The Centers for Medicare & Medicaid Services (CMS) recently published a new fact sheet summarizing the Medicare rules and regulations for Critical Access Hospitals (CAHs).  This latest version includes the revised CAH location requirement relative to other facilities to include areas with only secondary roads available and the requirement to inform the patient or the representative of their rights before starting or ending care and establish a grievance process.

 This month, the Substance Abuse and Mental Health Services Administration (SAMHSA) released the updated certification criteria for Certified Community Behavioral Health Clinics (CCBHCs), a model designed to ensure access to coordinated comprehensive behavioral health care. This new document follows from a draft version of SAMHSA released in December. SAMHSA also posted a summary of changes between the new criteria and the previous version and deadlines for implementation of the updated criteria. Currently, there are over 500 CCBHCs operating across the country, including some CCBHCs in rural areas.

  The Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment Advisory Commission (MACPAC) submit annual reports to Congress with analyses and recommendations from Commissioners on Medicare and Medicaid, respectively.  In their March report, MedPAC highlights Medicare and total operating margins for rural and urban hospitals and recommends a new Medicare Safety Net Index to identify safety net hospitals and direct payments to them.  MACPAC examines Medicaid’s Disproportionate Share of Hospital (DSH) payments to rural and urban hospitals.

  Among the key findings in this report from the University of Minnesota Rural Health Research Center: A higher proportion of urban adults (18.8 percent) live in crowded housing than rural adults (14.4 percent), with differences by race and ethnicity. Urban Hispanic adults have the highest proportion in crowded housing, followed by both rural Hispanic adults and rural American Indian adults.

  In January, the Federal Communications Commission (FCC) adopted an order and further notice of proposed rulemaking (FNPRM) (FCC 23-6) to amend Universal Service Rural Health Care (RHC) Program rules.  The order restored the method of calculating rural and urban rates as it existed before the adoption of the 2019 Rule and Order that created a rates database.  It also simplified invoicing procedures and altered priority rules if the program cannot fully fund all applications submitted.  The FNPRM sought comment on new application data collection plans to verify that the requested support is consistent with prevailing charges for similar telecommunications services in the area.  It also proposed capping support for satellite service at the level of terrestrial service, proposes changes to expedite new healthcare provider review, and proposed other changes to streamline the application process.  The order and FNPRM were published in the Federal Register on March 23, 2023, starting a 30-day public comment period (ending April 24, 2023) and a subsequent 30-day reply comment period (ending May 22, 2023) for people to comment on other filer’s comments.  Interested parties may comment in the Electronic Comment Filing System (ECFS) under WC Docket No. 17-310 at: https://www.fcc.gov/ecfs/filings/standard