Last week, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would make changes to simplify the processes for eligible individuals to enroll and retain eligibility in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program. This proposed rule would remove barriers and facilitate enrollment of new applicants, particularly those dually eligible for Medicare and Medicaid; align enrollment and renewal requirements for most individuals in Medicaid; establish beneficiary protections related to returned mail; create timeliness requirements for redeterminations of eligibility in Medicaid and CHIP; make transitions between programs easier; eliminate access barriers for children enrolled in CHIP by prohibiting premium lock-out periods, waiting periods, and benefit limitations; and modernize recordkeeping requirements to ensure proper documentation of eligibility and enrollment. Medicaid is an important source of health care coverage for rural America, covering nearly a quarter of individuals under age 65 living in rural areas. Of interest to rural stakeholders, CMS is seeking comment on whether States either should be permitted or required to update beneficiary contact information based on information obtained from specific groups including providers like Federally Qualified Health Centers and Rural Health Clinics.

Comments are due by November 7th. 

Last week, the U.S. Department of Health & Human Services approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage from 60 days to 12 months after pregnancy in Indiana and West Virginia.  It’s the latest move in the White House’s whole-government effort to improve maternal health outcomes, particularly for women in underserved and rural communities where a series of barriers means higher rates of morbidity and mortality.

 In a study of 10.4 million rural Medicare beneficiaries, researchers discovered continuous growth in telemedicine use between 2010 and 2019 – especially for care provided by nurse practitioners and other non-physician clinicians.  Medicare beneficiaries with serious mental illness (e.g., bipolar disorder) used a disproportionate share of all telemedicine visits, with more than 1 in 10 beneficiaries using telemedicine annually in 891 counties in the U.S.

The Centers for Medicare & Medicaid Services (CMS) seeks public input on access to health care and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency. CMS will use the comments received to identify opportunities for improvement and efficiencies across CMS policies, programs, and practices. CMS notes that responses may include, but are not limited to, challenges in accessing care in underserved areas, including rural areas.

Responses by November 4

While studies have shown rural children face higher rates of many adverse childhood experiences – also known as ACEs – new research aimed at distinguishing urban-rural differences finds factors that may give rural areas an edge in positive experiences. These include a greater likelihood that children volunteer in their church, school, or community; they are more likely to have a mentor for advice or guidance; and that they are more likely to live in a safe and supportive neighborhood.

The Federal Office of Rural Health Policy awarded approximately $1,990,000 to the Rural Health Redesign Center Organization (RHRCO) from Harrisburg, Pennsylvania in a three-year cooperative agreement intended to provide technical assistance (TA) to rural health care providers and organizations in the Northern Border Regional Commission (NBRC). This cooperative agreement will help providers and organizations prioritize health issues, identify funding sources, assist with grant writing and develop strategic plans – with the overall intent to increase health care delivery capacity within the region. In alignment with the Rural Northern Border Region Healthcare Support Program, RHRCO’s proposed project will provide rural healthcare providers with technical assistance to improve access to care, including behavioral health and substance use disorder (SUD) services, workforce development, recruitment, and retention, and support transitions to value-based care. The TA provided in this cooperative agreement will continue to build on FORHP’s efforts to help underserved NBRC rural communities identify and better address their health care needs.

The Centers for Disease Control and Prevention (CDC) is investigating a case of poliomyelitis, or paralytic polio, in New York state in an unvaccinated patient who presented to an emergency room with lower limb weakness and fever. CDC urges all healthcare providers to ensure their patients are current on the primary polio vaccination series. Healthcare providers should consider polio in the differential diagnosis of patients with sudden onset of limb weakness, especially in unvaccinated individuals and those with recent international travel to places where poliovirus is circulating. During this COCA Call, presenters will discuss the history of polio in the United States and the current New York state outbreak. They will also review clinical aspects of poliovirus infection, how to report suspected cases and recommendations for polio vaccination in the U.S.

As part of National Recovery Month, HRSA’s Office of Women’s Health (OWH) and Office of Intergovernmental and External Affairs Regions 3 and 9 will host a webinar. This webinar is part of OWH’s Women’s Health Leadership Series, which focuses on emerging issues and innovative women’s health practices by and for HRSA-supported organizations and other safety net settings of care. Register here for the Thursday, Sept. 15, 3:00 – 4:00 pm webinar.

CDC’s Advisory Committee on Immunization Practices updated its flu vaccine recommendations for the 2022-2023 flu season. Influenza vaccination of persons aged ≥6 months will reduce symptoms that might be confused with those of COVID-19. Current guidance for the administration of COVID-19 vaccines indicates that these vaccines can be co-administered with influenza vaccines. Consult the CDC webpage for updated information.

With the state’s economy still in its post-pandemic recovery, a tight labor market and a resurgent labor movement offer new possibilities for the commonwealth’s workers. And if policymakers make the right choices, the state could “enjoy a return to shared prosperity for the first time in decades.” Those are the top line takeaways from the labor-friendly Keystone Research Center’s annual ‘State of Working Pennsylvania’ report, which was released just days ahead of this year’s Labor Day celebrations.