– Comment by September 9. This proposed rule from the Centers for Medicare & Medicaid Services (CMS), issued on July 10, 2024, seeks public comment on payment updates and policy changes to Medicare’s physician fee schedule payments and includes other proposals affecting Medicare and Medicaid beneficiaries. Proposals include payment for both in-person and virtual caregiver training services, permitting certain health care providers to provide virtual direct supervision to auxiliary personnel when required, temporary extension of virtual supervision of residents by teaching physicians in certain cases, permitting Opioid Treatment Programs (OTPs) to furnish periodic assessments using audio-only communications technology when video is not available on a permanent basis, and the return of statutory restrictions on geography, site of service, and practitioner type for non-behavioral health telehealth services. The proposed rule also includes proposed updates applicable to Rural Health Clinics (RHCs), including to allow RHCs to bill for administration of part B preventive vaccines at time of service, continue to require provision of primary care services but no longer enforce “primarily engaged in furnishing primary care services,” seeks comment on how to define “mental diseases” as related to the requirement that RHCs cannot be “primarily engaged in the treatment of mental diseases,” and to eliminate productivity standards. The rule also includes updates to the Quality Payment Program, Medicare Shared Savings Program, and several other proposals affecting RHCs including removal of hemoglobin/hematocrit from the six required lab services and permitting RHCS to bill individual HCPCS care management codes instead of G0511. In addition, coverage for necessary dental exams and procedures are being considered for certain treatment services and expansion of colorectal cancer screenings to promote better access for all beneficiaries is being proposed.

This infographic from the University of Minnesota Rural Health Research Center provides a snapshot of rural-urban differences in midwife-attended births, including changes over time as access to rural obstetric care declined and severe maternal morbidity and mortality rose across the United States.

For the expansion of existing approved residency programs and the establishment of newly approved residency programs. This program trains physicians and dentists in community-based settings with a focus on rural and underserved areas, providing the majority of training in community-based outpatient settings where most people receive their health care. The NOFO has two components: one to support residency slots starting in Academic Year (AY) 2024-2025 and another to support residency slots starting in AY 2025-2026. You must apply to the announcement number that corresponds to the specific academic year and NOFO number.

Academic Year 2024-25 (HRSA-25-091)–Application due September 5, 2024 11:59 p.m. ET.

• Eligible applicants: Teaching Health Center Planning and Development grant recipients and other programs that have filled positions in the 2024 residency match process but have not received THCGME funding from HRSA.
• Award: $10 million to up to six grantees over a period of four years.

Academic Year 2025-26 (HRSA-25-077)–Applications due September 20, 2024 at 11:59 p.m. ET.

• Eligible applicants: Current teaching health centers, Teaching Health Center Planning and Development grant recipients who have obtained accreditation, and other programs who are planning to be accredited and train, starting July 1, 2025, are eligible to apply. Funding for these new slots will depend on congressional appropriations.
• Award: $80 million to 41 grantees over a period of four years.

The Association of State and Territorial Health Officials (ASTHO) explains policy and programs from HRSA’s Bureau of Health Workforce that state-level policymakers can use to address shortages in rural areas.

Family First Health, a federally qualified health center in Central Pennsylvania has partnered with Bro2Go to create the “Get Healthy” initiative to provide health and social services to formerly incarcerated citizens. Health services will include assistance with enrolling in and navigating insurance, free blood pressure screenings, rapid HIV testing, and education on health and nutrition. Read more.

You can improve staff satisfaction, retention, and resilience by executing a customized workforce well-being strategy. Join the Bureau of Primary Health Care for this webinar to learn about a practical tool that can hone your strategy. The speakers will also explore a real-life scenario that illustrates how to use the tool. Wednesday, July 24, 2:00-3:00 pm.

On June 13, 2024, the Centers for Disease Control and Prevention (CDC) released a Health Alert Network (HAN) regarding the U.S. Department of Justice announcement of a federal health care fraud indictment against a large subscription-based telehealth company that provides attention-deficit/hyperactivity disorder (ADHD) treatment to patients ages 18 years and older across the United States. Patients whose care or access to prescription stimulant medications is disrupted, and who seek medication outside of the regulated healthcare system, might significantly increase their risk of overdose due to the prevalence of counterfeit pills in the illegal drug market that could contain unexpected substances, including fentanyl. In addition to concerns about using illegally acquired stimulant medications, untreated ADHD is associated with adverse outcomes, including social and emotional impairment, increased risk of drug or alcohol use disorder, unintentional injuries, such as motor vehicle crashes, and suicide. Health officials and healthcare providers may need to assist affected patients seeking treatment for ADHD and should communicate overdose risks associated with the current illegal drug market as well as provide overdose prevention education and mental health support. More information is available.

The DHS (Department of Human Services) Medicaid team recently updated the MCOs by region and which PH MCOs contract with which Dental and Vision MCOs. DHS also updated the contact information for the HealthChoices/Community HealthChoices/Behavioral MCOs as of July 2024. Click here for additional HealthChoices general information. Click here for additional Behavioral HealthChoices general information.

The Centers for Medicare and Medicaid Services (CMS) have issued a proposed rule, or Notice of Public Rulemaking, that could create exceptions to the existing four walls requirement for Indian Health Service (IHS)/Tribal clinics, behavioral health clinics, and clinics located in rural areas. The official language posted to the federal register can be found on page 15 and is below.

“This proposed rule includes a proposal to create exceptions to the Medicaid clinic services benefit four walls requirement, to authorize Medicaid payment for services provided outside the four walls of the clinic for IHS/Tribal clinics, behavioral health clinics, and clinics located in rural areas. Our current regulation at 42 CFR § 440.90(b) includes an exception to the four walls requirement under the Medicaid clinic services benefit only for certain clinic services furnished to individuals who are unhoused. We believe these proposed exceptions would help maintain and improve access for the populations served by IHS/Tribal clinics, behavioral health clinics, and clinics located in rural areas.”

As a reminder, this is a proposed rule intended to announce and explain CMS’ plan to address the problem. As such, all proposed rules must be published in the Federal Register to notify the public and to give them an opportunity to submit comments. The proposed rule and the public comments received on it form the basis of a final rule. Interested parties should provide public comment on this proposed rule to the addresses listed in the federal register by Sept.9, 2024. While CMS works through this process, the Office of Mental Health and Substance Abuse Services (OMHSAS) continues to work toward a more immediate solution for Pennsylvania providers. Reminder, FQHCs are not required to comply with the four walls requirement.