- CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- Public Inspection: CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Announcing the 2030 Census Disclosure Avoidance Research Program
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization 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
HRSA Makes Awards for the Rural Residency Planning and Development Program (RRPD)
The Health Resources and Services Administration (HRSA) awarded $6.7 million to support the creation of new accredited and sustainable rural residency programs to expand the physician workforce in rural areas. The RRPD program is a multi-year collaborative initiative between HRSA’s Federal Office of Rural Health Policy (FORHP) and Bureau of Health Workforce (BHW) to increase physician training opportunities in rural communities and focus on improving access to high quality health care providers. The incoming RRPD cohort will collaborate with the RRPD-Technical Assistance Center throughout the duration of their three-year grant.
To learn more about the RRPD-TA center, please visit www.RuralGME.org.
President Signs Executive Order on Promoting Competition in the American Economy
President Biden signed an executive order (EO) titled ‘Executive Order on Promoting Competition in the American Economy.’ According to the release, the President signed the EO with the hopes of building on recent economic momentum to further promote and encourage competition in the American economy. The President hopes the EO will help lower prices for families, increase wages for workers, and promote innovation and spur up faster economic growth.
The full text of the EO can be accessed here, and the National Rural Health Association has highlighted a few prominent health care provisions in the text, below.
The President used this executive order to address his concerns within the prescription drug industry. The order directs the Food and Drug Administration (FDA) to work with states to import prescription drugs from Canada, directs the Department of Health and Human Services (HHS) to increase support, production of generic and biosimilar drugs, and direct HHS ban “pay for delay” procedures brand-name manufacturers use to keep generic manufacturers out of the market.
Most notably, the EO focuses in on hospital consolidation and their impacts, particularly those in rural America. In the EO, the President encourages the Justice Department and the Federal Trade Commission (FTC) to review and revise their merger guidelines. Further, the EO directs HHS to support existing hospital price transparency rules and complete the implementation of surprise medical billing rules.
ARC Issues RFP for Education and Workforce Development Projects
The Appalachian Regional C0mmission (ARC) has issued a request for proposals from consultants to assess the extent to which ARC’s education and workforce development grants have contributed to the achievement of ARC’s strategic goals.
ARC funds approximately 500 grants a year, approximately 20% of which include investments that support educational opportunities and institutions. Education and workforce development grants support skill development and workforce training for students and adults with the aim of creating a seamless system enabling Appalachians to succeed in existing industries, expanding options for workers transitioning into different sectors, and encouraging innovation for future opportunities.
How to Apply!
Proposals should be submitted as one Word or PDF file to Regina Van Horne (rvanhorne@arc.gov), Program Evaluator Division of Research & Evaluation, by 5:00 PM Eastern Time on August 9, 2021.
New America’s Health Rankings Report Released
The United Health Foundation launched a new America’s Health Rankings report, which provides a deep dive into health disparities data in the United States. The inaugural report builds on over 30 years of data to provide a comprehensive portrait of the breadth, depth, and persistence of disparities across the nation.
Office of Minority Health Announces $250 Million in Grant Awards for Health Literacy and Equity in COVID-19 Services
The HHS Office of Minority Health (OMH) has announced $250 million in grant awards to 73 local governments as part of a new initiative to identify and implement best practices for improving health literacy to enhance COVID-19 vaccination and other mitigation practices among underserved populations. Over the next two years, awardee projects will demonstrate the effectiveness of working with local community-based organizations to develop health literacy plans to increase the availability, acceptability, and use of COVID-19 public health information and services by racial and ethnic minority populations.
CDBG-CV Broadband Quick Guide Now Available
From the HUD Exchange
The CDBG-CV Broadband Quick Guide is a user-friendly tool that summarizes some of the ways Community Development Block Grant CARES Act (CDBG-CV) grantees can help narrow the digital divide through the provision of broadband infrastructure and services to communities in need due to coronavirus. The Guide provides an overview of the potential uses of CDBG-CV for broadband access under the criteria for eligible activities and national objectives in the Community Development Block Grant (CDBG) regulations as well as Federal Register Notice FR 6218-N-01, including:
- Broadband Infrastructure
- Emergency Payments
- Housing Activities
- Economic Development
- Digital Training and Education Support
- Planning and Administration
The Quick Guide also provides examples of how a national objective can be met for CDBG-CV eligible activities and several models for broadband expansion in both urban and rural communities with CDBG and other federal resources.
Supreme Court Agrees to Hear Hospital Lawsuit Challenging HHS’ 340B Cuts
Fierce Healthcare
The Supreme Court agreed to hear a major dispute between the hospital industry and the federal government over cuts to 340B hospitals.
The court agreed to hear the case during its next term that begins in October, according to an order list released on Friday. A decision could be rendered sometime next year.
The case called American Hospital Association v. Becerra centers on the Medicare reimbursement rate paid for outpatient drugs and whether the Department of Health and Human Services singled out 340B-covered entities.
HHS traditionally set reimbursement rates for drugs based on the average sales price and applied it across all hospital groups. But the lawsuit said that practice changed in 2018 when HHS singled out 340B hospitals, the lawsuit argues.
HHS argued that the cuts were to ensure that Medicare payments were more aligned with the costs expended by the hospital to acquire the drug, which would be lower for a 340B hospital.
The agency has argued it had broad statutory authority to adjust drug payments. A legal challenge from hospital groups followed, but an appellate court found that HHS had the authority to make the cuts.
AHA cheered the Supreme Court’s decision, arguing that the cuts have had an adverse impact on patients.
“We are hopeful the court will reject the appellate court decision deferring to the government’s interpretation of the law that clearly imperils the important services that the 340B program helps allow eligible hospitals and health systems to provide to vulnerable communities,” said Melinda Hatton, general counsel for the AHA, in a statement.
How A Fire Department Funding Model Could Preserve Rural Emergency Departments And Quality Emergency Care
Health Affairs, Commentary, June 14, 2021
Nearly 60 million rural Americans depend on local hospitals and their emergency departments (EDs) when serious (for example, trauma, stroke, heart attack) and potential (for example, chest or abdominal pain) emergencies occur. Yet, since 2010, 136 small and rural hospitals have closed. The COVID-19 pandemic accelerated this trend, with a record 20 new hospital closures in 2020 and many more at risk. Mortality worsens when hospitals close because of reduced access to the life-saving skills of emergency physicians and the hospitals where they work.
Recent policy initiatives have attempted to address rural hospital closures. Some Pennsylvania rural hospitals and all Maryland hospitals are funded through global budgets. Starting in January 2023, a new rural emergency hospital (REH) designation will allow rural critical access hospitals to convert to an REH and receive fixed payments to support infrastructure and a 5 percent increase in fee-for-service payments in return for maintaining an ED and specified outpatient services. A weakness of these models is that they focus on supporting the hospital facility alone. None ensure sufficient resources to pay for the 24/7/365 on-site emergency physician, plus some level of surge capacity, needed to provide ED patient care.
To understand why rural and small hospitals struggle to maintain high-quality emergency physicians in their EDs, it is important to describe the economics of ED staffing and how the COVID-19 pandemic changed those economics for the worse. Pre-pandemic, a delicate balance of volume, complexity, and payer-mix supported ED staffing with fee-for-service payments. Some visits reimbursed well and required few resources (for example, privately insured, low acuity). For other visits (for example, Medicare, Medicaid, high acuity, and uninsured), reimbursement did not cover costs. Medicaid expansion under the Affordable Care Act reduced uninsured visits but has been no panacea. Medicaid expansion replaces unreimbursed visits by uninsured patients but only with well-below-cost Medicaid rates. Expansion also generates payer crowd-out: Some visits, previously well-reimbursed by commercial insurance, become low-paying Medicaid visits.
No Surprises – Protecting Patients from Surprise Medical Bills
The Biden-Harris Administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise billing happens when people unknowingly get care from providers that are outside of their health plan’s network and can happen for both emergency and non-emergency care. Balance billing, when a provider charges a patient the remainder of what their insurance does not pay, is currently prohibited in both Medicare and Medicaid. This rule will extend similar protections to Americans insured through employer-sponsored and commercial health plans.
“No patient should forgo care for fear of surprise billing,” said HHS Secretary Becerra. “Health insurance should offer patients peace of mind that they won’t be saddled with unexpected costs. The Biden-Harris Administration remains committed to ensuring transparency and affordable care, and with this rule, Americans will get the assurance of no surprises.”
The full press release with embedded links to fact sheets and the interim rule can be accessed here.
Research: Rural Pennsylvania Suicide Rates Are Rising
According to a study funded by the Center for Rural Pennsylvania, between 1999 and 2018, suicide rates across the state significantly increased. In 2018, the researchers said, the suicide rate in rural areas of the state was 25% higher than in urban areas.
While the study of suicides showed that the rate is higher in rural areas, those numbers may be even higher still, researchers said.
While the study didn’t specifically address the causes of the discrepancy in suicide rates in urban and rural areas, it did look at some of the indicators of higher suicide rates.
Higher numbers of handgun sales per 1,000 residents, lower levels of education, lower incomes, larger populations over age 65, and higher levels of unemployment all correlate with higher county suicide rates, the study found.
“In terms of our particular report, we are not able to deduce exactly why those rates have been increasing,” said Dr. Daniel Mallinson, one of the study’s authors. “But others whose work has looked at that…they’ve been able to gather some quantitative evidence on that. For instance, there’s been a rise of deaths of despair, particularly in rural areas in the US, and not just in suicides but also in overdoses and alcohol-related deaths.”
The researchers connected these deaths of despair to the loss of quality of life and less economic opportunities, which have had “substantial impacts on people’s lives directly and on people’s resources but it also has damaged or undermined communities and families.”
Beyond the quality of life issues, according to the National Advisory Committee on Rural Health and Human Services, rural areas also tend to be at higher risk due to limits in the “accessibility, availability, and acceptability of mental health care services.”
Rural counties tend to have smaller ratios of mental health providers per capita. For instance, in Sullivan County, Pennsylvania, there are only 16 mental health providers per every 100,000 people, according to the Pennsylvania Department of Health. Compare that to Montgomery County, Pennsylvania, with 333 mental health providers per 100,000. And 23 of the 24 Health Professional Shortage Areas in Pennsylvania, identified by the U.S. Health Resources and Services Administration as areas that have a shortage of healthcare professionals, are rural areas of the state.