Rural Health Information Hub Latest News

HHS Selects the First Drugs for Medicare Drug Price Negotiation

For the first time, Medicare will be able to negotiate prices directly with drug companies, lowering prices on some of the costliest prescription drugs.

For the first time, thanks to President Biden’s Inflation Reduction Act – the historic law lowering health care costs – Medicare is able to negotiate the prices of prescription drugs. The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced the first 10 drugs covered under Medicare Part D selected for negotiation. The negotiations with participating drug companies will occur in 2023 and 2024, and any negotiated prices will become effective beginning in 2026. Medicare enrollees taking the 10 drugs covered under Part D selected for negotiation paid a total of $3.4 billion in out-of-pocket costs in 2022 for these drugs.

The Biden-Harris Administration has made lowering prescription drug costs and improving access to innovative therapies a key priority. Alongside other provisions in the new law that increase the affordability of health care and prescription drugs, allowing Medicare to negotiate prescription drug prices will strengthen the program’s ability to serve people with Medicare now and for generations to come. The negotiation process will consider the selected drug’s clinical benefit, the extent to which it fulfills an unmet medical need, and its impact on people who rely on Medicare, among other considerations, such as costs associated with research and development as well as production and distribution for selected drugs. As a result of negotiations, people with Medicare will have access to innovative, life-saving treatments at lower costs to Medicare.

The selected drug list for the first round of negotiation is:

  • Eliquis
  • Jardiance
  • Xarelto
  • Januvia
  • Farxiga
  • Entresto
  • Enbrel
  • Imbruvica
  • Stelara
  • Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill

These selected drugs accounted for $50.5 billion in total Part D gross covered prescription drug costs, or about 20%, of total Part D gross covered prescription drug costs between June 1, 2022 and May 31, 2023, which is the time period used to determine which drugs were eligible for negotiation. CMS will publish any agreed-upon negotiated prices for the selected drugs by September 1, 2024; those prices will come into effect starting January 1, 2026. In future years, CMS will select for negotiation up to 15 more drugs covered under Part D for 2027, up to 15 more drugs for 2028 (including drugs covered under Part B and Part D), and up to 20 more drugs for each year after that, as outlined in the Inflation Reduction Act.

View a fact sheet from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at: https://aspe.hhs.gov/reports/aspe-ira-drug-negotiation-fact-sheet.

View a CMS fact sheet on the drugs selected for the Medicare Drug Price Negotiation Program at: https://www.cms.gov/files/document/fact-sheet-medicare-selected-drug-negotiation-list-ipay-2026.pdf – PDF.

More information on the Medicare Drug Price Negotiation Program is available at https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation.

Research Spotlight: New Study Shows Students’ Experiences Varied during the COVID-19 Pandemic  

Researchers from the University of California released a paper this month examining the disparate impacts of the COVID-19 pandemic on school students. The pandemic exacerbated longstanding educational inequities in student academic performance and mental health outcomes based on race, ethnicity, and socioeconomic status.

Data from students across the United States during the 2020-21 school year shows:

  • Pre-existing achievement gaps in reading and math widened notability for students of color and those from high-poverty school districts.
  • Absenteeism and grade retention increased at higher rates for Black and Hispanic students, who were more likely to attend schools negatively impacted by the transition to remote learning.
  • School closures were more typical in underserved communities, and low-income families had limited access to traditional in-person instruction and high-quality remote learning experiences.
  • The pandemic led to widespread increases in fear, anxiety, depression, loneliness, and behavioral issues for students of all ages, regardless of race, ethnicity, or socioeconomic status.
  • School engagement rates were highest among students from households with higher incomes and parental education levels.

Black and Hispanic students were more likely than White students to feel very or extremely worried about the pandemic. They reported disproportionately high rates of COVID-related stress despite their caregivers being less likely than white caregivers to report concerns about their children’s mental health in the wake of school closures.

Universal Free Breakfast Helps School-Aged Children Succeed 

Each day, families struggle with food security and the ability to provide their children with healthy meals that fuel their minds and bodies. Lack of nutrient-rich food impacts child development, overall health outcomes, mental and behavioral health and academic achievement, performance, and participation. Free school breakfast has been one initiative provided to Pennsylvania school-aged children to combat child hunger and ensure students succeed.

For the first time, all Pennsylvania public school students heading back to school this month will be eligible to receive a free breakfast regardless of income. The 2023-24 budget includes a $46.5 million increase to provide universal free breakfast to Pennsylvania’s 1.7 million public school students.

Our fact sheet shows the benefits of free school breakfast, including:

  • Increasing access to nutritious meals and building healthy eating habits.
  • Improving academic performance, including concentration, memory, comprehension, and learning, while reducing hunger-related behavioral problems.
  • Reducing the stigma associated with students who access free or reduced meals compared to their peers.

The state budget also expands free lunch to 22,000 eligible students for reduced-price lunch. While universal free breakfast and expanded free lunch are a great first step for Pennsylvania students, PPC advocates for expanding free lunch to all students because no child should go hungry, and no parent should worry about feeding their child.

Pennsylvania Maternal Health State and County Fact Sheets Released

Maternal health ensures mothers and birthing parents are healthy and their children have the best start possible. Research shows healthy mothers are more likely to raise healthy babies. Unfortunately, the U.S. has the highest maternal mortality rate among developed countries, and racial disparities plague the health care system for Black and Brown women.

Our first-ever maternal health county fact sheets show each county’s overall perinatal vulnerability index (PVI). The PVI uses data across five domains: behavioral health, environmental context, health care availability, pregnancy and birth outcomes, and social stratification. The fact sheets also highlight data about prenatal care and the percentage of low birth weight births.

In 2020, there were over 130,000 total births across Pennsylvania. Yet, only 13 counties had moderate access to care, and six counties were considered maternity care deserts, based on the March of Dimes Maternity Care Deserts Report (2022).

Research shows low birth weight is a strong indicator of maternal health, and the rate increased nationally by 4% since 2014. When children are born with low birth weight, there is an increase in the risk for future health and developmental issues.

Racial disparities limit access to maternal health care and can impact the health of both mother and child:

  • The rate of non-Hispanic Black women giving birth to children with low birth weight is 14.5% compared to 6.8% of White women and almost double the state rate of 8.3% across all races.
  • When comparing counties, the rate of low birth weight among Black women ranged from 22.9% in Lebanon County to 7.5% in Bucks County.

Thriving PA aims for women and birth parents to have access to the health resources needed for a healthy pregnancy and delivery. Maternal health is necessary for raising healthy children, and more attention is needed to make maternal health care more accessible, especially for Black and Brown women who have a higher risk of poor birth outcomes and maternal mortality and morbidity.

CMS Awards Navigator Grants and Releases Annual Enrollment Assistance Bulletin

Since 2013, Navigators have helped Americans understand their health insurance options and facilitated their enrollment in health insurance coverage through the Federally-facilitated Marketplace (FFM). As trusted community partners, their mission focuses on assisting the uninsured and other underserved communities.

On August 25, 2023, CMS awarded $98.6 million in Navigator cooperative agreement awards to 57 returning organizations who will continue serving as Navigator awardees in states with a FFM. These awards support the work of organizations that offer assistance to consumers navigating, shopping for, and enrolling in health insurance coverage for plan year 2024. At this link are the 57 organizations receiving 2023-2024 CMS Navigator cooperative agreement awards for the FFM(s) they have received cooperative agreements to serve: https://www.cms.gov/files/document/2023-2024-navigator-awardee-summaries.pdf. All 29 FFM states for PY 2024 have at least one Navigator awardee organization.

Additionally this week, CMS published the annual guidance on training for navigators, CMS Enrollment Assistance Bulletin, 2023-01: Guidance Regarding Training, Certification, and Recertification for Navigators and Certified Application Counselors in Federally-facilitated Exchanges.  This bulletin provides annual guidance on the training, certification, and recertification requirements and procedures for Navigators, certified application counselors (CACs), and CAC designated organizations (CDOs) in the Federally-facilitated Marketplaces (FFMs). You can access the bulletin at:  https://www.cms.gov/files/document/2023-cms-assister-bulletin-final-508.pdf.

CDC Announces Director of Office of Rural Health

The Centers for Disease Control and Prevention (CDC) is pleased to announce that Diane M. Hall, PhD, MSEd, has been selected to serve as the permanent director of the CDC Office of Rural Health. She has served as the Office’s acting director since March of this year. As director, Dr. Hall will continue to lead and coordinate CDC’s rural health work and strategy to strengthen the delivery of rural public health services across the U.S.

Prior to coming to the Office of Rural Health, located in CDC’s Public Health Infrastructure Center, Dr. Hall served in CDC’s Office of the Associate Director for Policy and Strategy, Office of the Director, as CDC’s rural health lead, led the office’s Strategic Engagement and Capacity Building work, and oversaw training activities focused on using policy to improve the population’s health. As a recognized expert in knowledge synthesis and translation, she led the development of the office’s policy portal, the Policy Analysis and Research Information System (POLARIS).

Throughout the COVID-19 pandemic, Dr. Hall held several leaderships positions within CDC’s response. She also held various positions in CDC’s Division of Violence Prevention where she worked on research related to the prevention of teen dating violence, intimate partner violence, sexual violence, and youth violence. Prior to coming to CDC, she held an academic appointment at the University of Pennsylvania, serving as the lead coordinator for a master’s program in psychology.

Dr. Hall earned her B.A. in Psychology from Hollins College (now Hollins University), and obtained her MSEd in psychological services and PhD in school, community, and child clinical psychology from the University of Pennsylvania.

Dr. Hall and the CDC Office of Rural Health look forward to strengthening our relationships with all who have an interest in improving the health and well-being of rural America!

Pennsylvania Announces Partial Implementation of Interstate Nurse Licensure Compact

The Pennsylvania Department of State is pleased to announce that Pennsylvania will take a big step by partially implementing the interstate Nurse Licensure Compact, an agreement among 41 states and U.S. territories and administered by National Council for State Boards of Nursing, that recognizes the practicing privileges for nurses licensed under the compact.

Starting Sept. 5, 2023, registered nurses (RNs) and licensed practical nurses (LPNs) who hold multistate licenses through the compact will be permitted to practice in the commonwealth without obtaining a Pennsylvania license. This step should help ease Pennsylvania’s severe nursing shortage, alleviate burdens on overworked nursing staffs, make conditions safer for both patients and healthcare workers, and increase patients’ access to in-person and telehealth care.

November 2022 industry survey by The Hospital and Healthsystem Association of Pennsylvania showed vacancy rates of 30% for RNs providing direct care, and it cited a U.S. Health Resources and Services Administration report projecting that, by 2030, demand for LPNs in Pennsylvania will exceed the number of available workers by 27.8%.

The Department of State continues to work diligently with its state and federal partners to satisfy the preconditions necessary to allow the State Board of Nursing to issue multistate licenses to Pennsylvania nurses who want to be able to practice in compact member states.

Among the preconditions we must meet is being able to certify to other compact states that Pennsylvania’s State Board of Nursing has performed an FBI criminal background check on Pennsylvania applicants, a process that requires FBI authorization. The Department of State is actively seeking this authorization and is awaiting a response.

Meanwhile, we are ensuring that Pennsylvania meets other technical and regulatory requirements so that the commonwealth can fully implement the compact as quickly as possible once we receive FBI and statutory approval to access the FBI’s criminal background database.

We will keep you informed of our progress in achieving this crucial second step toward full implementation of the compact.

For answers to frequently asked questions about how the compact affects in-state and out-of-state nurses, as well as Pennsylvania patients, visit the State Board of Nursing’s webpage.

To learn more about the compact, visit nursecompact.com or email nursecompact@ncsbn.org.

Crest and Oral-B Launch Communications Campaign

Crest and Oral-B have launched their latest #ClosingAmericasSmileGap campaign focusing on oral care supplies for back-to-school for students. For every Crest or Oral-B product purchased from August 1st to September 30th, Crest and Oral-B will donate oral care supplies to a child in need.

To underscore the critical need for oral healthcare among these communities, Crest and Oral-B have released a “U.S. Kids’ Oral Health Report Card” that sheds light on the shocking discrepancies in access, affordability, and education between low and high-income families in the U.S.

Click here for more information.
Click here to view the report card.

Funding Opportunity! Pennsylvania Oral Health Plan Mini-Grants

PCOH is requesting proposals for the 2023-2024 Oral Health Plan Mini-Grant Program. The purpose of this program is to facilitate the implementation of the goals and recommendations of the 2020-2030 PA Oral Health Plan, as well as to advance the oral health of all Pennsylvanians. Requests may not exceed $4,000.

Applications are due by September 29th at 5 pm.

Click here to view the guidelines.
Click here to apply.

Funding for this project is through the Pennsylvania Department of Health through Centers for Disease and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) under the Preventive Health and Health Services Block Grant. 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 CDC, HHS or the U.S. Government.

CMS Requests Applications for New Primary Care Model

This week, the Innovation Center at the Center for Medicare & Medicaid Services released a Request for Applications detailing policies and requirements for the Making Care Primary Model. Interested applicants may apply later this month when the Application Portal opens. The model will launch on July 1, 2024, in eight states: Colorado, North Carolina, New Jersey, New Mexico, New York, Minnesota, Massachusetts, and Washington, and will operate over a ten-year period.  This model aims to strengthen coordination between patients’ primary care clinicians, specialists, social service providers, and behavioral health clinicians, to drive improved chronic disease prevention, fewer emergency room visits, and better health outcomes.  While Rural Health Clinics are not eligible, other rural primary care providers (including Federally Qualified Health Centers) may seek to participate.