For the first time in history, Medicare will have the ability to negotiate lower prescription drug prices because of the Inflation Reduction Act. The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued initial guidance detailing the requirements and parameters—including requests for public comment— on key elements of the new Medicare Drug Price Negotiation Program for 2026, the first year the negotiated prices will apply. Alongside other provisions in the new drug law, the Medicare Drug Price Negotiation Program will strengthen Medicare’s ability to serve people currently in Medicare and for generations to come.

“For far too long, millions of Americans have had to choose between their prescription drugs and other monthly expenses,” said HHS Secretary Xavier Becerra. “President Biden is leading the fight to lower the cost of prescription drugs – and with the Inflation Reduction Act, we’re making historic progress. Through the Medicare Drug Price Negotiation Program, we will make sure seniors get a fair price on Medicare’s costliest prescription drugs, promote competition in the market, and ensure Medicare is strong for beneficiaries today and into the future.”

“Drug price negotiation is a critical piece of how this historic law improves the Medicare program,” said CMS Administrator Chiquita Brooks-LaSure. “By considering factors such as clinical benefit and unmet medical need, drug price negotiation intends to increase access to innovative treatments for people with Medicare.”

The Biden-Harris Administration has made lowering high prescription drug costs and improving access to innovative therapies a key priority. CMS is releasing its initial guidance for how Medicare intends to use its new authority to effectively negotiate with drug companies for lower prices on selected high-cost drugs. The negotiation process will focus on key questions, including but not limited to the selected drug’s clinical benefit, the extent to which it fulfills an unmet medical need, and its impact on people who rely on Medicare. As a result of negotiation, people with Medicare will have access to innovative, life-saving treatments at costs that will be lower for both them and Medicare.

“Negotiation is a powerful tool that will drive drug companies to innovate to stay competitive, fostering the development of new therapies and delivery methods for the treatments people need,” said Meena Seshamani, M.D., Ph.D., CMS Deputy Administrator and Director of the Center for Medicare. “This initial guidance is the next step in the extensive engagement CMS has had to date with interested parties, and we look forward to continuing to receive comment on key policy areas and engage with the public as we implement the Negotiation Program.”

This initial guidance is one of a number of steps CMS laid out in the Medicare Drug Price Negotiation Program timeline for the first year of negotiation. The initial program guidance details the requirements and procedures for implementing the new Negotiation Program for the first set of negotiations, which will occur during 2023 and 2024 and result in prices effective in 2026. Key dates for implementation include:

• By September 1, 2023, CMS will publish the first 10 Medicare Part D drugs selected for initial price applicability year 2026 under the Medicare Drug Price Negotiation Program.
• The negotiated maximum fair prices for these drugs will be published by September 1, 2024 and prices will be in effect starting January 1, 2026.
• In future years, CMS will select for negotiation up to 15 more Part D drugs for 2027, up to 15 more Part B or Part D drugs for 2028, and up to 20 more Part B or Part D drugs for each year after that, as outlined in the Inflation Reduction Act.

CMS is seeking comment on several key elements in today’s guidance. Comments received by April 14, 2023, will be considered for revised guidance. CMS anticipates issuing revised guidance for the first year of negotiation in Summer 2023.

CMS is committed to collaborating and engaging with the public in the implementation of the Inflation Reduction Act. CMS is working closely with patients and consumers, Medicare Part D plan sponsors and Medicare Advantage organizations, drug companies, hospitals and health care providers, wholesalers, pharmacies, and others. Public feedback contributes to the success of the Medicare Drug Price Negotiation Program, and this initial guidance is one tool, among many, that CMS will use to ensure interested parties know when and how they can make their voices heard on implementation of this new drug law.

View a fact sheet on the Medicare Drug Price Negotiation Program Initial Guidance

Read the Medicare Drug Price Negotiation Program Initial Guidance.

The Appalachian Regional Development Act of 1965, which formally established ARC to help strengthen economic growth in the region, was signed into law 58 years ago today! Since then, we have invested more than $4.5 billion in approximately 29,000 economic development projects across all 13 Appalachian states.

Despite this progress, there’s more work to be done, which is why we’re excited to award up to $145 million this year through ARISE, INSPIRE, and POWER! Explore our current funding opportunities and help us build on economic growth and progress in the Appalachian Region.

Learn more here.

Pennsylvania Organization for Women in Early Recovery

Since 1991, the Pennsylvania Organization for Women in Early Recovery (POWER) has offered tailored treatment and support services to women in recovery. An ARC INSPIRE grant helped them enhance treatments, expand support offerings, and widen their service area to help even more women sustain recovery and enter the workforce

The Single Family Housing Guaranteed Loan Program (SFHGLP) is pleased to announce a two year extension of guidance originally published on April 29, 2022 which makes non-U.S. citizens with valid Social Security Numbers (SSN) and work authorization, as evidenced by documentation such as an Employment Authorization Document (EAD), Form I-766, temporarily eligible to apply for assistance. This extension expires on May 2, 2025.

Please note, applicant(s) must meet all other criteria set forth in 7 CFR Part 3555 and Handbook 1-3555.

Thank you for supporting the Single-Family Housing Guaranteed Loan Program!

Help Resources

Rural Development Help Desk:

For GUS system, outage or functionality assistance

Email: RD.HD@USDA.GOV

Important Links:

SFHGLP Lending Partner Webpage: https://www.rd.usda.gov/page/sfh-guaranteed-lender

SFHGLP Webpage:https://www.rd.usda.gov/programs-services/single-family-housing-guaranteed-loan-program

USDA LINC Training and Resource Library:

https://www.rd.usda.gov/programs-services/lenders/usda-linc-training-resource-library

Procedure Notices: https://www.rd.usda.gov/resources/directives/procedures-notices

USDA Rural Development is conducting a review of all areas under its jurisdiction to identify areas that no longer qualify as rural for housing programs.  The last rural area reviews were performed in 2017-2018 using 2015 American Community Survey (ACS) data.  Rural area designations are reviewed every five years. This review will utilize the 2020 United States decennial census data.

Based on the 2020 US census data and rural area guidance located in Handbook HB-1-3550, Chapter 5, the rural eligibility designation is under review for the following areas in Pennsylvania:

Currently eligible communities under review (population):

1. Northampton and Lehigh Counties – (Bethlehem Line Adjustment)

Currently eligible communities under review (Rural in Character):

1. Columbia County – Bloomsburg (“Rural in Character” under review.)
2. Columbia County – Berwick (“Rural in Character” under review.)
3. Lancaster County – Ephrata (“Rural in Character” under review.)
4. Lancaster County – Elizabethtown (“Rural in Character” under review.)
5. Franklin County – Chambersburg (“Rural in Character” under review.)
6. Franklin County – Waynesboro (“Rural in Character” under review.)

Ineligible communities under review (expansion of ineligible areas):

1. Lancaster County – Columbia (Line Adjustment)
2. York County – Weigelstown (Line Adjustment)
3. Allegheny County – Franklin Park (Line Adjustment)
4. Allegheny County – Monroeville (Line Adjustment)

Ineligible communities under review (reconsideration of eligibility):

1. Lycoming County – Williamsport (Minor Boundary Adjustments)
2. Montgomery County – Pottstown (Minor Boundary Adjustments)

The public shall have 90 days from the date of this public notice to submit comments regarding the potential loss of eligibility for Rural Development housing programs.  Comments should be sent to pasfh@usda.gov.  For details, or questions about specific changes, please contact the Pennsylvania Rural Development Housing Program staff at (717) 237-2186.

Just off the historic U.S. Route 66 in eastern New Mexico, a 10-bed hospital has for decades provided emergency care for a steady flow of people injured in car crashes and ranching accidents.

It also has served as a close-to-home option for the occasional overnight patient, usually older residents with pneumonia or heart trouble. It’s the only hospital for the more than 4,500 people living on a swath of 3,000 square miles of high plains  of Albuquerque.

“We want to be the facility that saves lives,” said Christina Campos, administrator of Guadalupe County Hospital in Santa Rosa. Its leaders have no desire to grow or be a big, profitable business, she said.

But even with a tax levy to help support the medical outpost, the facility lost more than $1 million in the past six months, Campos said: “For years, we’ve been anticipating kind of our own demise, praying that a program would come along and make us sustainable.”

Guadalupe is one of the nation’s first to start the process of converting into a Rural Emergency Hospital. The designation was created as part of the first new federal payment program launched by the Centers for Medicare & Medicaid Services for rural providers in 25 years. And though it is not expected to be a permanent solution to pressures facing rural America, policymakers and hospital operators alike hope it will slow the financial hemorrhage that continues to shutter those communities’ hospitals.

More than 140 rural hospitals have closed nationwide since 2010, and health policy watchers aren’t sure how many of the more than 1,700 rural facilities eligible for the new designation will apply. CMS officials said late last month that seven have already filed applications. Dr. Lee Fleisher, director of the Center for Clinical Standards and Quality at CMS, said how long it will take to review the applications will vary. The agency declined to provide the names or locations of hospitals seeking the designation.

Read more.

U.S. Department of Agriculture (USDA) Rural Development State Director Bob Morgan announced that USDA is awarding six grants to agriculture producers in rural Pennsylvania.

“Ag producers are vital to the system that helps feed Pennsylvanians. Any time we can support them is a success for us as an agency,” Morgan said. “I am glad these grant funds are getting to operations for them to expand their markets and increase revenue.”

The grant awards total $894,290 for six projects in four Pennsylvania counties through the Value Added Producer Grants program.

The projects in Pennsylvania awarded funds today are listed below.

• North Mountain Pastures LLC in Perry County was awarded a grant of $250,000 to help with processing costs as the farm goes through a growth phase over the next three years. The goal is to increase sales by reaching new customers through a strategic marketing campaign built around on-line marketing of direct-shipped meats. This is anticipated to increase its customer base by approximately 800 and its revenue by approximately $719,711 over a three-year period.
• Roots to River Farm LLC in Bucks County was awarded a grant of $250,000 for processing and marketing an herbal fortified wine, made from its farm-grown fennel. This wine is aromatized with radicchio and herbs, along with a proprietary blend of spices and citrus. Funds will also be used for marketing the new product and securing a foothold in the increasingly competitive American aperitif market. This includes costs for advertising, web re-design and social media management. This project is anticipated to increase its customer base by roughly 6,000 and increase its revenue by approximately $215,000 over three years.
• Katydid Hill LLC in Schuylkill County was awarded a grant of $250,000 for processing, packaging and marketing activities related to producing herbal tea blends grown on the farm. The goal is to increase sales through the expansion of the company’s market and product line. This project will serve a socially disadvantaged independent producer and is anticipated to increase its customer base by roughly 35,000 and its revenue by approximately $439,000 over a three-year period.
• Manoff Market Cidery LCC in Bucks County was awarded a grant of $45,000 for processing and marketing activities to help launch a hard cider product into the Bucks County, Greater Philadelphia, and New Jersey areas. The goal of the project is to increase retail sales by promoting its products through print, visual and social media advertisements. This project is anticipated to increase its customer base by roughly 4,000 and its revenue by approximately $231,000 over a 15-month period.
• Tinicum Farm Collective LLC in Bucks County was awarded a grant of $49,420 for processing, packaging and marketing activities to expand production of the popular and distinct Heirloom Pumpkin Pie to a wider wholesale market in the Greater Philadelphia Region. The goal is to increase sales to customers by providing a retail-ready product that will become the cornerstone of the farm and bakehouse. This project will serve a socially disadvantaged independent producer and is anticipated to increase its customer base by seven retail outlets and its revenue by approximately $45,000 over a one-year period.
• Crooked Row Farm in Lehigh County was awarded a grant of $49,870 to process, market and sell hot pepper sauces, dried pepper powders, marinades, salad dressings, culinary oils, teas, and soaps made from its farm grown herbs and specialty peppers. Funds will also be used to enhance its online marketing capability. This project is anticipated to increase the farm’s customer base by 1,500 and its revenue by approximately $193,000 over a 12-month period.