuals using medical marijuana for a mental or substance use disorder, to “document the client’s understanding of the risks of marijuana use and willingness to work toward other, evidence-based alternatives to treat their mental and substance use disorder.”