- CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- Public Inspection: CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Announcing the 2030 Census Disclosure Avoidance Research Program
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
USDA Rural Development’s Community Facilities Program Accepting Applications for FY 2024 Funding
Please read the information below to see how USDA Rural Development can help your community!
The Community Facilities Program provides affordable funding to develop essential community facilities in rural areas under 20,000 population. The loan rate is currently 3.875% and would be fixed for the life of the loan. Terms can be up to 40 years for acquisition or renovation of real estate and the useful life of equipment purchased. This loan program has no fees or prepayment penalties and does not require prevailing wages.
CF video (lumen5.com) Check out this video of for more information on the Community Facilities program and great projects USDA Rural Development has funded in PA.
See below for more examples of recent projects funded through our program in Pennsylvania.
USDA Rural Development Community Facilities Loan & Grant Program and Pennsylvania Nonprofits
What can Rural Development do for your organization and community?
- Purchase, construct, and/or improve essential community facilities, and pay related eligible project expenses
- Computer and technology upgrades
- Construction, acquisition, or rehabilitation of facilities an ADA compliance
- Parking and paving improvements
- HVAC equipment, electrical upgrades, emergency generators
- Interior improvements
- Training equipment
Examples of Projects in Pennsylvania include:
- LifeQuest Assisted Living in Bucks County received a Community Facilities Direct Loan of $39.9 Million to construct 123 new assisted living units and renovation of the existing nursing center to implement a 10-15 bed memory care unit.
- Bear Creek Foundation in Luzerne County received a Community Facility Direct Loan of $11.4 Million to construct a 36,000 square-foot addition to its existing charter school.
- Meadville Public Library in Crawford County received a Community Facility Direct Loan and Grant of $132,460 for a roof replacement.
- Big Valley Ambulance Club, Inc in Mifflin County received a Community Facilities Direct Loan and Grant of $128,200 for the purchase of a 2023 Life Line Victory liner ambulance.
- Penn Township in Clearfield County received a Community Facilities Direct Loan and Grant of $85,000 for the purchase of a Freightliner chassis with dump box and appurtenances.
- Sutersville Volunteer Fire Company in Westmorland County received a Community Facility Direct Loan and an Economic Impact Initiative Grant of $187,700 to purchase a new pumper truck, hose and spreader package for the fire department.
Please note that all applications are considered as loan only first. Grant funding is awarded based on financial need, availability of funds, and are a maximum of $50,000.
For more information on our program and how to apply, contact:
Crawford, Erie, Forest, Venango & Warren Counties
Courtney Bailey – Courtney.Bailey@usda.gov #814-547-5938
Allegheny, Armstrong, Beaver, Butler, Greene, Lawrence, Mercer & Washington Counties
Keith Lehman – Keith.Lehman@usda.gov #724-482-5289
Clarion, Fayette, Indiana, Jefferson & Westmoreland Counties
Eli Bratich – Eli.Bratich@usda.gov #724-482-5283
Blair, Cambria & Somerset Counties
Ron Moore – Ronald.Moore3@usda.gov #724-261-3891
Cameron, Columbia, Centre, Clearfield, Clinton, Elk, Lycoming, McKean, Montour, Northumberland, Potter, Snyder, Sullivan, Tioga and Union Counties
Judy Bartlett – Judy.Bartlett@usda.gov #570-749-3051
Bradford, Lackawanna, Luzerne, Susquehanna, Wayne & Wyoming Counties
Charles Garnett – Charles.Garnett@usda.gov #570-836-5111, x121
Berks, Bucks, Carbon, Chester, Lancaster, Lehigh, Monroe, Montgomery, Northampton, Pike, Schuylkill & Philadelphia Counties
Tonya St. Clair – Tonya.Stclair@usda.gov #484-795-7614
Adams, Bedford, Fulton, Franklin, Huntingdon, Juniata & Mifflin Counties
Ana Liza Setters – Analiza.Setters@usda.gov #717-601-3247
Cumberland, Dauphin, Delaware, Lebanon, Perry & York Counties
Melissa Kuhns – Melissa.Kuhns@usda.gov #717-601-3245
Revised Rural Health Value Catalog of Value-Based Initiatives Released
The Rural Health Value team is pleased to share updates to the Catalog of Value-Based Initiatives for Rural Providers. Two new models are now included: AHEAD and GUIDE
Catalog of Value-Based Initiatives for Rural Providers
This catalog summarizes rural-relevant, value-based programs primarily by the Centers for Medicare & Medicaid Services (CMS) and its Center for Medicare & Medicaid Innovation (CMMI), to help rural leaders and communities identify HHS value-based programs appropriate for rural participation.
The following models are now included in the catalog:
States Advancing All-Payer Health Equity Approaches and Development Model (AHEAD) – a state total cost of care model that seeks to drive state and regional health care transformation and multi-payer alignment, with the goal of improving the total health of a state population and lowering costs. CMS will release a Notice of Funding Opportunity in late Fall 2023, with applications due in Spring 2024.
Guiding an Improved Dementia Experience (GUIDE) – participants in the GUIDE Model will establish dementia care programs (DCPs) that aim to improve quality of life for people with dementia, help them remain in their homes and communities, and reduce strain on their unpaid care givers. A Request For Applications was released in Fall 2023, with model launch July 2024.
Related resources on the Rural Health Value website:
- Rural Community Engagement Resource Guide – Provides rural health care leaders a variety of toolkits, strategies, and information to help initiate, improve, and inspire community engagement strategies that support value. The accompanying infographic highlights strategies for community engagement and benefits aligned with value-based care (2023)
- Demonstrating Your Value: A Guide to Potential Value-Based Care Partnerships for Rural Health Care Organizations – This Rural Health value resource assists CAH leadership in demonstrating the value CAHs bring to networks, affiliations, payers, community-based organizations, or accountable care organizations (updated 2023)
New Report Provides Medicare Advantage Enrollment Update for 2023
New from the RUPRI Center for Rural Health Policy Analysis
Medicare Advantage Enrollment Update 2023
Edmer Lazaro, DPT, MSHCA; Fred Ullrich, BA; and Keith Mueller, PhD
The Rural Policy Research Institute (RUPRI) continues to monitor MA enrollment trends and how it is influenced by changes in health policies. More MA plans are being offered in 2023 than in any other year, indicating the appeal of this program for insurers throughout the country. The MA program delivers the program’s benefits to 53.9 percent of metropolitan beneficiaries, and the current rate of growth shows similar trends among nonmetropolitan enrollees. Such plans are attractive because they typically offer extra benefits, often with no additional premium. As the market continues to grow and enrollment rates in MA increase, researchers should continue to examine how well the MA program serves its beneficiaries, especially those living in nonmetropolitan areas. Changes in the MA program highlight the importance of developing policies that aim at improving care access for nonmetropolitan enrollees.
Click here to read the full report.
USDA Report Analyzes Three of Its Rural Broadband Programs and Their Reach
A new report from the U.S. Department of Agriculture examines three broadband programs and if they were able to reach the target audiences.
The report looked at three programs: The Broadband Initiatives Program (BIP) was the largest of them in terms of funds obligated during the study period, with about $3.6 billion in grants and loans in Fiscal Year 2010. ReConnect obligated $1.5 billion in grants and loans from Fiscal Year 2019 to Fiscal Year 2021, and Community Connect obligated $253 million in grants from Fiscal Year 2009 to Fiscal Year 2021.
“The populations served by all three programs tended to be more rural, less educated, poorer, and older than those in areas not served (for BIP) or ineligible (for Community Connect and ReConnect),” the report stated. “All programs reached a larger share of the American Indian/ Alaska Native (AIAN) and White populations than other races and a larger share of the non-Hispanic than Hispanic population.”
However, only 10% of AIANs who lived in areas eligible for ReConnect in 2020 were in approved project services areas, the lowest percentage for any racial group. This resulted from a low percentage of the eligible AIAN population in areas proposed to be served in ReConnect applications and not from a greater share of AIANs in areas that would have been served by rejected or withdrawn applications.
“Outreach and technical assistance efforts may help address some of the observed differences across racial and ethnic groups in their tendency to be included in applications to broadband programs and in their likelihood of having applications approved,” the report stated.
Brian Whitacre, a professor and Jean & Patsy Neustadt Chair in the department of Agricultural Economics at Oklahoma State University, said he was pleased to see a report that looks at outcomes.
“In the past, we’ve had all these federal broadband programs, and we’ve never really done an analysis of where that money is going,” he told the Daily Yonder.
This report, he said, looks at whether the money is going to the people it’s intended to.
Read the full article on The Daily Yonder website.
Pennsylvania Gov. Josh Shapiro Proclaims November 13-17, 2023 Rural Health Week in Pennsylvania
In an effort to draw attention to the wide range of issues that impact rural health, Gov. Josh Shapiro has declared November 13-17, 2023, as Rural Health in Pennsylvania week at the request of the Pennsylvania Rural Health Association (PRHA).
Gov. Shapiro made the proclamation to promote awareness of the full range of issues that impact rural health care throughout the Commonwealth and the health status of rural Pennsylvanians. Nationally, Pennsylvania ranks as one of the states with the highest number of rural residents, with 26 percent of Pennsylvanians residing in rural areas. In recognition of Pennsylvania’s diverse rural needs, the Commonwealth has supported the development of the Center for Rural Pennsylvania, the Pennsylvania Office of Rural Health, and other agencies and initiatives to address the needs of rural Pennsylvanians.
The week encompasses November 16, which is National Rural Health Day, established in 2011 by the National Organization of State Offices of Rural Health (NOSORH) to showcase rural America; increase awareness of rural health issues; and promote the efforts of NOSORH, State Offices of Rural Health (SORHs) and others in addressing those issues.
“Nearly 59.5 million Americans, including 3.4 million Pennsylvanians, live in rural communities,” said Lisa Davis, PORH director and outreach associate professor of health policy and administration at Penn State. “These small towns and communities continue to be fueled by the creative energy of citizens who step forward to provide a wealth of products, resources, and services.
Rural communities also face unique health care concerns: a lack of providers; accessibility issues, particularly in terms of transportation and technology; and affordability issues as the result of larger percentages of uninsured and underinsured citizens and greater out-of-pocket health costs. Rural hospitals and health care providers, which frequently are the economic backbone of the communities they serve, deserve special consideration so that they can continue to provide high-quality services and meet the needs of rural residents.”
To celebrate the work being done to achieve health care access and equity in Pennsylvania, the Pennsylvania Office of Rural Health will present Pennsylvania Rural Health Awards during virtual ceremonies across rural Pennsylvania.
PRHA is dedicated to enhancing the health and well-being of Pennsylvania’s rural citizens and communities. Through the combined efforts of individuals, organizations, professionals, and community leaders, the Association is a collective voice for rural health issues and a conduit for information and resources. More information can be found at paruralhealth.org.
Editors: For additional information, please contact Lisa Davis, Director, Pennsylvania Office of Rural Health, at 814-863-8214 or lad30@psu.edu.
Can Rural Voters Be Swayed at the Ballot Box?
While partisanship remains strong among rural voters, certain messages resonated with voters across the political spectrum. They included battling inflation, bringing good-paying jobs to local communities, and battling corporate greed.
Could Democratic candidates, whose support among rural voters has waned considerably over the past two decades, regain some support utilizing these messages?
Big Takeaways
- The survey suggests as many as 37% of rural voters are swing blue-collar voters who could be swayed by the certain policy proposals and messaging.
- While partisanship remains strong among the rural electorate, voters were aligned on many of their chief concerns: affordable housing, the high cost of food, and corporate greed.
- Three messaging points — lowering prices; bringing good-paying jobs to local communities; and a populist message focused on corporate greed — received such broad support that they rivaled voters’ agreement on core values like family and freedom.
- President Joe Biden is viewed 18 points more unfavorably than Donald Trump, suggesting the Democratic Party has a lot of work ahead if they plan to move rural swing voters.
The Numbers
- 51 percent of Democrats thought the economy was working well for them, compared to 17 percent of Republicans.
- Respondents were asked to pick two issues from a list of 14 that were the most important for themselves and their families. The respondents could also choose “other,” “none,” or “not sure.
- 54% chose the rising cost of living as one of their most important issues, followed by retirement and Social Security (25 percent), health care (19 percent), dysfunction in government (15 percent), and jobs and the economy (15 percent).
- Respondents were asked to pick two concerns from a list of 11 that were the most important for themselves and their families. The respondents could also choose “other,” “none,” or “not sure.
- 43% chose the rising cost of food as one of their most important issues, followed by rising gas prices (24 percent), rising energy costs (21 percent), rising housing costs (19 percent), and a lack of good-paying jobs (18 percent).
Click here to read the full report.
CMS Has Finalized its Remedy for 340B Payments, and Hospitals Are Not Happy
From Fierce Healthcare
The Centers for Medicare & Medicaid Services (CMS) has dropped the final rule to remedy the invalidated 340B-acquired drug payment policy for calendar years 2018 to 2022.
Earlier in July, the federal government agreed to pay eligible hospitals in the 340B program $9 billion to offset payment cuts that the Supreme Court had previously ruled unlawful. The prescription drug payment cuts were made by the Department of Health and Human Services (HHS) in 2018 and subsequently opposed in the courts by the American Hospital Association (AHA) and other hospital groups.
In 2022, the Supreme Court rejected the massive payment cuts, ruling them to be unlawful because HHS did not follow the proper procedure.
As part of its final rule, CMS is maintaining budget neutrality. The agency estimates that hospitals were paid $7.8 billion more for non-drug items and services during that time period than they otherwise would have been without the 340B payment policy. To carry out the nearly $8 billion budget neutrality adjustment, CMS will reduce future non-drug item and service payments by adjusting the conversion factor for payments for outpatient services.
The offset was originally proposed for 2025 but faced industry pushback during the comment period. The adjustment will continue until the full $7.8 billion is offset, which CMS estimates will take 16 years.
In a statement, AHA president and CEO Rick Pollack commended the coming repayment to 340B hospitals but condemned HHS’ choice to cut Medicare rates. “HHS made a grievous mistake in choosing to claw back billions of dollars from America’s hospitals, especially those that serve rural, low-income, and other vulnerable communities. HHS decided to ignore hundreds of comments from hospitals and other providers explaining why this Medicare cut is both illegal and unwise,” he said.
Healthcare group purchasing organization Premier Inc. echoed Pollack’s disappointment. “Premier will continue to press CMS to hold hospitals harmless from policy deemed unlawful to preserve patient access to high-quality pharmaceuticals,” Soumi Saha, senior vice president of government affairs at Premier, said in a statement.
In a statement, Chip Kahn, president and CEO of the Federation of American Hospitals, condemned the rule, saying “CMS’s decision to brush aside the Medicare statute and recoup $7.8 billion from hospitals treating Medicare beneficiaries is extremely disappointing. This sets a dangerous precedent by breaking a promise to seniors and their providers that care will be covered.”
The annually determined payment rate is final, Kahn added, and hospitals rely on it to serve their populations. It does not allow Medicare to claw back funds. “This statutory predictability and stability of payment is mission critical to sustain patient access to care,” he said. The recoupment through outpatient rate cuts will also likely reduce Medicare Advantage plan payments to hospitals, per Kahn.
FCC Launches Inquiry into Role of Broadband Connectivity for Improving Maternal Health
Notice of Inquiry to Explore How FCC’s Broadband Health Mapping Tool Can Be Expanded and Enhanced to Address Maternal Health Crisis in U.S.
The Federal Communications Commission voted to launch a proceeding designed to explore ways the Commission’s Mapping Broadband Health in America platform could be expanded and enhanced to help better leverage digital health tools to improve maternal care.
The United States is the only developed country with increasing maternal mortality and severe maternal morbidity rates, and research from the Centers for Disease Control and Prevention suggests that more than 80 percent of these deaths and complications are preventable. Additional research further demonstrates that access to broadband and the connection to healthcare that Internet service enables can help address the crisis. Meanwhile, access to maternal health care remains a major challenge, especially for women of color, women living in rural areas, and women from lower income households. In June 2023, the Commission updated the Mapping Broadband Health in America platform to reflect certain maternal health data required under the Data Mapping to Save Moms’ Lives Act.
Through this inquiry, the Commission seeks comment on issues that will help guide the next phase of this mapping platform and inform associated data analytics work concerning the relationship between broadband and maternal health. This would include future plans to incorporate additional maternal health variables, other relevant data, and functionalities; to assess how best to address data limitations while still protecting privacy and confidentiality; and to ensure that future updates result in improved user experience and actionable insights.
In addition, this proceeding will also seek information and comment on current uses of broadband-enabled health technologies, solutions, and services that are available and being used in maternal health care, as well as the range of barriers that prevent access and utilization by childbearing women or women receiving postpartum care. Lastly, it will seek comment on potential actions or activities the Commission could pursue to help improve maternal health outcomes; to reduce maternal mortality and severe maternal morbidity rates; and to promote maternal health equity.
Action by the Commission October 19, 2023 by Notice of Inquiry (FCC 23-85). Chairwoman Rosenworcel, Commissioners Carr, Starks, Simington, and Gomez approving. Chairwoman Rosenworcel, Commissioners Carr, Starks, and Gomez issuing separate statements.
GN Docket No. 23-309
USDA Rural Development Invests $21.8 Million to Help Rural Business Owners and Ag Producers Lower Energy Costs, Generate Income and Expand Operations in Pennsylvania
U.S. Department of Agriculture (USDA) Dr. Karama Neal, Administrator, Rural Business Cooperative Service, announced that USDA is awarding an additional $3.6 million in grants to help 30 agricultural producers and rural small business owners make energy efficiency improvements and renewable energy investments to lower energy costs, generate new income, and strengthen the resiliency of their operations in rural Pennsylvania.
“Through the Inflation Reduction Act, President Biden and USDA are expanding access to clean energy, creating jobs and spurring economic growth for producers and small business owners in Pennsylvania, while saving people money on their energy costs,” said Dr. Karama Neal, Administrator, Rural Business Cooperative Service, USDA. “This is just another way USDA is committed to building our economy from the middle out and bottom up.”
In Fiscal Year 2023 more than $21.8 million in Rural Energy for America Program (REAP) funds were distributed to 168 energy efficiency improvement projects in rural Pennsylvania. The most recent announcement was made in September 2023.
The announcement today was made at Performance Motors a retail automotive business in Berks County that has been in operation since 1970. The dealership will use a $226,000 grant to purchase and install a 236 kilowatt (kW) solar photovoltaic system. The project annually is expected to save the business approximately $28,600 and replace 128,159 kilowatt hours (kWh), enough energy to power 26 homes.
You can read the full news release on our website.
FCC Seeks Feedback on Mapping Broadband for Maternal Health
The Federal Communications Commission (FCC) is seeking public comment on its interactive map that allows users to visualize broadband and health data at the national, state, and county levels. A special focus on maternal health was added earlier this year with the Data Mapping to Save Moms’ Lives Act, directing the FCC to incorporate publicly available data on maternal mortality. The Commission hopes to get feedback from the public on ways to further expand, refine, and enhance the platform. Read more details in FCC’s Notice of Inquiry and find comment procedures on page 18. The FCC provides a recording of its hour-long webinar to explain the map platform that took place on September 27. University of Minnesota research from 2019 found that, when controlling for sociodemographic factors and clinical conditions, “rural residents had a 9 percent greater probability of severe maternal morbidity and mortality, compared with urban residents.”
Comments are due on November 20.