Rural Health Information Hub Latest News

Congresswoman Announces New Bill to Addresses Rural Physician Shortages

Congresswoman Yadira Caraveo, M.D. (D-CO) announced a bill to expand healthcare accessibility in rural communities. The Rural Residency Planning and Development Act of 2024 (H.R. 7855), introduced by Rep. Caraveo (D-CO), and Rep. Carol Miller (R-WV), would authorize the Rural Residency Planning and Development program to continue building a strong pipeline of rural physicians for years to come. Nearly 20% of Americans live in rural areas, but only 10% of physicians practice in these communities. Among current medical residency programs, only two percent of training occurs in rural areas. To tackle this shortage, the Rural Residency Planning and Development program, housed under the Health Services and Resources Administration (HRSA), awards funding to support start-up costs to establish new rural residency programs. As of November 2023, award recipients have created 39 new accredited rural residency programs or rural track programs and enrolled 306 resident physicians training in rural clinical settings. Please find NRHA’s rural workforce legislative agenda here.

House Energy and Commerce Committee Expected to Hold Hearing on Telehealth Permanency

The House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA) and Subcommittee on Health Chair Brett Guthrie (R-KY) announced a subcommittee hearing to discuss telehealth permanency that will occur on April 10, 2024 at 10:00 AM ET. The hearing will focus on the discussion of legislative proposals that will support patients’ access to telehealth services. Establishing permanency of telehealth in rural communities via telehealth provides opportunity for essential access to health services and can greatly impact health outcomes for rural constituents. Key legislative proposals that are going to be considered that have rural relevance include:

  • H.R. 4189: CONNECT for Health Act of 2023 (Reps. Mike Thompson, David Schweikert, Doris Matsui)
  • H.R. 7623: The Telehealth Modernization Act of 2024 (Reps. Earl “Buddy” Carter, Lisa Blunt Rochester, Gregory Steube, Terri Sewell, Miller-Meeks, Debbie Dingell, Jefferson Van Drew, and Joseph Morelle)

Please find the press release here. Livestream of the hearing can be accessed here. Please find NRHA’s Rural Telehealth legislative priorities here.

Community Impact and Benefit of Critical Access and other Rural Hospitals

Examines the economic and health care benefit of Critical Access Hospitals (CAHs) on rural communities. Looks at the services provided, the economic health of CAHs, and the effect this has on their communities broadly. Includes comparisons of community benefit and patient care services indicators provided by CAHs and other rural and urban hospitals. The Flex Monitoring Team is a FORHP-supported consortium of researchers who evaluate the impact of HRSA’s Medicare Rural Hospital Flexibility Program.

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ONC Seeks Feedback on Federal IT Strategic Plan

Comment by May 28. The Office of the National Coordinator (ONC) for Health Information Technology (IT) seeks public input on their draft 2024-2030 Federal Health IT Strategic Plan, which was developed in collaboration with more than 25 federal organizations that regulate, purchase, develop, and use health IT. When finalized, this plan will serve as a roadmap for federal agencies to prioritize resources, align and coordinate efforts across agencies, signal priorities to the private sector, and benchmark and assess progress over time. It will also serve as a catalyst for alignment outside the federal government. Stakeholders must submit comments via the feedback form by May 28.

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CISA Seeking Comments on New Covered Cyber Incidents for Covered Entities such as Critical Access Hospitals

Comment by June 4. On April 4, 2024, the Cybersecurity and Infrastructure Security Agency (CISA) will release its proposed rule to implement new reporting requirements outlined in the Cyber Incident Reporting for Critical Infrastructure Act of 2022 (CIRCIA). Through this proposed rule, the CISA is seeking public comment and input on policies requiring Covered Entities to report Covered Cyber Incidents and ransomware payments to CISA within 72 hours of occurrence of cyber-attack incident or 24 hours after the ransom payment has been made. The rule identifies 16 Critical Infrastructure Sectors, which includes the Healthcare and Public Health sector, as being at risk for a Covered Cyber Incident. As part of the Healthcare and Public Health sector, the rule includes a hospital with 100 beds or more, or a Critical Access Hospital as a Covered Entity. Covered Cyber Incidents experienced by a Covered Entity would be reportable regardless of which part of the organization suffered the impact. Other Covered Entities include Class II (moderate risk) and Class III ( high risk) devices as classified by the U.S. Food and Drug Administration and manufactures of drugs listed in Appendix A Essential Medicines Supply Chain and Manufacturing Resilience Assessment developed by the U.S. Department of Health and Human Services and the Administration for Strategic Preparedness and Response. In total, CISA estimates that over 300,000 entities from the 16 sectors would be covered by the Proposed Rule.

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Medicare Proposes Updates for SNF, IRF, and Hospice Payment Rules

Comment by May 28.  CMS released proposed rules for Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF),  and Hospice Wage Index and Payment Rate updates. Each rule proposes updates to Medicare payment and quality measurement policies for Fiscal Year 2025, which begins October 1. The proposed rules indicate a 4.9 percent increase in payments for rural SNFs, a 4.6 percent increase for rural IRFs, and a 2.8 percent increase in payments for rural hospices.

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Medicare Proposes Updates to Inpatient Psychiatric Facility Payment Policies

Comment by May 28. On March 28, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare payment policies and rates for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) for fiscal year (FY) 2025. The proposal increases payment rates by 2.7 percent, and proposes payment increases for stays involving the use of electroconvulsive therapy. CMS has also issued a request for information regarding facility level payment adjustment factors, including rural and teaching status as well as a potential new adjustment for safety net patient populations.

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Final Rule Released Defining Short-Term Limited Duration Insurance

Last week, the Departments of Health & Human Services, Labor, and the Treasury released a final rule amending the definition of short-term, limited-duration insurance (STDLI), which is a type of health insurance coverage designed to fill temporary gaps in coverage when an individual is transitioning from one plan or coverage to another.  STLDI is not considered to be individual health coverage under the law, so it does not need to meet the same requirements as Marketplace plans.  Under this rule, the Departments are shortening the limit on the length of the initial contract term from 12 months to no more than three months.  Additionally, the maximum total coverage period is changing from 36 months to four months including renewals and extensions.  This rule also revises the federal standard for notices that insurers must use to help consumers better distinguish between comprehensive coverage and STLDI and get information on their health coverage options. This document also sets forth final rules that amend the regulations regarding the requirements for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit in the group and individual health insurance markets.

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CMS Extends the Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or CHIP Coverage Due to Unwinding of the Medicaid Continuous Enrollment

Last week, the Centers for Medicare & Medicaid Services (CMS) issued guidance extending the special enrollment period for people who are no longer eligible for Medicaid or Children’s Health Insurance Program (CHIP) due to the end of the Medicaid continuous enrollment, also known as “unwinding,” to Marketplace coverage in states using HealthCare.govfrom July 31, 2024, to November 30, 2024.  This extension is optional for state-based Marketplaces. Consumers who are determined eligible for this Unwinding SEP will have 60 days from the date on which they submit a new or updated to make a plan.  CMS’ Job Aid entitle, Assisting Rural Consumers provides information for navigators and assisters to educate rural consumers on Marketplace and Medicaid coverage and assist with enrollment.

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