Rural Health Information Hub Latest News

Here You Can Read About Telehealth and the End of the PHE

The COVID-19 public health emergency (PHE) officially ended on May 11, but many Medicare telehealth flexibilities remain in place temporarily. The Department of Health and Human Services (HHS) released a fact sheet to provide clarity around federal telehealth flexibilities. HHS will release additional guidance on updates and timing relating to the continuation of these flexibilities in the coming weeks. Learn more about telehealth policy changes with the end of the PHE. Earlier this spring, NRHA sent a letter to HHS on PHE flexibilities we would like to see made permanent, including telehealth provisions, and we continue to advocate for legislative change in Congress.

GAO Released a Report on Rural Health Care Accessibility 

 The Government Accountability Office (GAO) released a report titled, “Why Health Care is Harder to Access in Rural America.” The report found many rural residents face several challenges, including fewer health care providers, longer travel distances to get to health care, fewer transportation options, and less broadband internet. The report recommends that federal agencies learn more about the needs of rural residents and address the gaps in information regarding the healthcare needs of people living in rural areas. Join NRHA in fighting for rural health.

Good to Know!  Read How PHE is Unwinding Resources  

The PHE officially ended a week ago on May 11. NRHA is working with the Centers for Medicare and Medicaid Services (CMS) to ensure rural providers aren’t left behind. Please review the following resources and reach out to the NRHA team with any questions:

CMS Has Proposed a Rule on SNF Prospective Payment System:  Comments Have Been Requested

CMS released its fiscal year (FY) 2024 Skilled Nursing Facility (SNF) Prospective Payment System proposed rule. The proposed rule includes a 3.7% increase in payments to SNFs in FY 2024. This rule does not include the anticipated minimum staffing standards for nursing homes, which are expected later this spring. For more information, you can find NRHA’s full summary here. Please find CMS’ fact sheet here.

CMS Releases Inpatient Prospective Payment System Proposed Rule: Comments Have Been Requested   

CMS released the fiscal year (FY) 2024 Inpatient Prospective Payment System (IPPS) proposed rule. NRHA’s full summary is available here. CMS also released a fact sheet. Key provisions include:

  • Increased IPPS payments by 2.8% overall and 3.3% for rural hospitals.
  • Rural Emergency Hospital (REH) provisions include codifying conversion guidance and allowing REHs to be Medicare Graduate Medical Education eligible sites.
  • The proposed policy that hospitals reclassified as rural must be treated like geographically rural hospitals for wage index calculations.
  •  A safety net hospital request for information.

Here You Can Find An Important Notice for HRSA Grantees

  On May 26, HRSA will follow a federal requirement to upgrade security measures for online systems requiring a login for external users.  The new multi-factor login procedure will affect those who access HRSA’s Electronic Handbook (EHB) system, including grantees, grant applicants, service providers, and consultants. To avoid issues with upcoming application and reporting deadlines, it is important to set up the new login procedure ahead of the change on May 26.  HRSA is hosting a one-hour webinar session on May 12th at 1:00 pm ET to walk through the new process. Participants will need to register in advance; the webinar only has 3000 slots available, but the session will be recorded and made available to users.

The Kaiser Family Foundation Has Been Tracking State Medicaid Enrollment and Disenrollment

  During the COVID-19 PHE, states could receive enhanced federal payments for halting Medicaid disenrollments, also known as the Medicaid continuous enrollment provision. As of April 1, 2023, states are resuming operations to redetermine Medicaid eligibility for all enrollees.  The Kaiser Family Foundation (KFF) created a tracker to monitor changes in Medicaid enrollment during this unwinding period.  It presents the most recent Medicaid enrollment data available for each state as well as any unwinding data on monthly renewals, disenrollments, and other measures that may be available for a state.

You Can Read About the Guidance for States on Ending COVID-19 PHE Medicaid Flexibilities Here!

 This Center for Medicaid & CHIP Services (CMCS) Informational Bulletin (CIB) lists the end dates of certain COVID-19-related Medicaid and CHIP coverage and enhanced federal funding if the COVID-19 Public Health Emergency (PHE) ends on May 11, 2023, as expected. As part of their response to the COVID-19 PHE, states adopted many temporary flexibilities to support providers and individuals enrolled in Medicaid and CHIP, such as coverage of COVID-19 testing, treatment, and vaccinations.  The bulletin provides key dates to assist states with returning to routine Medicaid and CHIP operations.  About a quarter of rural adults under age 65 are covered by Medicaid.

The Government Accountability Office Releases Findings on Midwifery

Among other findings, the Government Accountability Office (GAO) reports that the number of midwives and midwifery students has increased; in 2021, midwives attended 12 percent of births in the U.S.  Access is still a concern, however. Students may have trouble with the cost of education and a limited number of training opportunities, while insurance coverage is spotty – leaving some people interested in having a midwife unable to afford one.  Recent data show that, in 2019, more than 30 percent of rural counties had no obstetric clinicians of any type.  The GAO reported on this shortage last year, with data supporting an increase in Medicaid reimbursement to close the gap in maternity care for rural areas.