Rural Health Information Hub Latest News

Pennsylvania Broadband Authority Releases BEAD Challenge

The Pennsylvania Broadband Development Authority (PBDA) has released the details of the BEAD Challenge process. Please visit the BEAD Challenge webpage for additional details to include registering for the BEAD Challenge portal, review the public map that identifies those areas deemed unserved, underserved, and statewide Community Anchor Institutions (CAIs). You can also watch the recording of the BEAD Challenge webinar that was held on March 29, 2024 and download the PowerPoint presentation used during the webinar.

The PBDA would like to remind eligible entities interested in submitting bulk challenges to consider requesting a license from CostQuest Associates. Tier D licenses are available here. Tier E licenses are available here. While a license is not required to participate and access the BEAD Challenge portal, it will help to simplify the submission of bulk challenges.

The timeline for the BEAD Challenge process is broken down into 3, 30-day windows which are as follows:

  1. Challenge Submission Period: Eligible entities will be able to submit challenge for 30 days. (April 24 – May 23)
  2. Rebuttal of Challenges: Entities that have been challenged will have 30 days to respond (May 24 – June 22)
  3. Final Determinations: The PBDA will decided if challenges and rebuttals are valid or not within 30 days (June 23 – July 22)

As a reminder, the PBDA will be holding three Office Hour Sessions, please click on each below to obtain additional details and to register.

Please don’t hesitate to reach out with questions to PABroadbandAuthority@pa.gov.

New Report: Race and Ethnicity May Affect Where Hospitals Transfer Patients

A new study in #HSR @WileyHealth examines racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences.

Black transfer patients were more likely to be transferred to public hospitals compared with White patients in most models tested. For instance, Black transfer patients were 0.5–1.3 percentage points (pp) more likely to be transferred to public hospitals than White patients treated in the same hospital with the same payer. In comparison, Hispanic transfer patients were − 0.6 pp to −1.2 pp less likely to be transferred to public hospitals than White patients treated in the same hospital with the same payer.

This study suggests large population-level differences in whether ED patients of different races/ethnicities were transferred to public hospitals were largely explained by hospital market and the initial hospital, suggesting that these factors may play a larger role in explaining differences in transfer to public hospitals, compared with other external factors.

The study authors include Charleen Hsuan JD PhDDavid J. Vanness PhDAlexis Zebrowski PhDBrendan G. Carr MDEdward C. Norton PhDDavid G. Buckler MSYinan Wang MPPDouglas L. Leslie PhDEleanor F. Dunham MD, MBA, and Jeannette A. Rogowski PhD.

Find more details about the article here.

Getting Connected with the Future Workforce

Last week, the Pennsylvania Workforce Development Association reinstituted their annual NextGen Youth Summit after a five-year hiatus to help Pennsylvania youth program providers collaboratively discover new opportunities for youth and young adults entering the workforce. Caitlin Wilkinson, Co-Director of the Pennsylvania Primary Care Career Center, represented PACHC and made some exciting new connections with the attendees that could lead to innovative collaborations that will help address Community Health Center workforce needs. Over the next few weeks, Caitlin will be meeting with these new connections but is happy to discuss individual health center needs or ideas in the meantime.

HRSA Names New Pharmacy Director

The Health Resources and Services Administration (HRSA) has announced Chantelle Britton as Director of the Office of Pharmacy Affairs (OPA) within the Office of Special Health Initiatives (OSHI). Britton will provide strategic leadership and oversight for the 340B Program and will guide OPA’s overall policy and implementation work. Britton has served as Acting Director of OPA since December 2023. She brings deep knowledge and experience with the 340B Program, drug pricing issues, health policy, access to care issues, safety-net programs, and HRSA’s federal and external partners to the permanent role. Prior to her appointment as Acting Director, Britton served for eight years as Senior Advisor in the Office of the Director of OPA.

2024 State of Medicaid Managed Care Report Released

Pennsylvania’s mandatory Managed Long Term Services and Supports (MLTSS) program, Community HealthChoices (CHC), was developed to enhance access and improve coordination of medical care. The Department of Human Services administers the Community HealthChoices program and is committed to increasing opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. Individuals 21 or older with Medicare and Medicaid may qualify for the CHC program. Pennsylvania’s CHC program was highlighted in this 2024 report.

2025 Medicare Advantage and Part D Final Rule Seeks to Protect Patients

Last week, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized policies that continue to strengthen enrollee protections and guardrails to ensure Medicare Advantage (MA) and Medicare Part D prescription drug plans best meet the needs of people with Medicare. This final rule also promotes healthy competition, increases access to care, and protects enrollees from harmful marketing by limiting the distribution of personal beneficiary data by Third-party marketing organizations and ensures that MA organizations analyze their utilization management (UM) policies and procedures from a health equity perspective. The Medicare statute requires that CMS establish guidelines to ensure that the use of compensation creates incentives for agents and brokers to enroll individuals in the MA or Part D plan intended to best meet the prospective enrollee’s health care needs. However, excessive compensation, and other bonus arrangements offered by plans to agents and brokers can result in individuals being steered to some MA and Part D plans over others based on the agent or broker’s financial interests, rather than the prospective enrollee’s healthcare needs. Additionally, the final rule generally prohibits contract terms between MA organizations/Part D sponsors and middleman Third Party Marketing Organizations (TPMOs), such as field marketing organizations, which may directly or indirectly create an incentive to inhibit an agent or broker’s ability to objectively assess and recommend the plan that is best suited to a potential enrollee’s needs. For more, see the final rule.

CMS Releases Updates FQHC/RHC Guidance, Including Telehealth

In mid-March, the Centers for Medicare and Medicaid Services (CMS) announced that they had updated their Medicare Learning Network (MLN) booklets for federally qualified health centers (FQHCs), rural health clinics (RHCs) and mental health services. The Medicare MLN booklets explain national Medicare policies on coverage, billing and payment rules for specific provider types. The telehealth related changes incorporate the extensions to pandemic telehealth flexibilities made by the Consolidated Appropriations Act (CAA), 2023, as well as changes to policy that were made in the 2024 Final Physician Fee Schedule. The major telehealth changes for the FQHC/RHC booklets include:

  • An allowance for FQHCs and RHCs, starting Jan. 1, 2024, to bill remote physiologic monitoring (RPM), remote therapeutic monitoring (RTC), community health integration (CHI), principal illness navigation (PIN), and PIN-Peer Support (PIN-PS) by billing the general care management code, 0511. Previously, remote monitoring was considered bundled under the FQHC/RHC’s all-inclusive rate and not reimbursed separately at all.
  • The booklet now specifies that FQHCs/RHCs can provide mental health visits using interactive, real-time telecommunication technology. However, the in-person visit mandated by the CAA, while currently waived, will go into effect Jan. 1, 2025.

Pennsylvania Issues RFA for Enrollment Assister Program

The Pennsylvania Department of Human Services (DHS) issued a Request For Application (RFA) procurement for an Enrollment Assister Program to provide enrollment, outreach and educational services to Physical HealthChoices and CHIP consumers statewide. The duration of the procurement is for three years with one additional two-year option. The application deadline is April 23, 2024. The current vendor for the program is Maximus.

State Medicaid Rolls Shed 500,000 People after COVID-Inspired Rule Change Ended

One year after the enrollment requirements were reinstated, Pennsylvania’s Medicaid program has dropped about half a million people, going from a record high of 3.7 million participants to 3.2 million as of February, according to state data. Now, state and local officials are examining their efforts to keep people enrolled in health insurance during this transition phase as they make plans to improve the renewal process going forward. State officials said they launched proactive outreach and awareness campaigns to prepare people for the reinstated renewal requirements by sending multiple messages through email, text and postal mail. They wanted to limit the various kinds of challenges people could face when reapplying, officials said, especially for those who had never gone through a renewal process before. Click here to learn more.

GAO Releases Report on Health Centers

The Government Accountability Office (GAO) has released a report: “Health Centers: Revenue, Grant Funding, and Methods for Meeting Certain Access-to-Care Requirements” that highlights how Community Health Center revenue increased from $26.3 billion in 2017 to $42.9 billion in 2022. Senate HELP Committee Ranking Member Bill Cassidy, M.D. (R-LA) and House Energy and Commerce Committee Chairwoman Cathy McMorris Rodgers (R-WA) released a misleading statement about the report. Their press release emphasizes – in both the title and text – that health center total revenues increased by 60% between 2018 and 2022. The report is accurate, but fails to emphasize the reasons why health center funding has increased, including:

  • Medicaid Enrollment Increases. Higher Medicaid enrollment led to higher Medicaid reimbursement. Seven states expanded Medicaid during this time period adding about 2.8 million additional patients.
  • Temporary Funding Increases. A significant portion of the increased funding was temporary COVID-19 emergency funding that has now expired.
  • Patient Volume Increases. Importantly, health centers are now serving 2 million more patients since 2017, increasing revenue.
  • Inflation. The report does not adjust the revenue increases for inflation.

What the report doesn’t discuss is that the Medicaid Unwinding that started in 2023 has led to significant financial challenges for health centers; a recent NACHC survey found an average $600,000 loss per health center as a result of the unwinding. In addition, following expiration of the temporary pandemic funding, high inflation and workforce shortages are leaving health centers financially insecure. NACHC has released a statement providing additional context to media outlets and will provide resources to educate Hill offices about the financial pressure health centers face.