- Rural Children Struggle to Access Hospital Services, Say Researchers
- Outlining the Intersection between Health Care and Missing and Murdered Indigenous People
- Biden-Harris Administration Announces Critical More Than $1.5 Billion State and Tribal Opioid Response Funding Opportunities
- RPHARM Program Fulfills Need for Rural Pharmacists
- Farmers Don't Do Mental Health
- A Pilot Program in Rural Vermont Hopes to Build a Blueprint for Substance Abuse Recovery
- Rural Telehealth Extension Reintroduced in Congress
- Students From Across the State Emphasized the Need for Mental Health Resources in Rural Alaska During a Conference
- The South Was the Center of Rural Population Growth Last Year
- How HHS SUD Confidentiality Regulations Will Impact Rural Providers
- VA Announces Expansion of "Close to Me" Cancer Program as Part of the Cancer Moonshot, Bringing Cancer Diagnosis and Treatment Closer to Thousands of Veterans
- Navajo Psychiatrist Bridges Gaps Between Native American Culture and Behavioral Health Care
- Biden-Harris Administration Releases National Strategy for Suicide Prevention and First-Ever Federal Action Plan
- Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don't Meet Them.
- Rural Communities Face Primary Care Physician Shortage
Infrastructure Conversations on Capitol Hill Stall
The Biden administration initially chose Memorial Day as the target date to decide which route to take on infrastructure: bipartisan or through reconciliation (the process to pass legislation in the Senate by 50 votes). On Thursday, a group of Senate Republicans announced a counterplan for $928 billion in infrastructure spending, much lower than the president’s $2.2 trillion plan. It is unclear which route the administration and Congress will take. NRHA continues to talk with offices on both sides of the aisle about the needs of rural providers. Key issues include the need for capital for rural hospitals, 100 percent broadband connectivity in rural areas, and the need for additional investment in the health workforce.
FDA Approves Storage of Pfizer Vaccine for Up to One Month
The Food and Drug Administration (FDA) updated its guidance for health care providers administering the vaccine and allows for undiluted, thawed Pfizer-BioNTech COVID-19 Vaccine vials to be stored in refrigeration for up to one month. The previous time span was up to five days.
New Funding Available for the HRSA Telehealth Technology-Enabled Learning Program
HRSA expects to make nine awards of up to $475,000 each to connect specialists at academic medical centers with primary care providers in rural areas to improve patient care in their communities via new funding for the administration’s Telehealth Technology-Enabled Learning Program. More specifically, these learning opportunities will address unmet needs for their target population, which could include populations who have historically suffered from poorer health outcomes. Applications from public, private, and nonprofit entities are due on June 25.
President Biden Releases Full FY 2022 Budget Request
President Biden released his FY 2022 budget request and appendices for individual departments, including the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA).
USDA Launches Resource Guide to Help America’s Rural Workforce Build Back Better
United States Department of Agriculture (USDA) Deputy Under Secretary for Rural Development Justin Maxson unveiled a resource guide to help rural community leaders start and expand employment opportunities and access resources to train, recruit and create a sustainable rural workforce.
“America’s rural workforce is critical to the success of the nation’s economy,” Maxson said. “As USDA continues to respond to the COVID-19 pandemic and help restore the economy, we remain committed to helping rural employers build back America’s rural workforce to be better, stronger and more equitable than ever before.”
The resource guide outlines programs and services available at USDA and other federal agencies that support workforce development in rural communities. It helps community leaders and other local entities access resources more easily to create jobs, train talent, expand educational opportunities and provide technical assistance.
A resource matrix organizes USDA funding opportunities by four key assistance types:
- Workforce development planning;
- Infrastructure and equipment financing;
- Industry and employer engagement, entrepreneurship and local business development; and,
- Education, training and apprenticeship.
The guide also features examples of how customers have used USDA programs to support each assistance type. It includes recommendations on how rural leaders can replicate this assistance in their communities.
Additional resources to support rural workforce development are available at www.rd.usda.gov/rwin.
To learn more about investment resources for rural areas, contact the nearest USDA Rural Development state office.
Under the Biden-Harris Administration, Rural Development provides loans and grants to help expand economic opportunities, create jobs and improve the quality of life for millions of Americans in rural areas. This assistance supports infrastructure improvements; business development; housing; community facilities such as schools, public safety and health care; and high-speed internet access in rural, tribal and high-poverty areas. For more information, visit www.rd.usda.gov. If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page.
USDA touches the lives of all Americans each day in so many positive ways. In the Biden-Harris Administration, USDA is transforming America’s food system with a greater focus on more resilient local and regional food production, fairer markets for all producers, ensuring access to safe, healthy and nutritious food in all communities, building new markets and streams of income for farmers and producers using climate smart food and forestry practices, making historic investments in infrastructure and clean energy capabilities in rural America, and committing to equity across the Department by removing systemic barriers and building a workforce more representative of America. To learn more, visit www.usda.gov.
Commentary: The Future of Rural Libraries Could Be Healthcare
With newly available funding opportunities and new technologies, libraries could be at the forefront of the rural healthcare revolution.
Libraries are in the vanguard of transforming healthcare delivery. Libraries reach out and touch virtually everyone in their communities across the entire economic spectrum. The same way libraries brought high-speed Internet to the underserved communities, so they will deploy telehealth to bring affordable healthcare where it’s most needed..
In October 2020, the Daily Yonder spotlighted Pottsboro, Texas’ public library and its director, Dianne Connery, who had plans to open a telehealth center in the library. Connerly seems to have unleashed significant pent-up desire to replicate telehealth in libraries nationwide.
She rolled out her telehealth center in January 2021 and in February she was promoted to rural special projects librarian. “Manage your expectations because it takes a while to build the crowd to telehealth services,” she said. “We only set appointments for two days a week. Our partner, the University of North Texas Health Science Center, will keep our growth steady and controlled.”
A lot of libraries right now are struggling to keep up with everything that’s going on,” said Henry Stokes, library technology consultant at Texas State Library and Archives. “But as they move forward and see their peers push telehealth initiatives, we’ll see health become prominently featured in libraries. Telehealth is such a great fit!” The Federal Communications Commission’s $7.1 billion E-rate grant program for libraries and schools will move many libraries sooner rather than later.
Biden Administration Continues Efforts to Increase Vaccinations By Bolstering Payments for At-Home COVID-19 Vaccinations for Medicare Beneficiaries
Action Could Impact as many as 1.6 Million People with Medicare
As part of President Biden’s commitment to increasing access to vaccinations, the Centers for Medicare & Medicaid Services (CMS) today announced an additional payment amount for administering in-home COVID-19 vaccinations to Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach. This announcement further demonstrates continued efforts of the Biden-Harris Administration to meet people where they are and make it as easy as possible for all Americans to get vaccinated. There are approximately 1.6 million adults 65 or older who may have trouble accessing COVID-19 vaccinations because they have difficulty leaving home.
While many Medicare beneficiaries can receive a COVID-19 vaccine at a retail pharmacy, their physician’s office, or a mass vaccination site, some beneficiaries have great difficulty leaving their homes or face a taxing effort getting around their communities easily to access vaccination in these settings. To better serve this group, Medicare is incentivizing providers and will pay an additional $35 per dose for COVID-19 vaccine administration in a beneficiary’s home, increasing the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose. For a two-dose vaccine, this results in a total payment of approximately $150 for the administration of both doses, or approximately $70 more than the current rate.
“CMS is committed to meeting the unique needs of Medicare consumers and their communities – particularly those who are home bound or who have trouble getting to a vaccination site. That’s why we’re acting today to expand the availability of the COVID-19 vaccine to people with Medicare at home,” said CMS Administrator Chiquita Brooks-Lasure. “We’re committed to taking action wherever barriers exist and bringing the fight against the COVID-19 pandemic to the door of older adults and other individuals covered by Medicare who still need protection.”
Delivering COVID-19 vaccination to access-challenged and hard-to-reach individuals poses some unique challenges, such as ensuring appropriate vaccine storage temperatures, handling, and administration. The Centers for Disease Control and Prevention (CDC) has outlined guidance to assist vaccinators in overcoming these challenges. Today’s announcement now helps to address the financial burden associated with accommodating these complications.
The additional payment amount also accounts for the clinical time needed to monitor a beneficiary after the vaccine is administered, as well as the upfront costs associated with administering the vaccine safely and appropriately in a beneficiary’s home. The payment rate for administering each dose of a COVID-19 vaccine, as well as the additional in-home payment amount, will be geographically adjusted based on where the service is furnished.
How to Find a COVID-19 Vaccine
As today’s action demonstrates, a person’s ability to leave their home should not be an obstacle to getting the COVID-19 vaccine. As states and the federal government continue to break down barriers – like where vaccines can be administered – resources for connecting communities to vaccination options remain key. Unvaccinated individuals and those looking to assist friends and family can:
- Visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.
- Text GETVAX (438829) for English or VACUNA (822862) for Spanish for near-instant access to details on three vaccine sites in the local area.
- Call the National COVID-19 Vaccination Assistance Hotline at 1-800-232-0233 (TTY: 1-888-720-7489) for assistance in English and Spanish.
Coverage of COVID-19 Vaccines
The federal government is providing the COVID-19 vaccine free of charge or with no cost-sharing for all people living in the United States. As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers cannot charge patients any amount for administering the vaccine.
Because no patient can be billed for COVID-19 vaccinations, CMS and its partners have provided a variety of information online for providers vaccinating all Americans regardless of their insurance status:
- Original Medicare and Medicare Advantage: Beneficiaries with Medicare pay nothing for COVID-19 vaccines or their administration, and there is no applicable copayment, coinsurance or deductible.
- Medicaid and the Children’s Health Insurance Program (CHIP):State Medicaid and CHIP agencies must cover COVID-19 vaccine administration with no cost sharing for nearly all beneficiaries during the COVID-19 public health emergency (PHE) and for over a year after it ends. For the very limited number of Medicaid beneficiaries who are not eligible for this coverage (and do not receive it through other coverage they might have), providers may submit claims for reimbursement for administering the COVID-19 vaccine to underinsured individuals through the COVID-19 Coverage Assistance Fund, administered by the Health Resources and Services Administration (HRSA), as discussed below. Under the American Rescue Plan Act of 2021 (ARP), signed by President Biden on March 11, 2021, the federal matching percentage for state Medicaid and CHIP expenditures on COVID-19 vaccine administration is currently 100% (as of April 1, 2021), and will remain 100% for more than a year after the COVID-19 PHE ends. The ARP also expands coverage of COVID-19 vaccine administration under Medicaid and CHIP to additional eligibility groups. CMS recently updated the Medicaid vaccine toolkit to reflect the enactment of the ARP at https://www.medicaid.gov/state-resource-center/downloads/covid-19-vaccine-toolkit.pdf.
- Private Plans: The vaccine is free for people enrolled in private health plans and issuers COVID-19 vaccine and its administration is covered without cost sharing for most enrollees, and such coverage must be provided both in-network and out-of-network during the PHE. Current regulations provide that out-of-network rates must be reasonable as compared to prevailing market rates, and the rules reference using the Medicare payment rates as a potential guideline for insurance companies. In light of CMS’s increased Medicare payment rates, CMS will expect health insurance issuers and group health plans to continue to ensure their rates are reasonable when compared to prevailing market rates. Under the conditions of participation in the CDC COVID-19 Vaccination Program, providers cannot charge plan enrollees any administration fee or cost sharing, regardless of whether the COVID-19 vaccine is administered in-network or out-of-network.
The Biden-Harris Administration is providing free access to COVID-19 vaccines for every adult living in the United States. For individuals who are underinsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine through the COVID-19 Coverage Assistance Fund administered by the Health Resources and Services Administration (HRSA) after the claim to the individual’s health plan for payment has been denied or only partially paid. Information is available at https://www.hrsa.gov/covid19-coverage-assistance.
For individuals who are uninsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA). Information on the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program is available at https://www.hrsa.gov/CovidUninsuredClaim.
More information on Medicare payment for COVID-19 vaccine administration – including a list of billing codes, payment allowances and effective dates – is available at https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment.
More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html.
Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on @CMSgov
Rural and Minority Health Research Center Annual Report Published
Over the last 20 years, health equity has been the focus of the Rural and Minority Health Research Center (RMHRC) at the University of South Carolina. For health equity to exist, obstacles that prevent all individuals from having an opportunity to live a healthy life must be identified and addressed. COVID-19’s impact on rural and minority communities has further illuminated the challenges rural communities, persons of color, and Indigenous people face. Increased socioeconomic burden, inadequate access to healthcare, and higher unemployment rates have exacerbated the impact from COVID-19 on these citizens who are disproportionately susceptible to the risks of COVID-19 infection and death.
The RMHRC Annual Report highlights our goals, accomplishments, and team members. In 2020, our research led to 59 peer-reviewed publications seven of which are presented in the annual report.
The Center’s data driven research can be used to inform impactful policies and improve population health. Let us know how we can help you support rural health.
Dental Benefit Limit Exceptions (BLE) Process Simplified in Pennsylvania
The Pennsylvania Health Law Project (PHLP) recently published a simplified overview of the April changes to the Medicaid Benefit Limit Exception (BLE) process. Individuals can contact PHLP’s Helpline at 1-800-274-3258 or staff@phlp.org for help with a Medicaid dental service denial.
WHO Declares Oral Health a Global Priority
The World Health Organization (WHO) has officially declared oral health a global priority. Health ministries supported a new resolution that urged oral health be included in the noncommunicable disease agenda. The resolution recommended a shift from the traditional curative approach towards a preventive approach that includes promotion of oral health within the family, schools and workplaces, and also a comprehensive and inclusive approach to the delivery of oral health care within the primary health care system. WHO also recommended that oral health care be included in universal health coverage programs. WHO will draft a global strategy on tackling oral diseases for consideration in 2022 and recommend an action plan by 2023.