- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- 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: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- 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
Updated COVID-19 Funding Sources Impacting Rural Providers Released
The Technical Assistance and Services Center (TASC), in coordination with the Federal Office of Rural Health Policy (FORHP), are pleased to provide an update of the COVID-19 Funding Sources Impacting Rural Providers guide. This funding resource is intended to support rural health care providers, along with their state and local partners, navigate the availability of federal funds to support the novel coronavirus (COVID-19) pandemic response and recovery efforts. This guide is updated regularly to capture changes in funding sources.
Seven tables, or matrices, are provided for quick reference at the beginning of this resource. The tables can be used to check eligibility of participation in funding sources by provider types: rural prospective payment system (PPS) and critical access hospitals (CAH), rural health clinics (RHC), federally qualified health centers (FQHC), long-term care (LTC) or skilled nursing facilities (SNF), tribal facilities, and emergency medical services (EMS). The tables also provide an at-a-glance view for each provider type sharing the different types of funds that may be accessed from various funding sources dependent on their participation eligibility. Each funding source is described in its own section of this resource with an executive summary followed by further detail on the use of funds, reporting requirements, hyperlinks to the legislation and detailed information.
The guide can be found in COVID-19 Collection located on The National Rural Health Resource Center’s website. This collection consists of trusted and reliable resources, such as the COVID-19 Funding Sources Impacting Rural Providers Guide, along with standing links to additional organizations’ COVID-19 resources, FAQs, webinars, tools, and trainings. The Center aims to help direct the most up-to-date and relevant tools and resources to rural hospitals, clinics, and their communities. This Collection will be updated regularly to help assist with the abundance of circulating information relating to COVID-19.
Rural U.S. Hospitals Are on Life Support as a Third Wave of COVID-19 Strikes
Time Magazine
When COVID-19 hit the Southwest Georgia Regional Medical Center in Cuthbert, a small rural town in Randolph County, in late March, the facility—which includes a 25-bed hospital, an adjacent nursing home and a family-medicine clinic, was quickly overwhelmed. In just a matter of days, 45 of the 62 nursing home residents tested positive. Negative residents were isolated in the hospital while the severely ill patients from both the nursing home and the local community were transferred to other better-equipped facilities.
“We were trying to get the patients out as fast as possible,” says Steve Whatley, Southwest Georgia Regional’s board chairman. “It was a daily nightmare.”
The scramble was exacerbated by a dire lack of medical necessities. Employees had to diligently conserve personal protective equipment. The hospital had no ventilators. And the nursing home’s air systems had to be retrofitted to create negative-pressure rooms to contain the airborne virus particles. Making matters even worse, one of the county’s only two physicians became ill with a severe respiratory disease unrelated to the coronavirus, while the other had an unexpected surgery requiring eight weeks of recovery time. Nurse practitioners stepped up as Southwest Georgia Regional waited for backup from neighboring health care organizations. More than 30 of 200 employees stopped working out of fear or because they got sick; the state of Georgia provided six nurses and two respiratory therapists as emergency relief. Despite the heroic efforts of the center’s staff, more than a dozen nursing home residents died within eight weeks of the virus’ arrival, though it’s unclear how many were directly due to COVID-19.
The ordeal left Southwest Georgia Regional—which was already struggling to survive—in financial shambles, as costs related to the coronavirus greatly exceeded revenues. It will permanently close on Oct. 22, making it the seventh Georgia hospital to do so since 2010. After Southwest Georgia Regional closes, Randolph County will become the 55th in the state to have no hospital at all. Residents will need to drive 30 minutes west and across the state line to Eufaula, Ala. or 50 minutes east to Albany, Ga. for care.
The middle of a pandemic is a bad time for a hospital to close. Yet Southwest Georgia Regional isn’t unique. Hospitals in St. Paul, Minn., Chicago, Houston and Philadelphia have recently closed or are set to do so soon. And in rural areas of the country, where hospitals often have enough beds for just a few dozen patients, 15 facilities have shuttered this year as of Oct. 20, including 11 since March, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill. There may be as many as 18 such closures in 2020, topping last year’s record high. The hospitals in the worst financial shape generally have one thing in common: they serve the country’s most vulnerable people, who rely on Medicare and Medicaid or who are poor and uninsured.
HHS Expands Relief Fund Eligibility and Updates Reporting Requirements
This afternoon, HHS through HRSA announced the latest Provider Relief Fund (PRF) application period had been expanded to include provider applicants such as residential treatment facilities, chiropractors, and eye and vision providers that have not yet received PRF distributions. Further, HHS also updated its September 19, 2020, Frequently Asked Questions (FAQ) document clarifying purposes of relief payments and loss revenues.
Community Health Centers Sue HHS to Install Method to Handle 340B Violations After Drugmaker Feud
FIERCE Healthcare
An association representing community health centers is suing the Department of Health and Human Services (HHS), seeking help in combating drug manufacturers that are refusing to give their products to 340B contract pharmacies.
Filed last week in the U.S. District Court for the District of Columbia by the National Association of Community Health Centers, the lawsuit is the latest salvo in an escalating feud over the 340B drug discount program. The centers want HHS to install a dispute resolution process to give 340B entities a pathway to remedy program violations.
The lawsuit comes after several drug companies announced they won’t provide 340B-discounted products to contract pharmacies, third-party entities that are hired by a 340B entity to dispense the drugs.
Data Show More Than 539,000 Confirmed COVID-19 Cases in Appalachia
Appalachia reached two grim milestones last week when the Region recorded 500,000 confirmed COVID-19 cases and 10,000 covid-related deaths. From March 6, 2020, COVID-19 cases increased at a gradual pace. In the past few months, the number of confirmed cases increased faster, and has continued to increase every day since October 2. This week, Appalachia set a new record high for the seven-day rolling average of new daily cases with 5,062 on October 20th. The seven-day average of new daily cases was 4,425 a week ago and 3,805 two weeks ago.
The seven-day rolling average of new daily deaths stands at 68 per day, up from 60 a week ago and 53 two weeks ago. As of 11:30am today, October 22, 2020, there were 545,567 cumulative cases throughout Appalachia and 10,666 cumulative deaths in 383 of Appalachia’s 420 counties.
For more information on the coronavirus in Appalachia, visit here.
New Report Estimates How Many Households May Be At Risk of Eviction Because of the COVID-19 Pandemic
COVID-19 and associated economic shutdowns have led to unprecedented job losses and concerns about how households will pay rent while unemployed and make up for missed payments once reemployed. While the CDC has temporarily halted evictions until December 31, 2020, accrued rental debt will put many households at risk of eviction once the moratorium expires. Household Rental Debt During COVID-19 provides new estimates of the number of households with rental debt, and the amount of debt owed, resulting from pandemic-related job losses.
Key findings:
- As a result of pandemic-related job losses, we estimate that by December 2020, 1.3 million renter households will owe $7.2 billion in rent, which is around $5,400 each. These 1.3 million households contain 3.9 million individuals: 2.8 million adults and 1.1 million children. This is in addition to any household debt that existed before the pandemic.
- Policies designed to replace lost income for unemployed workers — such as standard state UI, the supplementary $600 per week CARES Act UI benefit available from April through the end of July, and the Economic Impact Payments sent to households in April — have been very effective at preventing rental debt for those households that receive them.
- Hispanic households, Black households, and family households headed by single women are disproportionately likely to experience rental debt by December 2020.
- There is substantial variation in rental debt outcomes by state, as detailed in the report.
Read the report.
Even With ACA’s Fate in Flux, Open Enrollment Starts Soon. Here’s What’s New
Facing a pandemic, record unemployment and unknown future costs for COVID-19 treatments, health insurers selling Affordable Care Act plans to individuals reacted by lowering rates in some areas and, overall, issuing only modest premium increases for 2021.
“What’s been fascinating is that carriers in general are not projecting much impact from the pandemic for their 2021 premium rates,” said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University in Washington, D.C.
Although final rates have yet to be analyzed in all states, those who study the market say the premium increases they have seen to date will be in the low single digits — and decreases are not uncommon.
That’s good news for the more than 10 million Americans who purchase their own ACA health insurance through federal and state marketplaces. The federal market, which serves 36 states, opens for 2021 enrollment Nov. 1, with sign-up season ending Dec. 15. Some of the 14 states and the District of Columbia that operate their own markets have longer enrollment periods.
The flip side of flat or declining premiums is that some consumers who qualify for subsidies to help them purchase coverage may also see a reduction in that aid.
Here are a few things to know about 2021 coverage. Read more.
Pennsylvania Downtown Center Partners with USDA to Provide Rural Placemaking Technical Assistance
United States Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Bette Brand announced that USDA has signed cooperative agreements with five organizations to support placemaking technical assistance throughout the United States.
USDA is providing the assistance through the Rural Placemaking Innovation Challenge (RPIC). The department and its partners will help rural communities develop actionable strategies to capitalize on local community assets and potential through the creation of quality public spaces that contribute to the community’s social, physical, and economic well-being. Through RPIC, USDA is empowering rural communities to improve their quality of life and prosperity through revitalization, workforce development, entrepreneurship, broadband, housing, and tourism efforts.
The department is partnering with only five organizations throughout the country who will help develop placemaking plans with leaders in rural communities for the next two years. These organizations are listed below.
In the Northeast, the Pennsylvania Downtown Center (PDC), in Harrisburg, will use a $140,000 grant to provide placemaking services to support downtown revitalization in five separate community revitalization initiatives throughout Pennsylvania: three individual municipalities and partners – New Castle – New Visions; Clarion – Clarion Blueprint Community, Inc. and Reynoldsville – Reynoldsville Community Association and two “regional” programs – The Allegheny-Clarion Valley Blueprint Community (Emlenton, Foxburg and the City of Parker), and the Juniata River Blueprint Communities (Mount Union, Mapleton, and Shirley Township). Funds will be used to develop community assessments, revise and refresh vision statements, strategic action plans, annual work plans, and provide supportive technical assistance through September 2022.
In the South, Winrock International Institute for Agricultural Development will use a $215,000 grant to help develop a plan to support rural tourism opportunities; in the Midwest, McClure Engineering Company will use a $215,000 grant to develop a plan to support housing, workforce and broadband development; in the Midwest, Pierce County, Neb., will use a $215,000 grant to develop a plan to support outreach to students and recent graduates for rural entrepreneurship opportunities in the agricultural sector; and in the West, Tolani Lake Enterprises in Winslow, Ariz., will use a $215,000 grant to provide technical assistance to develop a plan to support Tribal lands and tourism for the Navajo Nation.
To be innovative, local placemaking efforts need to understand and adapt to the challenges of current issues. Placemaking is a process that connects vision, strategy, implementation, and funding, into a unified effort that will improve the overall environment and quality of life in a community. To be sustainable, placemaking needs to provide local organizations with the knowledge and skills to understand, to adapt, and to change outdated perceptions and attitudes. We intend the RPIC effort to help communities do just that – Innovate-Succeed-Sustain.
PDC intends for the RPIC effort to help communities innovate, succeed, and sustain with these outcomes: improved community perceptions, increased organizational capacity, better informed organizations, increased volunteerism, and overall increased buy-in to the communities’ revitalization effort.
Existing local, regional, statewide, and national public, private, nonprofit, and philanthropic partnerships will be assessed and encouraged to be expanded during this project. Newly identified partners will be encouraged to participate, including but not limited to diversity, equity, and inclusion practices so that organizational representation better matches the socio-economic profile of the communities they serve.
“We are thrilled to be partnering with USDA Rural Development and honored to be one of only five selected programs. We look forward to using this new and exciting initiative to bring more attention to Pennsylvania’s rural communities, by helping to increase local capacity, and by growing and enhancing existing implementation and funding partners. This is an opportunity to build from recent investment from the Federal Home Loan Bank in Pittsburgh (FHLBank) Blueprint Communities program and assist the communities in their next phase of revitalization,” says PDC’s Executive Director, Julie Fitzpatrick.
Founded in 1987, the mission of Pennsylvania Downtown Center is to build and support the capacity of local nonprofit organizations, municipalities, and individuals to enhance the overall well-being and sustainability of Pennsylvania’s core communities. PDC accomplishes this mission by engaging and educating local community leaders and volunteers, to advance the sense of place, quality of life and economic vitality of the Commonwealth’s downtowns, traditional neighborhood business districts and nearby residential areas. For more information about designated Main Street or Elm Street programs or nationally accredited communities, contact Maria Wherley at (717) 870-9334 or email here.
Contact: Maria Wherley, Pennsylvania Downtown Center, Inc.
(717) 870-9334 or mariawherley@padowntown.org
PO Box 1265
Harrisburg, PA 17108
(717) 233-4675
Department of Homeland Security Launches New Center for Countering Human Trafficking
WASHINGTON—U.S. Department of Homeland Security (DHS) Acting Secretary Chad Wolf announced the opening of the DHS Center for Countering Human Trafficking, the U.S. government’s first-ever integrated law enforcement operations center directly supporting federal criminal investigations, victim assistance efforts, intelligence analysis, and outreach and training activities related to human trafficking and forced labor.
The center, which has been operational since early September, is based in Washington and led by U.S. Immigration and Customs Enforcement (ICE), a global leader of criminal investigations into human trafficking and sexual exploitation. The center will be staffed with law enforcement officials from Homeland Security Investigations (HSI) and across DHS, as well as subject matter experts and support staff from 16 DHS components—all focused on the “4 Ps” of the center’s mission: prevention, protection, prosecution and partnerships.
“Human trafficking is modern day slavery. There is no other way to say it,” said Acting Secretary Chad Wolf. “The words are strong because the actions are evil. The forms of exploitation, sex trafficking, forced labor, and domestic servitude that constitute human trafficking are antithetical in every way to the principles of human dignity that Americans hold dear. The launch of this Center for Countering Human Trafficking represents the investment of resources, attention, and time by President Trump to combat and dismantle all forms of human trafficking.”
On Jan. 15, Wolf signed and released the DHS Strategy to Combat Human Trafficking, the Importation of Goods Produced with Forced Labor, and Child Sexual Exploitation (https://www.dhs.gov/publication/strategy-combat-human-trafficking-importation-goods-produced-forced-labor-and-child) which pledged to bolster DHS efforts to combat human trafficking and forced labor.
“Human Trafficking, whether through sex or labor, is a detriment to our society and threatens the moral conscience of our nation. Criminal organizations target those who are most vulnerable and exploit them through any means necessary, Victims are treated as commodities rather than human beings, with no regard for their health and well-being,” said ICE Senior Official Performing the Duties of Director Tony Pham. “ICE, along with our internal and external partners, will continue to fight against these atrocities and answer victims’ cries for help. The Center for Countering Human Trafficking will serve as evidence that when we work collectively against such heinous acts, we combat the threat they pose to national security and to public safety.”
ICE’s HSI has long been a global leader in investigating human trafficking and sexual exploitation cases and bringing offenders to justice. The Center will build on the agency’s “victims first” approach, which balances victim identification, rescue and support with prevention, investigation, and prosecution of traffickers. ICE HSI is uniquely positioned to utilize criminal, immigration, and trade-based authorities to proactively identify, disrupt and dismantle cross-border human trafficking organizations.
In fiscal year 2019, ICE initiated 1,024 human trafficking and forced labor related cases which led to 2,197 criminal arrests. These effective actions resulted in nearly 700 convictions and the rescue of more than 400 victims.
Reporting suspected sexual or labor exploitation can help decrease or stop further victimization, as well as lead to the identification and rescue of other possible victims. To report suspicious activity or instances of sexual abuse or exploitation, contact your local law enforcement agency. Tips can be submitted online at https://www.ice.gov/tipline, by phone at 866-DHS-2-ICE or by contacting your local ICE office.
For more information about the Department of Homeland Security’s overall efforts against human trafficking, visit http://www.dhs.gov/blue-campaign
COVID-19 Patients Swamp Rural Hospitals
Stateline, Pew
The nation’s pandemic hotspots have shifted to rural communities, overwhelming small hospitals that are running out of beds or lack the intensive care units for more than one or two seriously ill patients.
And in much of the Midwest and Great Plains, hospital workers are catching the virus at home and in their communities, seriously reducing already slim benches of doctors, nurses and other professionals needed to keep rural hospitals running.
Nationwide, positive coronavirus cases started rising in mid-September as children and college students returned to school, more businesses reopened and more people started resuming daily activities outside of their homes. Wisconsin and other less populous states became the new hotspots.
This week, per capita rates of COVID-19 were highest in North Dakota, followed by South Dakota, Montana, Wisconsin, Nebraska, Idaho, Utah, Wyoming, Iowa, Arkansas and Illinois. Hospitalization rates also were rising in those states and others.
Health care experts expect that a seasonal spike in flu and pneumonia, combined with a steady rise in COVID-19 cases, will swamp many health care systems, particularly in rural areas.
Wisconsin recently opened a 530-bed field hospital on state fairgrounds in Milwaukee that was set up in the early days of the pandemic but sat unused until now. Last week, 50 beds were readied for patients, and the staff was working on transfers with hospitals that were hitting their capacity limits. The number of hospitalized COVID-19 patients in the state tripled in the last 30 days.
In Oklahoma City and the surrounding area, no ICU beds were available last week, according to the University of Oklahoma. The lack of beds required medical professionals in those already understaffed hospitals to spend hours on the phone arranging patient transfers to other Oklahoma hospitals.
Fewer than 20 ICU beds were available in the entire state of North Dakota, according to state data. That meant patients had to be transferred hundreds of miles, in some cases to South Dakota and Montana.