- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research 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
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- CMS: Request for Information; Health Technology Ecosystem
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
Celebrate 75 Years of Community Water Fluoridation
The American Public Health Association (APHA) and the American Dental Association (ADA) are hosting “A Toast to Community Water Fluoridation – Celebrating 75 Years!” on Sunday, October 25th at 7 p.m. ET. This celebration will serve as an opportunity to highlight the inspiring perseverance of public health partners across the country. There are multiple featured speakers including Rear Admiral Assistant Surgeon General Timothy Ricks.
UPMC Cole Recognized for Innovative Post-Acute and End-of-Life Care
The National Rural Health Resource Center (The Center) and the Federal Office of Rural Health Policy (FORHP) recently recognized UPMC Cole for their innovative approach to post-acute care and palliative services in the region with its Critical Access Hospital award. The nomination for the award was made by Lannette Fetzer, Quality Improvement Coordinator, from the Pennsylvania Office of Rural Health (PORH). The award will be presented to UPMC Cole on November 4 in a virtual ceremony.
Located in one of the most remote regions of Pennsylvania, UPMC Cole provides necessary and lifesaving services focused on the needs of the communities it serves. A comprehensive community needs assessment identified a population of high risk, vulnerable patients who experienced a lack of support for comprehensive palliative services. Existing hospital services did not adequately meet and support the physical, emotional, spiritual, and social needs of those suffering from a serious or life-threatening illness. Advanced illnesses were limited to a home-based hospice program or placement in a skilled nursing facility. In response, UPMC Cole developed a robust and innovative palliative care service transforming care.
“An interdisciplinary team, passionate about palliative and end of life care, met routinely to identify service gaps and community needs and formulated concise goals utilizing best practices for end-of-life care,” said Timothy Brown, president, vice president of operations, UPMC Cole Medical Group. “Kristin Kratzer and Andrea Heller, MD, were appointed to lead this program to implement palliative services across the continuum of care. The team provided community education to ensure that palliative care services did not replace primary care, but rather supported and complemented established and trusted services.”
The Critical Access Hospital Recognition was established by The Center and the Federal Office of Rural Health Policy (FORHP) to recognize the excellent work in critical access hospitals (CAHs) and other rural safety net providers throughout the country. The recognition shares excellence and innovation and honors the achievements.
“The achievement in post-acute care initiatives by CAHs is impressive,” stated Sally Buck, chief executive officer at The Center. “It reflects the innovation required to address unique population health needs in rural communities. Providing services locally benefits the patient, the overall community, and enhances CAH performance outcomes.”
“UPMC Cole is dedicated to providing a comprehensive system of high-quality health care to include premier post-acute and palliative care services for their patients,” said Jennifer Edwards, Rural Health Systems Manager and Deputy Director from the Pennsylvania Office of Rural Health. “This program is a shining example of innovation, and commitment to the transition to value that the CAHs in Pennsylvania are pursuing every day.”
For more information on palliative care and other services available at UPMC Cole, visit UPMCSusquehanna.org.
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About UPMC
A $21 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates more than 90,000 employees, 40 hospitals, 700 doctors’ offices and outpatient sites, and a 3.8 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.4 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $500 million in federal, state, and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside among the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.
CMS COVID-19 Stakeholder Engagement Calls – October
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.
Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.
Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts
CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)
Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:
- Increase Hospital Capacity – CMS Hospitals Without Walls;
- Rapidly Expand the Healthcare Workforce;
- Put Patients Over Paperwork; and
- Further Promote Telehealth in Medicare
Next Office Hours:
Tuesday, October 13th at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 6379959
Audio Webcast link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2607
Tuesday, October 27th at 5:00 – 6:00 PM Eastern – save the date, dial in to be provided
Weekly COVID-19 Care Site-Specific Calls
CMS hosts calls for certain types of organizations on an intermittent basis to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.
Nursing Homes
Wednesday, October 14th at 4:30 – 5:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1897041 Audio Webcast Link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2622
Wednesday, October 28th at 4:30 – 5:00 PM Eastern – save the date, dial in to be provided
For the most current information including call schedule changes, please click here
To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.
New Rural Health Brief: Medicare Advantage Enrollment Update 2019
Medicare Advantage Enrollment Update 2019
Abdinasir K. Ali, MPH; Fred Ullrich, BA; and Keith Mueller, PhD
The 2019 edition of the RUPRI Center’s annual report on Medicare Advantage (MA) enrollment shows that as of March 2019, 35.0 percent of eligible Medicare beneficiaries were in an MA plan. The proportion of metropolitan enrollment (37.0 percent) is higher than that in nonmetropolitan counties (25.6 percent) but the rate of growth in enrollment has been higher in nonmetropolitan counties for the past two years.
Although well over half of metropolitan MA enrollment has been in HMO plans over the past 10 years (65.0 percent in 2019), since 2012 the plurality of nonmetropolitan MA enrollment has been in local PPO plans. However, nonmetropolitan enrollment in both HMO plans and local PPOs has grown consistently since 2009 (2019 enrollment: 32.7 percent and 45.2 percent, respectively). Growth in these two plan types has come largely at the expense of nonmetropolitan PFFS plans which accounted for 54.5 percent of nonmetropolitan MA enrollment in 2009, but only 2.0 percent by 2019.
Please click here to read the brief.
Pennsylvania Governor Announces Additional $96 Million for Small Businesses Impacted by COVID-19
Pennsylvania Governor Tom Wolf announced that an additional $96 million in state grants have been approved for 5,373 Pennsylvania small businesses that were impacted by the business closure order due to the COVID-19 public health crisis.
Businesses in every county were approved for grants in this round of funding, and 52 percent are historically disadvantaged businesses.
To date, more than 10,000 businesses were approved for $192 million in grants through the COVID-19 Relief Statewide Small Business Assistance Program.
“The COVID-19 pandemic has been caused a lot of hardship for our business community, and it has been particularly difficult for Pennsylvania’s small businesses to weather the economic effects of this crisis. Pennsylvania’s small business owners are community-focused employers, and they drive our economy, so they deserve our support as we continue to navigate this public health crisis,” Gov. Wolf said. “As we seek to recover, and rebuild our economy following the downturn caused by this pandemic, it’s critical that we provide opportunities for these businesses to recover and rebound, and this funding will provide much-needed support for businesses in communities across the state.”
The governor announced this funding at the Broad Street Market in Harrisburg and was joined by public officials and the owners of two local businesses: D.McGee Design Studio, located in the market, which was approved for a $10,000 grant, and Gifted Hands Barber Studio, located on 3rd Street near the market, which was approved for a $5,000 grant.
The COVID-19 Relief Statewide Small Business Assistance funding was developed in partnership with state lawmakers and allocated through the state budget, which included $2.6 billion in federal stimulus funds through the Coronavirus Aid, Relief and Economic Security (CARES) Act, of which $225 million was earmarked for relief for small businesses.
The Department of Community and Economic Development (DCED) distributed the funds to the Pennsylvania Community Development Financial Institutions (CDFIs), which are administering the grants.
“We’ve seen the impact of this pandemic-fueled economic crisis on the small businesses in our communities. We targeted these funds to reach the smallest and most vulnerable businesses across the state and as CDFIs, we were able to mobilize our networks to reach those who have been hardest hit by the pandemic,” said James Burnett, vice chair of the PA CDFI Network and executive director of the West Philadelphia Financial Services Institution. “The PA CDFI Network is grateful for the partnership of Governor Wolf and the Pennsylvania Legislature as we move quickly to get these resources into the hands of those most impacted by the crisis.”
“I am extremely proud we were able to work together and to get much needed grants to the small businesses across the Commonwealth of Pennsylvania that serve as the backbone to our economy,” said state Senator Vincent Hughes (D-Philadelphia/Montgomery). “With that said, this should not be the end of the push to help our small business community. There are still CARES dollars available and thousands of businesses that have applied for this program seeking relief and the General Assembly must prioritize focusing on those needs and getting our people through this pandemic.”
New Phase of Provider Relief Fund Opens for Applications
Providers are encouraged to apply for the latest round of Provider Relief Fund (PRF) support. Applications will be considered regardless of whether your organization was previously eligible for, applied for, received, accepted, or rejected prior PRF payments. For this newest phase, funding will be allocated to providers based on assessed financial losses and changes in operating expenses caused by COVID-19. For more information about the Phase 3-General Distribution, please visit the Provider Relief Fund webpage.
Apply here through November 6
Register for the webcast on October 15 at 3 p.m. ET to learn more.
HHS: Hospitals Must Now Report Flu Data and COVID-19 Numbers
Healthcare Dive
Hospitals now must send CMS their seasonal flu data alongside COVID-19 data or risk losing Medicare and Medicaid funding, senior officials announced at a press conference Tuesday.
Beginning Wednesday, hospitals will receive notice whether they are in line with current reporting requirements, CMS Administrator Seema Verma said. They will be issued guidance on how to correct course and then given 14 weeks, or four notices, to do so.
CMS in August issued an interim final rule mandating hospitals send their COVID-19 data to federal agencies or risk losing funding, swiftly chided as “heavy-handed” by the American Hospital Association. AHA said this announcement answers some of the questions posed since the initial rule, and excludes psychiatric and rehabilitation hospitals, which generally do not treat COVID-19 patients, from reporting.
HHS wants to know how many COVID-19 cases, influenza cases and days on hand of personal protective equipment hospitals have — or it will revoke federal reimbursement.
Those data points and a slew of others will be used to direct federal resources to hospitals and communities in the highest need as influenza season and the COVID-19 pandemic clash, HHS Ambassador Deborah Birx said during a Tuesday call with reporters.
A harsh flu season coinciding with continued hot spots of novel coronavirus activity could respark concerns of hospital capacity that surfaced in the beginning of the crisis.
CDC Director Robert Redfield said while the agency has always collected seasonal flu data, the new requirements will “give us a fuller picture of what is happening hospital to hospital regarding influenza.”
“It is uncertain what will happen this fall and winter,” Redfield said. “However, CDC is preparing for there to be a COVID-19 and seasonal influenza activity at the same time. As Americans spend more time indoors this fall and winter, and people start going back to work and school, the risk of flu and COVID will only rise.”
Earlier into the pandemic, HHS sent out one-time data requests to hospitals to aid in distribution of remdesivir and other needed treatments or supplies. HHS said in a fact sheet that the daily reporting is now the sole mechanism for distribution calculations heading into winter.
Hospitals already must submit reports on COVID-19 testing, capacity and utilization under the August rule. Now they must submit daily data on total hospitalized patients with laboratory-confirmed influenza, previous day’s influenza admissions and total ICU patients with laboratory-confirmed influenza. They’ll also have to submit numbers on total hospitalized patients with both laboratory-confirmed COVID-19 and influenza, and previous day’s deaths for patients with both COVID-19 and influenza.
The guidance on reporting can be found at: https://www.hhs.gov/sites/default/files/covid-19-faqs-hospitals-hospital-laboratory-acute-care-facility-data-reporting.pdf
Improve Health Equity During Hispanic Heritage Month
This year, as the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) honors National Hispanic Heritage Month, we hope to focus on prioritizing health for the nation’s 60 million Hispanics by encouraging annual flu shots and sharing resources to help Hispanics take steps toward better health.
Each year from September 15 to October 15, National Hispanic Heritage Month recognizes the contributions, achievements, and histories of Hispanics and Latinos in American culture. Many face unique challenges within the Hispanic community, including language barriers, poverty, lack of education, and immigration status that have affected Hispanics health and health care access.
This year, more than ever, it is important to prioritize our health. Like other minority groups, Hispanics are disproportionately affected by chronic health conditions putting them at an increased risk of developing certain illnesses such as the flu or COVID-19. Factors such as underlying health conditions and a lack of access to health care services put the Hispanic community at an increased risk of contracting these viruses.
As this year’s flu season will be compounded with COVID-19, it is important that all adults and children get the flu vaccine. Although the flu shot can reduce the risk of illness and hospitalization and is covered by Medicare, Medicaid, and most health plans, only 36 percent of Hispanic Medicare fee-for-service beneficiaries and 65 percent of Hispanic Medicare Advantage beneficiaries received the flu vaccine in 2018.
Recognizing Hispanic Heritage Month is part of our strategy to foster innovation by sharing resources and initiatives that can help to improve access to health care services and improve health equity within the Hispanic community. Below are several resources you can use this month and beyond.
Partner Resources
- Review our new data snapshot, Annual Influenza Vaccination Disparities in Fee-for-Service Beneficiaries that provides an overview of the flu vaccine and vaccination rate data by race, ethnicity, and gender among Medicare beneficiaries.
- Read CMS OMH’s, Understanding the Health Needs of Diverse Groups of Hispanic Medicare Beneficiaries, which examines the future medical needs and challenges of a fast growing Hispanic population.
- Review the Racial, Ethnic, and Gender Disparities in Health Care in Medicare Advantage stratified report, which looks at racial and ethnic differences in health care experiences and clinical care for Medicare Advantage beneficiaries.
- View CMS OMH’s Quality Improvement & Interventions to find evidence-based interventions that can contribute to reducing health disparities and lowering cost. Key resources include:
- Download and share our Rural Health Strategy: 5 Key Objectives in Spanish and English, which provides five objectives to help move rural health providers and their patients forward.
- Visit the HHS Office of Minority health page for information and social graphics in English, Hispanic Heritage Month page or Spanish, Mes de la Herencia Hispana.
Consumer Resources
- Looking for information on COVID-19? Visit this CMS OMH webpage for COVID-19 Federal resources focusing on vulnerable populations: cms.gov/omhcovid19 and C2C COVID-19: go.cms.gov/c2ccovid19.
- Download and share From Coverage to Care (C2C) resources which are all available in both English and Spanish:
- A Roadmap to Better Care and a Healthier You
- A Roadmap to Behavioral Health
- How to Maximize Your Health Coverage video series
Share Connected Care resources, such as the “Connecting the Dots” patient animated videos, available in both Spanish and English, to help individuals living with multiple chronic conditions learn more about the benefits of chronic care management services.
Pennsylvania Recognizes National Farmers Day: October 12
The profession of farming began around 12,000 years ago with the domestication of livestock, as hunters and gatherers settled down and started to plan their own food. Farming is one of the oldest jobs around.
Take a moment on October 12 to thank all the farmers that work to grow and produce our food. Remember: their families play a big role too!
HOW TO CELEBRATE NATIONAL FARMERS DAY
- Thank a farmer for their hard work.
- Read about a farmer
- Shop at a Farmers Market in Pennsylvania
- Use social media to show gratitude and support: #ThankAFarmer #NationalFarmersDay #UndeniablyDairy #
- Plant a garden. Start your own mini-farm.
- Stores will mark or display locally-grown produce near the front or with signs.
- Look for PA-Preferred labels on products or marked in the aisles.
- On milk, if it was bottled in Pennsylvania, the number printed on the outside of the container will begin with #42.
Support For Victims And Survivors Of Domestic Violence Or Sexual Assault
October is Domestic Violence Awareness Month. This month provides an opportunity to remember victims of domestic violence, raise awareness of what domestic violence is, how to recognize it, and what we can all do to collectively prevent it.
Domestic violence is a pattern of coercive behavior used by one person to gain power and control over another in an intimate or familial relationship. In Pennsylvania alone, 112 victims died from domestic violence incidents last year. Domestic violence can happen to anyone regardless of gender, socio-economic status, race, or sexual orientation.
Unfortunately, during this unprecedented time, recommendations necessary to prevent the spread of COVID-19 also lead to those experiencing domestic violence facing even more anxiety and new challenges to navigate. Victims and survivors are spending more time in close proximity with their abusers, increasing the risk to their safety and well-being during an already stressful time. If you or someone you know is unsafe, resources are available.
Help is Available
The Pennsylvania Coalition Against Domestic Violence (PCADV) provides domestic violence services 24-7 via their find help page and the National Domestic Violence Hotline at 1(800) 799-7233 or by texting LOVEIS to 22522. Legal help is available from PCADV at pasafelaw.org.
The Pennsylvania Coalition Against Rape (PCAR) provides sexual assault crisis services. Those resources can be found at www.pcar.org or at 1-888-772-7227 for a 24-hour hotline to be connected to a local sexual assault center. Help for sexual assault survivors is also available from the National Sexual Violence Resource Center (NSVRC).
Suspected child abuse or neglect can be reported 24/7 to DHS’ ChildLine available at 1-800-932-0313.