- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: CMS: Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Request for Information; Health Technology Ecosystem
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- State: 60-Day Notice of Proposed Information Collection: J-1 Visa Waiver Recommendation Application
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
New Report: Bank Branch Closures and Banking Deserts in PA, NJ, and DE
A new Philadelphia Fed report finds that the loss rate of bank branches in the Third District states of Pennsylvania, New Jersey, and Delaware more than doubled during the pandemic. Here are some of the highlights from the study.
- The three states combined experienced a net loss of 627 branches and a significant increase in the number of banking deserts, census tracts without nearby bank branches, during the pandemic.
- The number of lower-income, non-White, or rural banking deserts increased from six to 11 from 2019 to 2022.
- The share of low- and moderate-income (LMI) individuals living in banking deserts increased by 30 percent.
Increasing bank branch closures are a cause for concern, as banking deserts can limit opportunities for lower-income residents to improve their financial health and accrue wealth.
Read the report.
Looming Cuts to Emergency SNAP Benefits Threaten Food Security in Rural America
On a cold morning in early February, Tammy King prepared and loaded boxes and bags of vegetables, fruits, milk, frozen meat, and snacks into cars lined up outside the Friends in Service Helping food pantry, known in rural northeastern Nevada as FISH.
The beginning of the month is busy for the food pantry, King said, because people who receive benefits from the federal Supplemental Nutrition Assistance Program, known as SNAP, come to stock up on free food that helps them stretch their monthly allotments. The food pantry, one of a few in this city of about 20,000 people, serves more families now than at any point in King’s 20 years of working there, she said. In January, FISH provided food boxes to nearly 790 people.
But King and other food bank managers fear that demand will spike further in March, when officials roll back pandemic-era increases to SNAP benefits. The program, administered by the Department of Agriculture, provides monthly stipends to people with low incomes to spend on food. Before 2020, those payments averaged a little more than $200 and were hiked by a minimum of $95 during the pandemic.
Officials estimate families King works with will see a 30% to 40% decrease in SNAP payments as emergency allotments tied to the public health emergency halt in 32 states, including Nevada. Other states, such as Georgia, Indiana, Montana, and South Dakota, have already ended the emergency allotments.
The cuts to SNAP benefits will uniquely hurt people living in rural America, said Andrew Cheyne, managing director of public policy for GRACE, a nonprofit run by the Daughters of Charity of St. Vincent de Paul focused on reducing childhood hunger. A higher percentage of people depend on SNAP in rural areas compared with metro areas. And those areas already have higher rates of food insecurity and poverty.
“We have so many households who simply aren’t going to know that this is happening,” Cheyne said. “They’re going to go to the grocery store and expect to have money in their account and not be able to buy the food they need to feed their families.”
And as the fallout from those cuts hits, food pantry managers in rural areas find themselves on the front lines trying to fill gaps in their communities. They and food policy experts fear it won’t be enough. For every dollar worth of groceries a food bank distributes to a community, SNAP delivers $9.
Public Health Emergency (PHE) 1135 Waivers: Updated Guidance for Providers
On February 9, the Department of Health and Human Services (HHS) announced the Public Health Emergency (PHE) for COVID-19 will end on May, 11, 2023. COVID-19 remains a significant priority for the Biden-Harris Administration and over the next several months, the Centers for Medicare & Medicaid Services (CMS) will work to ensure a smooth transition. During the PHE, CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure easier access to care during the PHE for health care providers and their beneficiaries.
Some of the flexibilities that were created during the pandemic were recently expanded by the Consolidated Appropriations Act, 2023. Others, while critical during our initial responses to COVID-19, are no longer needed. CMS has made further updates to our CMS Emergencies Page with useful information for providers – specifically around major telehealth and individual waivers – that were initiated during the Public Health Emergency (PHE).
Please reference the following guidance in response to the PHE ending May 11, 2023:
Provider-specific fact sheets about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers
CMS COVID-19 Waivers and Flexibilities for Providers include:
- Physicians and Other Clinicians
- Hospitals and CAHs (including Swing Beds, DPUs), ASCs and CMHCs
- Teaching Hospitals, Teaching Physicians and Medical Residents
- Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities)
- Home Health Agencies
- Hospice
- Inpatient Rehabilitation Facilities
- Long Term Care Hospitals & Extended Neoplastic Disease Care Hospitals
- Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
- Laboratories
- Medicare Shared Savings Program
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies
- Medicare Advantage and Part D Plans
- Ambulances
- End Stage Renal Disease (ESRD) Facilities
- Participants in the Medicare Diabetes Prevention Program
- Intermediate Care Facility for Individuals with Intellectual Disabilities
Department of Health & Human Services Fact Sheet: https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html
In the coming weeks, CMS will be hosting stakeholder calls and office hours to provide additional information. Please continue to visit the CMS Emergencies Page for continuous updates regarding PHE sunsetting guidance as information becomes available to the public.
HRSA Makes $30 Million Available for Health Centers to Expand Early Childhood Development Services
Funding will help health centers provide recommended developmental screenings and follow-up services for children and further integrate early childhood development into care teams.
The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), announced the availability of approximately $30 million for HRSA-funded health centers to expand early childhood development care through increased screenings and follow-up services.
“HRSA-funded health centers are dedicated to meeting the unique needs of their communities – including providing key preventive services and care to help their youngest patients thrive,” said Administrator Carole Johnson. “This funding will strengthen and expand the availability of early childhood screenings and follow-up services that are vital for ensuring that kids get the support they need and have the tools to lead healthy, happy lives.”
Health centers provide essential preventive and primary care services to underserved communities across the country. Children undergo rapid physical, cognitive, linguistic, and emotional growth and development at this stage, and screening efforts help identify developmental or behavioral conditions, language delays, or other needs, such as food insecurity and housing instability, that can contribute to gaps in school readiness and impact a student’s ability to succeed.
Health centers that receive these awards will use the funding to strengthen their capacity to provide more children with recommended developmental screenings and follow-up services, including by developing the health center workforce necessary to deliver these services and focusing on the patient and caregiver experience.
Applications are due in Grants.gov on March 17, 2023 and in HRSA Electronic Handbooks on April 18, 2023. Visit the Early Childhood Development Technical Assistance Webpage for the notice of funding opportunity, technical assistance information, and other resources.
HRSA-funded health centers served 30 million people through nearly 1,400 health centers across the United States, collectively operating more than 14,000 service delivery sites in communities across the country.
To locate a HRSA-supported health center, visit: https://findahealthcenter.hrsa.gov/.
USDA Seeks Feedback from Broadband Technical Assistance Providers and Rural Communities
The Infrastructure Investment and Jobs Act (IIJA) (Pub. L. 117-58) provided the Rural Utilities Service (RUS) Telecommunications Program with funding for technical assistance and pre-development planning activities to support the most rural communities. RUS received additional funding for these purposes in the Consolidated Appropriations Act, 2023 (Pub. L. 117-328). RUS will host two listening sessions to solicit important feedback from rural communities interested in receiving broadband technical assistance and technical assistance providers serving rural communities.
Rural Communities interested in receiving broadband technical assistance are encouraged to register to attend the Broadband Technical Assistance for Rural Communities Listening Session on Thursday, February 23rd at 1 PM ET. Register for this session here.
The goal of this listening session is to solicit valuable insight into the challenges communities face in gaining broadband access, the types of technical assistance resources that would best serve these communities, and how RUS can best provide support.
Technical Assistance Providers interested in providing broadband technical assistance to support the most rural communities are encouraged to register to attend the Broadband Technical Assistance Providers Listening Session on Tuesday, February 28th at 1 PM ET. Register for this session here.
The goal of this listening session is to solicit input on the opportunities available to provide technical assistance for rural communities, the barriers to deliver these services, and how RUS can help providers overcome these barriers.
Contact
If you have any questions or issues, please complete the Contact Us Form.
Pennsylvania Dentists Discuss Oral Health During Children’s Dental Health Month
From WITF, On the Spark
According to the Centers for Disease Control, about 1 in 5 children between the ages of 5 and 11 have at least one untreated decaying tooth and children between the ages of 5 and 19 are twice as likely to have cavities if they come from low-income households.
According to the University of Illinois College of Dentistry, there is a connection between oral health and a person’s overall health and well-being.
February is Children’s Dental Health Month and Dr. LaJuan Mountain, vice president of dental services at Family First Health, and Dr. Sam Mansour, Pennsylvania Dental Association’s statewide national children’s dental health month chair, joined us on The Spark Thursday to discuss the importance of children’s dental health, the barriers to receiving dental care and ways to overcome them.
Dr. Mountain said, a healthy mouth consists of firm and pink gums and no disruptions or discoloration in the enamel. She also said, oral health is not the general consensus that she is seeing in our communities because of a lack of accessibility, high costs, insurance challenges, dentist office schedules, a lack of oral health literacy and more.
On The Spark we also discussed the Family First Health’s Mobile School Dentist program that provides in-school dental care for all ages and grade levels in York, Adams and Lancaster County.
“It’s having a tremendous impact. I’ve been doing this program for almost a decade and I’m actually seeing kids that I first started to treat in Head Start, and they’re now in junior high. So that means we’ve actually followed kids throughout their entire academic life thus far, and we’re seeing improvement,” Dr. Mountain said. “…We’re exposing them to the importance of their oral health, but also opportunities in health care, especially because the individuals we’re interacting with are often in that low socioeconomic environment.”
New Report: The Role of Telehealth in Achieving a High Performing Rural Health System: Priorities in a Post-Pandemic System
Telehealth usage increased during the Public Health Emergency (PHE), and this has fueled discussions on the optimum use of telehealth in healthcare delivery. Based on experiences during the PHE, and new applications of telecommunications technologies, this report assesses potential improvements in rural health service delivery, as well as potential unintended consequences that could undermine goals to improve services for currently underserved populations. The assessment is guided by the over-arching framework of the high-performing rural health system (HPRHS), to understand the benefits of telehealth in improving health equity as affecting four pillars of the HPRHS – access, affordability, community health, and quality.
Click here to open the full document.
Principal Authors: Joel M. James, MPH and Keith J. Mueller, PhD (Panel Chair)
Prepared by the RUPRI Health Panel: Alva O. Ferdinand, DrPh, JD; Alana D. Knudson, PhD; Jennifer P. Lundblad, PhD, MBA; A. Clinton MacKinney, MD, MS; Timothy D. McBride, PhD; Nancy E. Schoenberg, PhD
USDA Rural Development Launches the Rural Data Gateway Expanding Access to Data on USDA Funded Projects in Rural Communities
New integrated Rural Investment Dashboards make more than a decade of USDA Rural Development (RD) investment history instantly accessible to the public!
This uncomplicated interface allows users to sift through RD data gleaned from investments in rural housing, health care, broadband, businesses, infrastructure and much more. With its project-level county and congressional district data, the Rural Data Gateway opens a new chapter in RD’s ongoing commitment to investment transparency. To learn more, read the full news release.
New Policy Brief: Patient Transfers to and from CAHs During the COVID-19 Pandemic
A new policy brief is available on the Flex Monitoring Team website: Patient Transfers to and from Critical Access Hospitals During the COVID-19 Pandemic. In this brief, the Flex Monitoring Team describes the volume, barriers, and facilitators of inbound and outbound patient transfers as found in a survey of Critical Access Hospital CEOs.
Eight Pennsylvania Municipalities Solve EMS Crisis by Creating First-of-its-Kind Regional Municipal Authority
After a year-long cooperative process, eight municipalities in Pennsylvania have incorporated a first-of-its-kind regional municipal authority to address the region’s emergency medical services crisis.
The new Municipal Emergency Services Authority of Lancaster County will fund, manage and provide EMS services to member municipalities in northwest Lancaster County. It will be the first rate-setting regional municipal emergency services authority in Pennsylvania. The founding municipalities are Conoy Township, East Donegal Township, Elizabethtown Borough, Elizabeth Township, Marietta Borough, Mount Joy Township, Penn Township and West Donegal Township.
The path to forming the authority began in 2018, when municipalities in the northwest portion of Lancaster County were at a crossroads with the future of emergency medical services at risk.
Many EMS agencies are struggling to maintain services in the face of soaring costs, funding shortfalls and staffing challenges. Northwest EMS in northwest Lancaster County, which was recognized as Pennsylvania EMS Agency of the Year in 2020 by the Pennsylvania Emergency Health Services Council, was facing insolvency due to insufficient revenue and rising costs.
“Although Northwest EMS is widely known for outstanding service, less than half of municipal residents contribute to the organization through subscriptions,” said Marc Hershey, Elizabethtown Borough Council President and chair of the committee of municipal leaders who convened to address the local EMS crisis. “The average gap between gross billings and insurance payments was averaging over $4 million a year. And increasing expenses for equipment, fuel, certifications, trainings and employee benefits were taking a heavy toll. In short, municipalities in our region needed a bold solution to continue to meet their statutory obligation to ensure EMS readiness to answer the call.”
At the start of 2021, the committee began studying and exploring alternatives. Upon conducting a collaborative analysis, the committee arrived at an innovative solution: Creation of a regional municipal emergency services authority under the Pennsylvania Municipality Authorities Act to fund and provide EMS readiness and services on a regional basis.
Over a period of several months, the committee engaged in municipal public meetings, additional public education initiatives and a public hearing on the proposed solution. The process culminated in eight municipalities in the region enacting ordinances to form the Municipal Emergency Services Authority of Lancaster County. The authority was incorporated on February 7.
“This initiative demonstrates how municipal cooperation can solve regional problems,” said Rob Brady, president of ROBB Consulting and a consultant on the project. “Bringing municipalities together for a common regional cause is no small feat but, as a group, this committee of local leaders embraced a regional mindset to drive the process. Looking forward, the authority will enable each of the member municipalities to ensure that EMS services continue to be available with readiness to respond.”
The board of the authority consists of a representative from each of the authority’s founding municipalities. The board will be responsible for determining the authority’s services and fees.
Instead of generating operating revenue through municipal and membership contributions, the authority will set a reasonable and uniform annual fee to property owners, on par with Northwest EMS subscription rates. As a regional municipal entity, the authority will hold public hearings, enabling community members to have a voice regarding any changes to services or rates.
The authority will begin holding board meetings in March. A public hearing is expected to be held in late summer on the authority’s emergency services and fee structure. The authority plans to be operational and begin providing services by early 2024.
“It is our hope that the Municipal Emergency Services Authority of Lancaster County will serve as a model for other municipalities in Pennsylvania facing an EMS crisis,” Hershey said. “Paving a path to this solution took hard work, but there was never a question that a municipal-led solution was needed. EMS is an essential public service. As municipal leaders, we recognized that we not only needed to solve this problem to meet our statutory obligation. We needed to solve this together to potentially save the lives of our neighbors, family members and friends.”