Rural Health Information Hub Latest News

Regulation Implementing EO on Insulin and Epinephrine Delayed

HRSA published a notice in the Federal Register officially delaying the effective date for new regulation implementing President Trump’s Executive Order (EO) on FQHC 340B prices for insulin and EpiPens. The effective date has been delayed by 60 days-–the maximum time allowed under the White House order–until March 22. Per the notice, this delay will “give Department officials the opportunity for further review and consideration of new regulations.” There have been some media coverage and social media posts mischaracterizing the regulation as well as the impact of its delay. For talking points if your health center is contacted or if you want to respond to misrepresentations, contact Eric Kiehl, PACHC Director of Policy & Partnership. 

Extended Grace Period for IHS Facilities

The Centers for Medicare & Medicaid Services (CMS) has extended the grace period previously granted to Indian Health Service (IHS) facilities, and facilities operated by Tribes and Tribal organizations, to claim Medicaid reimbursement for services provided outside of the “four walls” of the facility to October 31, 2021.  This bulletin also explains the steps Tribal facilities and states will need to take before the extended grace period expires in order to continue to be reimbursed for services provided outside the four walls of the facility after October 31st.

Notice of Benefit and Payment Parameters for 2022 Finalized

This final rule updates the requirements for benefits and payments for issuers offering individual market Qualified Health Plans on the Federal Health Insurance Exchange in 2022.  It clarifies that the network adequacy standards regulation does not apply to Qualified Health Plans that do not use provider networks and adds a new direct enrollment option for federally-facilitated Exchanges and State Exchanges.

New Rule on Patient Access to Prior Authorization Information

This final rule from the Centers for Medicare & Medicaid Services (CMS) requires Medicaid and CHIP programs, including managed care plans, and issuers of individual market Qualified Health Plans on the Federal Health Insurance Exchange to include in their patient access applications information about a patient’s pending and active prior authorization decisions in addition to claims and encounter data and laboratory results.