In this final rule, the Centers for Medicare & Medicaid Services (CMS) implements changes related to Medicare Advantage (MA) inpatient admission decisions, vaccine and insulin cost sharing, the Medicare Prescription Payment Plan, Medicare Advantage dual eligible special needs plans (D-SNPs), Star Ratings, and other programmatic areas. CMS is not finalizing three provisions from the proposed rule:

• Enhancing Health Equity Analyses: Annual Health Equity Analysis of Utilization Management Policies;
• Procedures and Ensuring Equitable Access to Medicare Advantage Services—Guardrails for Artificial Intelligence; and
• Part D Coverage of Anti-Obesity Medications (AOMs) and Application to the Medicaid Program.

There are other provisions from the proposed rule that are not included in this final rule. CMS may address them in future rulemaking, as appropriate.  As of January 2023, about 45 percent of rural Medicare beneficiaries were enrolled in an MA plan.

The Centers for Medicare & Medicaid Services (CMS) updated their Hospital Price Transparency Fact Sheet with information on compliance and enforcement. Under Hospital Price Transparency, all hospitals, including Critical Access Hospitals (CAHs) and Rural Emergency Hospitals (REHs), and hospital-based departments – which may include some Rural Health Clinics – are required to post pricing information about the items and services they provide on a publicly available website. CMS audits hospitals and investigates complaints from the public to ensure compliance. They also leverage automation to perform over 200 comprehensive hospital reviews per month. Consistent with standing policies, CMS will address non-compliance with swift enforcement, and they are planning a more systematic monitoring and enforcement approach, per the Executive Order.  A variety of resources are available to help hospitals, CAHs, and REHs comply with these requirements.

“GOP lawmakers are hunting for ways to slash federal spending, a process that could mean cuts to Medicaid programs that support more than 3.1 million Pennsylvanians.” Mike Makosky, president and CEO of the Fulton County Medical Center, spoke to the USA TODAY Network about how the loss of federal dollars might undermine his hospital’s ability to provide health care in this rural southcentral Pennsylvania community.” Source: USA Today Network

With the rash of benefit thefts from consumers utilizing the Supplemental Nutrition Assistance Program (SNAP), the PA Department of Human Services is suggesting recipients change their EBT card pins ahead of their monthly benefit distribution. The theft of benefits rarely happens right away but thieves wait until the monthly distribution occurs to steal benefits. Recipients can call DHS’ EBT Recipient Hotline at 1-888-EBT-PENN or use the mobile app ConnectEBT to change their PIN numbers. Consumers are also urged to take extra steps to ensure that where they are utilizing their cards for point-of-sale transactions do not have skimming devices attached. Read here for more tips.

Health insurance coverage is vital for families’ health and well-being. The benefits of coverage are documented from birth into adulthood and help to keep households financially stable. However, adults and children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) often experience disruptions in their health coverage when they fail to meet regular plan renewal deadlines. States are exploring ways to prevent families from churning off and on Medicaid and CHIP roles. Read more.

The National Health Service Corps (NHSC) loan repayment programs help repay part of school loan debt in exchange for service in a medically underserved area. Did you know Community Health Centers are automatically approved sites for these programs? The 2025 application is now open, and interested clinicians can now access the Application and Program Guidance documents for the NHSC, Substance Use Disorder, and Rural Community loan repayment programs. The application deadline is May 1. Share this information with your clinicians and clinician candidates!

The Drug Enforcement Administration (DEA) and HHS published a final rule to further delay the effective date of the Expansion of Buprenorphine Treatment via Telemedicine Encounter and the Continuity of Care via Telemedicine for Veterans Affairs Patients rules finalized in January 2025. In February, the DEA announced an initial delay of effective date until March 21, 2025, and accepted public comments on the decision. The DEA states that due to questions of “fact, law, and policy” both rules are delayed until Dec. 31, 2025. While these rules are delayed, rural patients receiving buprenorphine via telemedicine without an in-person visit can still do so through Dec. 31, 2025, due to the temporary extension of flexibilities that are in place.

On March 18, 2025, the Department of Health and Human Services (HHS) Sec. Robert F. Kennedy, Jr., renewed the public health emergency (PHE) declaration for the national opioid crisis, extending key federal flexibilities for another 90 days. While opioid-related overdose deaths have declined by 25.5% over the past year, synthetic opioids like fentanyl remain the leading cause of drug-related fatalities, with 150 Americans dying daily from overdose. In rural areas, rates of drug overdose deaths are rising and have surpassed rates in urban areas. The PHE, first declared in 2017, allows HHS to maintain expanded authorities for data collection, demonstration projects, and research initiatives aimed at improving treatment access and coordination. Sec. Kennedy emphasized the Administration’s commitment to treating the opioid crisis as a national security emergency, continuing efforts to prevent substance use, reduce overdose deaths, and support recovery programs.