Last week, the Departments of Health & Human Services, Labor, and the Treasury released a final rule amending the definition of short-term, limited-duration insurance (STDLI), which is a type of health insurance coverage designed to fill temporary gaps in coverage when an individual is transitioning from one plan or coverage to another.  STLDI is not considered to be individual health coverage under the law, so it does not need to meet the same requirements as Marketplace plans.  Under this rule, the Departments are shortening the limit on the length of the initial contract term from 12 months to no more than three months.  Additionally, the maximum total coverage period is changing from 36 months to four months including renewals and extensions.  This rule also revises the federal standard for notices that insurers must use to help consumers better distinguish between comprehensive coverage and STLDI and get information on their health coverage options. This document also sets forth final rules that amend the regulations regarding the requirements for hospital indemnity or other fixed indemnity insurance to be considered an excepted benefit in the group and individual health insurance markets.

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Last week, the Centers for Medicare & Medicaid Services (CMS) issued guidance extending the special enrollment period for people who are no longer eligible for Medicaid or Children’s Health Insurance Program (CHIP) due to the end of the Medicaid continuous enrollment, also known as “unwinding,” to Marketplace coverage in states using HealthCare.govfrom July 31, 2024, to November 30, 2024.  This extension is optional for state-based Marketplaces. Consumers who are determined eligible for this Unwinding SEP will have 60 days from the date on which they submit a new or updated HealthCare.gov to make a plan.  CMS’ Job Aid entitle, Assisting Rural Consumers provides information for navigators and assisters to educate rural consumers on Marketplace and Medicaid coverage and assist with enrollment.

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Effective January 1, 2024, most children under the age of 19 who meet their state’s Medicaid or Children’s Health Insurance Program (CHIP) eligibility requirements will remain continuously eligible (CE) for coverage for a full 12-month period. This issue brief estimates that the number of children eligible for Medicaid and CHIP will increase by 3.5 percent in states that previously had partial or no CE policies for children as of January 2023. This increase in average monthly eligibility is driven by an estimated 1.3 million children becoming eligible for at least one additional month of Medicaid or CHIP coverage. Ultimately, the impact of any federal 12-month CE policy is dependent on state enrollment of Medicaid- and CHIP-eligible children, as only enrolled children can benefit from CE expansion.  Medicaid and CHIP are important sources of coverage for rural children. As of 2020-2021, Medicaid/CHIP provided coverage for a larger share of both adults and children in small towns and rural areas than in metropolitan counties nationwide.

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The final rule from the Centers for Medicare & Medicaid Services (CMS) makes changes to simplify the eligibility and enrollment processes in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program. This rule aligns enrollment and renewal requirements for most individuals in Medicaid, creates timeliness requirements for redeterminations of eligibility, removes barriers to children enrolled in CHIP, and updates recordkeeping requirements.  These changes are intended to reduce coverage disruptions and increase retention of eligible individuals.  CMS also released new and updated resources to support the end of the Medicaid continuous enrollment, or ‘unwinding’, including guidance on unwinding processes and requirements for states; guidance to Medicaid managed care plans; and new resources for partners to help families navigate their state Medicaid fair-hearing process, such as if someone was determined no longer eligible for Medicaid.

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Thursday April 4 at 1:00 pm Eastern. Subject matter experts with the Centers for Medicare & Medicaid Services (CMS) will present the latest hospital price transparency policies and enforcement actions effective January 1, 2024, in a webinar produced by the Rural Health Information Hub (RHIhub).  These policies were effective January 1, 2021 and affect all hospitals operating in the United States.  For those who are unable attend, RHIhub keeps an archive of all webinars on its site.

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Named by the Centers for Disease Control and Prevention as one of the five leading causes of death for rural populations in the United States, unintentional injuries can be fatal or nonfatal injuries that are unplanned and often preventable.  This new resource from the Rural Health Information Hub (RHIhub) gives the how and why injuries are so prevalent, and then provides a collection of effective program models with resources for planning, funding, and sustainability.

Read the full article here.

HRSA increases loan repayment amounts by 50% for primary care providers who commit to practicing in high need and rural areas

Additional loan repayment available for primary care providers who commit to serve in shortage areas, demonstrate fluency in Spanish

The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced that it has increased by 50% the initial loan repayment amount available to primary care providers—M.D.s and D.O.s, including OB-GYNs and pediatricians; nurse practitioners; certified nurse midwives; and physician assistants—who commit to practicing in areas with significant shortages of primary care providers.

With the growing cost of medical school and increased challenges in recruiting primary care providers to high need areas, today’s action will help rural and historically underserved communities attract providers to deliver critical primary care services. These providers could have as much as $75,000 forgiven in exchange for a two-year service commitment.

HRSA also is offering up to an additional $5,000 in loan repayment to all National Health Service Corps Loan Repayment Program participants who can demonstrate fluency in Spanish and who commit to practice in a high need area serving patients with limited English proficiency. Providers will demonstrate language proficiency through an oral exam administered through an accredited language assessment organization.

Individuals with limited English proficiency disproportionately experience poor health outcomes and often substandard provider experiences, including challenges understanding doctors’ questions and diagnoses and reading and using prescriptions, referrals, and follow-up directions. This announcement comes as HHS Secretary Xavier Becerra is in the midst of a Latino Health Tour, underscoring the Biden-Harris Administration’s commitment to improving the health of that community.

“At the Health Resources and Services Administration, we are committed to taking action to help ensure that everyone has access to primary health care,” said HRSA Administrator Carole Johnson. “We know the importance of having a culturally competent and consistent source of primary care for improving health and wellness, managing chronic diseases and prescriptions, and coordinating across care teams. Yet, too often in rural communities and historically underserved communities, primary care remains difficult to access. That is why we are increasing our incentives to encourage primary care providers to practice in high need communities by paying a greater share of their educational loans.”

Through HRSA’s National Health Service Corps Loan Repayment Program, primary care medical providers could previously receive a maximum of $50,000 in initial loan repayment in return for a two-year full-time service commitment to practice in an area with a shortage of health professionals. This amount is nearly the same as the program offered 30 years ago, yet average medical student debt has grown more than four-fold over that same time period.

Now, eligible primary care providers can receive up to $75,000 in initial loan repayment in return for a two-year full-time service commitment to practice in those same areas. Participants have the opportunity to receive additional funding for extending their service commitment.

Today’s actions build on a host of Biden-Harris Administration actions to grow and support the primary care workforce, including investments in:

• Training primary care providers through the HRSA community-based Teaching Health Center Graduate Medical Education Program that is training more than 1,000 residents in more than 80 community-based residency programs;
• Supporting the creation of new primary care residency programs in rural communities, which when fully accredited and operational will have up to 540 slots for physicians in specialties including family medicine, internal medicine, psychiatry, and general surgery;
• Conducting over 25,000 trainings for practicing primary care providers including pediatricians, OB-GYNs, nurse midwives, and other maternal health care providers to identify and treat mental health conditions among children and adolescents and pregnant individuals and new moms;
• Training primary care residents in the prevention, identification, diagnosis, treatment, and referral of services for mental health and substance use disorders to integrate behavioral health into primary care;
• Increasing access to care for patients with special needs by training primary care medical students, physician assistant students, and medical residents in caring for individuals with intellectual and physical disabilities; and,
• Training new primary care providers in culturally and linguistically appropriate care for individuals with limited English proficiency through language immersion programs and other methods.

To apply visit: The National Health Service Corps Loan Repayment Program.

CMS is pleased to announce the availability of a new Research Identifiable File (RIF) that utilizes the Medicare Bayesian Improved Surname Geocoding (MBISG) algorithm to predict the race and ethnicity of Medicare beneficiaries. This data file is available for public use through the Chronic Conditions Warehouse (CCW).

CMS developed the MBISG algorithm to enhance existing race and ethnicity data to better understand the Medicare population.

How does it work?

The availability of the MBISG in the CCW gives researchers an opportunity to have more accurate indirect estimates of the race and ethnicity data on the Medicare population for analysis. The MBISG data includes a set of probabilities that the person is a member of six racial and ethnic groups: American Indian or Alaska Native (AI/AN), Asian American and Native Hawaiian or Other Pacific Islander (AA and NHPI), Black, Hispanic, Multiracial, or White. MBISG probabilities are based on U.S. Census Bureau data on race and ethnicity distributions by surname and Census block group, as well as CMS’s race and ethnicity administrative data and additional administrative elements including first name, demographics, and coverage characteristics.

To better understand the likelihood a person would prefer materials in Spanish, the MBISG data also includes a Spanish Preference Category. This categorizes the predicted probability that each person with Medicare would prefer Spanish language material.

The MBISG data consists of a single file that contains the race and ethnicity probabilities of people with Medicare enrolled on March 1, 2023. This dataset is separate from CCW’s Master Beneficiary Summary File (MBSF), which is partitioned by calendar year. Researchers should note the MBISG dataset will overlap with MBSF files, but the cohort of people included in the MBISG dataset will not match exactly to any given MBSF calendar year dataset.

Get more information

CMS is committed to advancing health equity, including the availability, use, and accuracy of health equity data. To learn more about CMS efforts about health equity, review the CMS Framework for Health Equity and to find out more specifically about efforts around health equity data, review The Path Forward: Improving Data to Advance Health Equity Solutions

Need help?

The CMS Office of Minority Health offers a Health Equity Technical Assistance program to assist organizations, researchers, and those looking for help around health equity data collection and analysis, resources to embed health equity, and other resources to improve health equity efforts. Contact HealthEquityTA@cms.hhs.gov for more information.

In addition, the CCW offers information and contacts for those with questions regarding the data warehouse. If you have a question more information about the MBISG data, you can also contact the MBISG team directly at mbisg@cms.hhs.gov.

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