Rural Health Information Hub Latest News

CMS Announces Progress in Promoting Health Equity in Rural Care Access Through Outpatient Hospital and Surgical Center Payment System Final Rule

Critical Access Hospitals and Small Rural Hospitals Can Convert to Rural Emergency Hospitals, Allowing Them to Remain Open to Serve Their Communities

The U.S. Department of Health and Human Services (HHS), through its Centers for Medicare & Medicaid Services (CMS), is improving access to health care — including behavioral health services — in rural communities. CMS is releasing the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period. This final rule will allow Critical Access Hospitals (CAHs) and small rural hospitals to convert to a Rural Emergency Hospital (REH), which may be a more sustainable option for rural hospitals facing closure and supports access to care in rural and underserved communities. An REH is a new Medicare provider type that furnishes outpatient services, emergency services, and observation care. In this rule, Medicare will also pay hospital outpatient departments to provide remote behavioral health services to people at home, which will improve access to care in rural communities and promote health equity.

“The Biden-Harris Administration continues to take steps to ensure all Americans, regardless of where they live, have access to high-quality, affordable health care, and this is especially important in rural America, where many hospitals have closed over the past two decades,” said HHS Secretary Xavier Becerra. “By helping rural hospitals stay open, we are helping residents of rural areas get the care they need close to home. Having access to care nearby is not only more convenient, but also leads to better health outcomes — and boosts local economies.”

“CMS is committed to expanding access to care in rural communities and ensuring people with Medicare get the high-quality care they need,” said CMS Administrator Chiquita Brooks-LaSure. “Through the establishment of Rural Emergency Hospitals, supporting clinic visits at rural sole community hospitals and enabling people with Medicare to remotely access behavioral health services in their homes, today’s actions promote patient safety, equity, and quality for these underserved communities. We received broad support for the role Rural Emergency Hospitals can play in advancing health equity and thank stakeholders for their thoughtful input during the public comment period.”

“Establishing Rural Emergency Hospitals can help ensure continued access to critical medical facilities in rural communities,” said Deputy Administrator and Director for the Center for Medicare, Dr. Meena Seshamani. “These facilities are often backbones of communities, but maintaining these businesses and keeping doors open can be challenging. Under today’s final rules regarding this new provider type, we hope to preserve and improve access to care in rural areas and take important steps toward advancing health equity nationwide.”

Updates to OPPS and ASC Payment Rates

CMS is updating the CY 2023 OPPS payment rates and ASC payment rates by 3.8%

Rural Emergency Hospitals

CMS is finalizing conditions of participation, payment rates, and Medicare enrollment requirements for Rural Emergency Hospitals, a new type of Medicare provider that Congress created in the Consolidated Appropriations Act, 2021. These policies for the newly created provider type takes effect on January 1, 2023. Rural hospitals are essential for providing health care in their communities, and the closure of these hospitals limits access to care in areas that are often already underserved. The availability of the REH designation will help support access to health care, particularly emergency services and outpatient services. The REH requirements in this final rule establish a full range of health and safety standards, requirements for services offered, staffing requirements, and physical environment and emergency preparedness standards. REHs will receive additional Medicare payments to help maintain access to a wide array of services in rural areas.

Improving Access to Behavioral Health Services in Rural Areas

CMS is establishing a policy that permits clinical staff of hospital outpatient departments to provide behavioral health services remotely to patients in their homes. CMS first implemented this policy through emergency rulemaking in response to the COVID-19 public health emergency. By making this policy permanent, CMS will ensure access to behavioral health services particularly for rural and other underserved communities, furthering health equity goals.

Enhanced Payment for Non-Opioid Pain Management Drugs and Biologicals

Consistent with the CMS opioid strategy, CMS is finalizing to separately pay for five qualifying non-opioid pain management drugs when administered in ambulatory surgical centers in CY 2023. This ensures that Medicare beneficiaries have access to non-opioid pain management drugs and encourages providers to use non-opioids rather than opioids for pain management.

Payment Adjustments for Additional Costs of Domestic NIOSH-Approved N95 Surgical Respirators

In a future pandemic or increase in community spread of COVID-19, hospitals need to be able to access a reliable supply of NIOSH-approved surgical N95 respirators to protect health care workers and their patients. Sustaining domestic production of these products is important for helping to maintain that reliability. CMS recognizes that hospitals may incur additional costs when purchasing domestically made NIOSH-approved surgical N95 respirators, so this final rule establishes additional hospital payments that would account for these costs.

For a fact sheet on the CY 2023 OPPS/ASC Payment System Final Rule (CMS-1772-FC), please visit:

For a fact sheet on Rural Emergency Hospitals, please visit:

For a CMS blog on the behavioral health polices in the CY 2023 Physician Fee Schedule and Outpatient Prospective Payment System final rules, please visit:

The CY 2023 OPPS/ASC Payment System Final Rule can be viewed here:

CMS Issues Final Rule on Medicare Enrollment and Eligibility Rules to Advance Health Equity

The Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare enrollment and eligibility rules to expand coverage for people with Medicare and advance health equity. The final rule, which implements changes made by the Consolidated Appropriations Act, 2021 (CAA), makes it easier for people to enroll in Medicare and eliminates delays in coverage. Among these changes, individuals will now have Medicare coverage the month immediately after their enrollment, thereby reducing any delays in coverage. In addition, the rule expands access through Medicare special enrollment periods (SEPs) and allows certain eligible beneficiaries to receive Medicare Part B coverage without a late enrollment penalty.  The FACT SHEET attached details the SEPS.

To view a fact sheet on the final rule, visit:

To view the final rule, visit:

Healthy Eating for Healthy Children: A Course for Dental Hygienists

The Oral Health Program at the Rhode Island Department of Health released a new online course to teach dental hygienists how to talk to parents and caregivers about food choices for children. This innovative approach focuses on using accessible and encouraging language as well as providing talking points and conversation starters to use with parents during dental visits. The course is free and takes approximately 80 minutes to complete.

Click here for more information and to take the workshop.

American Dental Association Launches Health Equity Initiative

The American Dental Association (ADA) launched a new Health Equity Action Team to help reduce disparities in oral health. Among the panelists is Dr. James Mancini, a Pennsylvania dentist and PA Coalition for Oral Health stakeholder. The ADA also published a Healthy Equity Resources webpage with resources for dentists to use to take action in their own communities.

Click here to read the ADA announcement.

Click here to view the Health Equity Resources page.

CDC Issues Health Advisory For Dental Health Care Personnel

The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network Health Advisory regarding nontuberculous Mycobacteria infections associated with contaminated dental unit waterlines and the need for dental health care personnel (DHCP) to follow established recommendations to ensure the safety of their patients. While rare, there have been multiple documented cases of disease transmission from dental unit waterlines. Dental unit waterlines promote bacterial growth and development of biofilm, thus all dental unit waterlines must be treated regularly with chemical germicides. The health advisory contains recommendations and a list of resources for DHCP to visit to learn more information.

Click here for the recommendations.

American Institute of Public Health Releases Dental Workforce Report

The American Institute of Public Health (AIDPH) released a research brief, “The Financial and Policy Impacts of the COVID-19 Pandemic on U.S. Dental Care Workers.”

The brief evaluates trends and differences of the dental health care workforce before and after the onset of the COVID-19 pandemic and assesses the impact of dental health care worker shortages by state and geographic region. Executive Director Helen Hawkey and Dr. Sean Boynes are among the authors. An interactive dashboard is being developed to map the changes among dental health care workers.

Click here to read the report.

New! Rural Health System Value-Based Care Innovators Roundtable: Strategies and Insights Released

The Rural Health Value team recently released a new Innovators Roundtable Report:

  • Rural Health System Value-Based Care Innovators Roundtable: Strategies and Insights
    This report describes interviews with five health systems supporting value-based care in their rural affiliates. Interview topics included organizational structure, governance and decision-making, operations, data and communication, contracts, and social determinants of health. The report includes common health system tensions and opportunities as they facilitate rural affiliate success in value-based care.

 Related resources on the Rural Health Value website:

Contact information:

Clint MacKinney, MD, MS, Co-Principal Investigator,