- Rural Children Struggle to Access Hospital Services, Say Researchers
- Outlining the Intersection between Health Care and Missing and Murdered Indigenous People
- Biden-Harris Administration Announces Critical More Than $1.5 Billion State and Tribal Opioid Response Funding Opportunities
- RPHARM Program Fulfills Need for Rural Pharmacists
- Farmers Don't Do Mental Health
- A Pilot Program in Rural Vermont Hopes to Build a Blueprint for Substance Abuse Recovery
- Rural Telehealth Extension Reintroduced in Congress
- Students From Across the State Emphasized the Need for Mental Health Resources in Rural Alaska During a Conference
- The South Was the Center of Rural Population Growth Last Year
- How HHS SUD Confidentiality Regulations Will Impact Rural Providers
- VA Announces Expansion of "Close to Me" Cancer Program as Part of the Cancer Moonshot, Bringing Cancer Diagnosis and Treatment Closer to Thousands of Veterans
- Navajo Psychiatrist Bridges Gaps Between Native American Culture and Behavioral Health Care
- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Communities Face Primary Care Physician Shortage
Community-Based Health Care Centers to Receive $10 Million in State CARES Act Funding
Late on Thursday, May 28, lawmakers approved SB 1108, which appropriates a substantial portion of the $3.9 billion in federal CARES Act dollars appropriated to Pennsylvania, including $20 million to the Department of Health. Of the $20 million, $10 million is designated for community-based health care centers that receive HRSA grant funding and $10 million for vaccine research. PACHC does not have details yet on how and when the funds will be distributed. The language in the legislation clearly states that “a payment received under this section may only be used to cover necessary COVID-19 related costs, including, but not limited to, those not otherwise reimbursed by Federal, State or another source of funding incurred during the period between March 1, 2020, and November 30, 2020.”
The legislature also approved a five-month PA 2020-21 budget, HB 2387. The approved budget took the 2019-20 budget and cut each line item across the board by 60 percent to account for the five months, which will require lawmakers and the Governor during the next few months to figure out how to pay for the other seven months of 2020-21, along with any additional spending they might want or need to do in excess of the flat funding already approved. The 60 percent cut included the line item for the Primary Health Care Practitioner program. It is expected that both bills will be signed by the Governor.
Checklist & Principles to Reopen Healthcare
As stay-at-home restrictions are relaxed, healthcare organizations must strategically plan on how and when to reopen.
- The American Medical Association (AMA) resource, COVID-19: A Physician Practice Guide to Reopening, originally developed for physician practices, can also help health centers prepare to reopen during the COVID-19 pandemic. Strategies and recommendations include compliance with governmental guidance; development of a preopening plan; institution of patient and staff safety measures; a tele-triage program; process to screen patients before in-person visits and limiting non-patient visitors.
- The United Kingdom’s Academy of Medical Royal Colleges released a May 2020 report, Principles for Reintroducing Healthcare Services, outlining six principles for reopening healthcare services. These principles are designed to help increase patient confidence in the healthcare system’s ability to provide care while also decreasing the spread of COVID-19. The six principles address clear messaging to the public that stresses the need to seek medical help for serious conditions; providing the option to seek remote or virtual care when appropriate; utilizing a shared decision-making process; enabling staff to deliver safe, equitable and clinically prioritized care and supporting staff with training and education.
AHRQ COVID-19 Resources
The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the safety, quality, and value of patient care delivered by America’s health care system. AHRQ is providing guidance and resources in response to COVID-19, including a surge capacity planning tool for hospitals. Read more here.
CDC Guidance for COVID-19 Case Investigation and Contact Tracing
The Centers for Disease Control and Prevention (CDC) provide comprehensive guidelines for local health departments determining who has been diagnosed with an infectious disease and providing support to people (contacts) who may have been infected through exposure to the patient. Read more here.
CMS Updates: June 1, 2020
CMS Announces Final Payment Notice for 2021 Coverage Year
The final Notice of Benefit and Payment Parameters for the 2021 benefit year, also referred to as the 2021 Payment Notice, minimizes the number of significant regulatory changes to provide states and issuers with a more stable and predictable regulatory framework that facilitates a more efficient and competitive market. These changes further the Administration’s goals of lowering premiums, promoting program integrity, stabilizing markets, enhancing the consumer experience, and reducing regulatory burden.
To view the full press release, go to: 2021 Payment Notice Press Release.
To view the final rule, go to: 2021 Payment Notice Final Rule
To view the fact sheet on the final rule, go to: 2021 Payment Notice Fact Sheet
COVID-19 Federal Response
The federal government is taking action to protect the health and safety of our nation’s patients and providers in response to the coronavirus disease 2019 (COVID-19). There are a number of sources of information about actions being taken across the federal government.
- To keep up with the important work the White House Task Force is doing in response to COVID-19, visit White House Task Force.
- For the latest information about COVID-19 prevention, symptoms, and answers to common questions, visit up-to-date COVID-19 information.
- For information on the actions CMS is taking in response to COVID-19, please visit the CMS News Room and Current Emergencies Website.
- For COVID-19 Guidance for private health insurance issuers and group health plans, visit Coronavirus Disease 2019 (COVID-19) FAQs
- Please see the HealthCare.gov webpage for Marketplace-specific information, visit Marketplace-specific relating to COVID-19
The Center for Consumer Information and Insurance Oversight (CCIIO) COVID-19-Related Guidance
The Departments of Labor, Health and Human Services, and the Treasury issued guidance to implement requirements under the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) that generally require private health issuers and employer group health plans to cover COVID-19 testing, the administration of that testing, and certain related items and services. This coverage must be provided for items and services that are furnished on or after March 18, 2020, with no out-of-pocket expenses, prior authorization or medical management requirements for the duration of the applicable emergency period. Visit FFCRA and CARES Act FAQs for more information.
Prior to the FFCRA and the CARES Act, CMS released guidance that explains that essential health benefits (EHB) generally includes coverage for the diagnosis and treatment of COVID-19. However, the exact coverage details and cost-sharing amounts for individual services may vary by plan, and some plans may require prior authorization before these services are covered. This guidance remains relevant for any treatment related to COVID-19, as well as diagnostic testing received before March 18, 2020. Please visit EHB Coverage for COVID-19 for more information. As noted above, under FFCRA and the CARES Act private health issuers and group health plans must now cover diagnostic services at no cost and with no prior authorization or medical management requirements
In addition, the Departments provided plans and issuers flexibility to reduce or eliminate cost-sharing for telehealth services, even in cases when a consumer may not have met their deductible. For more information, visit telehealth FAQs.
Lastly, CMS released guidance on payment and grace period flexibilities associated with the COVID-19 outbreak. CMS will exercise enforcement discretion to permit issuers of QHPs and stand-alone dental plans (SADPs) to extend payment deadlines for initial binder payments as well as ongoing premium payments during the period of the COVID-19 national emergency. Visit payment and grace period for more information.
New Guidance on Extension of Timeframes for COBRA and Coverage Appeals
On April 28, 2020, a Department of Labor notice, jointly issued with the Department of the Treasury and Internal Revenue Service, extends certain timeframes affecting participants’ rights to healthcare coverage, portability, and continuation of group health plan coverage under COBRA, and extends the time for plan participants to file or perfect benefit claims or appeals of denied claims. These extensions provide participants and beneficiaries of employee benefit plans sponsored by private sector employers additional time to make important health coverage and other decisions affecting their benefits during the coronavirus outbreak.
CMS released a guidance document concurring with the disaster relief specified by the Department of Labor, the Department of the Treasury and Internal Revenue Service and encouraging states, non-federal governmental plans (such as state and local employee health plans) and issuers offering coverage in connection with a group health plan to enforce and operate, respectively, in a manner consistent with this relief.
For a link to the Department of Labor, Treasury and Internal Revenue Service notice, visit COBRA Timeframes. Visit EBSA guidance for other guidance related to group health plans. For CMS guidance, visit the CMS website.
Economic Impact Payments and Unemployment Benefits
The CARES Act calls for the IRS to make economic impact payments of up to $1,200 per taxpayer and $500 for each qualifying child. If consumers get one of these payments, they don’t need to include it in the income they report on their HealthCare.gov application. These payments don’t impact their eligibility for financial assistance for health care coverage through the Marketplace, or their eligibility for Medicaid or the Children’s Health Insurance Program (CHIP). For more information, visit IRS Coronavirus Tax Relief information.
Unemployment benefits, including the additional $600 per week payments in the CARES Act, are taxable income included in modified adjusted gross income (MAGI). The CARES Act exempted the $600 payment increase from income calculations for purposes of eligibility for Medicaid and CHIP, but did not exempt the $600 per week payment increase for purposes of eligibility for subsidies to purchase health insurance coverage through the Marketplace. Please instruct consumers to report all unemployment payments, including the $600 per week payment increase, on their Marketplace application.
Guidance on Marketplace Coverage and Coronavirus
For more information on topics relating to Marketplace coverage and COVID-19, please visit Marketplace coverage for COVID-19. This page provides information on the following situations:
- If I lost my job or experienced a reduction in hours due to COVID-19
- Coverage start dates with a Special Enrollment Period due to loss in coverage
- If I can’t pay my premiums because of a hardship due to COVID-19
- If I’m enrolled in a Marketplace plan and my income has changed
- If I previously qualified for a Special Enrollment Period, but missed the deadline because I was impacted by the COVID-19 national emergency
- If I want to change my current Marketplace plan or enroll for the first time
- If my child is now living with me after their college sent them home early
- If I get a direct deposit or check from the IRS that is called an economic impact payment
COVID-19 Partner Toolkit
CMS has developed a toolkit to help you stay informed on CMS and HHS materials available on the COVID-19. Please share these materials, bookmark the page, and check back often for the most up-to-date information. To listen to the audio files and read the transcripts for the COVID-19 Stakeholder calls, visit the Podcast and Transcripts page. The link to the toolkit and more resources is available at Coronavirus Partner Tool Kit page.
Guidance on Medicaid and CHIP Coverage and Benefits Related to COVID-19
Medicaid and CHIP programs cover a broad range of benefits, which may vary by state. Some benefits are mandatory which means states are required to provide them while other benefits are optional for states to provide. Visit benefits related to COVID-19 for more information. Specific questions regarding covered benefits should be directed to the respective state Medicaid and CHIP agency. More information is available by contacting your state.
COVID-19: Using the CR Modifier and DR Condition Code
CMS revised MLN Matters Special Edition Article SE20011 on Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) to clarify when you must use modifier CR (catastrophe/disaster related) and/or condition code DR (disaster related) when submitting claims to Medicare. The update includes a chart of blanket waivers and flexibilities that require the modifier or condition code.
RWJ: Five Principles to Help Communities Recover from COVID-19
As the United States reports over 100,000 deaths from the COVID-19 pandemic, some people-especially people of color, families with low incomes, and other marginalized communities-are suffering disproportionately. They are also the communities whose health could be hardest hit if states rush to reopen without a robust, fair plan.
If your state and local leaders are weighing how best to reopen and recover from the COVID-19 pandemic, consider five principles that we believe should be embedded in those decisions.
Read: 5 Principles to Help Communities Recover from COVID-19 >
Covid-19 Crisis Puts Pressure on Farmers’ Mental Health
By Natalie Krebs
Studies have found the rates of mental illness and suicide are higher for farmers. They work long hours, have limited social contact and are at the mercy of factors such as weather. Now the COVID-19 pandemic is creating even greater challenges to their livelihood—and mental health.
Coronavirus Is Coming for Wildland Firefighters. They’re Not Ready.
By Zoya Teirstein
Keeping wildland firefighting crews safe this year will require a significant shift in the way the country fights wildfires. So far, the changes haven’t materialized.
Rural Counties with Covid-19 Cases from Meatpacking Have Infection Rates 5 Times Higher
By Leah Douglas and Tim Marema
A one-of-a-kind data set shows the statistical relationship between meatpacking and the spread of Covid-19 in rural America. Information compiled by the Food & Environment Reporting Network shows how meatpacking counties have some of the highest infection rates in the United States.