Rural Health Information Hub Latest News

Pharmacy Benefit Manager Fees Regulated

On December 14, 2021, the Centers for Medicare and Medicaid Services (CMS) unexpectedly issued a letter to U.S. Senator Ron Widen (D-OR) indicating that CMS plans to use its “administrative authority to issue proposed rulemaking” addressing price concessions and direct and indirect remuneration (DIR) fees that pharmacy benefit managers (PBMs) have increasingly charged to specialty and retail pharmacy providers in Medicare and other pharmacy benefit programs in recent years. The proposed regulation was issued on January 12.

New Pocket Guides from MidAtlantic AIDS Education and Training Center

The MidAtlantic AIDS Education and Training Center (AETC) has created several new pocket guides by Dr. Linda Frank and their regional partners which are available for download on their website. The new topics are:

  • Rapid Initiation of HIV Treatment
  • HIV and Medication Assisted Treatment Centers (MAT)
  • Differential Diagnosis of HIV and SARS-COV-2
  • Best Practices & Tips for Clinicians Providing Care for Patients with HIV via Telehealth
  • Integrating Geriatric Principles into an HIV Clinic
  • Workplace Burnout Guide for Health Professionals
  • Addressing Social Determinants of Health and Persons with HIV

You can also find all their other pocket guides and clinical tools here.

Pennsylvania Health Department Issues Update Guidance on COVID-19 Protocols

The Pennsylvania Department of Health (DOH) issued several Health Alert Updates to reflect the most recent guidance related to COVID-19, including updates for the general population and return to work guidance for healthcare personnel.

Click here for the latest DOH Health Alerts, Advisories and Updates.

New Legislative Report Calls for Changes to Help Overcome Primary Care Physician Shortage

A new report by a Pennsylvania legislative research agency offers many recommendations to help Pennsylvania’s nine medical schools take more steps to ease a shortage of primary care doctors in the state. The report by the Joint State Government Commission looks at the training needed to become a primary care doctor and efforts by the medical schools to promote primary care as a career choice. It examines a host of issues believed to contribute to the shortage in that practice, including student debt burden, doctor burnout and low public investment in primary care. Read the report, Medical School Impact on the Primary Care Physician Shortage.

Update on Telehealth in Pennsylvania

In October, the state Senate passed SB 705 authorizing the regulation of telemedicine by professional licensing boards and providing for insurance coverage of telemedicine. Sponsored by Senator Vogel, SB 705 is now with the House of Representatives for their consideration. The bill has language that was in the previous version of the bill that led to Governor Wolf vetoing the bill last session. PACHC is not aware that any progress has been made between the House of Representatives and the Governor’s office to address the issues from last session. At this time, the House is not expected to act on this legislation. This creates a conundrum when reviewing the OMAP Telehealth Bulletin, which notes that telehealth is allowed “if permitted according to their scope of practice, licensure, or certification.” Nothing in the practice acts “permits” telehealth. The current waiver allowing for telehealth expires on March 31, 2022. There have been rumors of a possible extension of some of the waivers, such as telehealth, beyond the March 31 deadline. PACHC is working with the legislature and the administration, along with other provider groups, to try and get clarification on the future of telehealth amidst these political issues.

New Best Practice Approach Report on Teledentistry

A new CareQuest Institute and Association of State and Territorial Dental Directors (ASTDD) Best Practice Approach Report encourages state/territorial oral health programs and stakeholders to identify community barriers to care and consider teledentistry as part of the solution. The practical Report includes guidelines and recommendations, best practice criteria, myriad resources, and several examples of teledentistry in use across the country.–nQo9ZV2zmYMfjBjHPaIj8Im47SURP9j_CeO_IHHErmncVqGh-zmsa8_YHue-2XCornAqje5uuhE7bbaHqTvIOd-7XwQ&utm_source=newsletter

Disparities Relating to HIV and PrEP

The Centers for Disease Control and Prevention (CDC) recently released two reports which may be of interest to health center providers:

America’s Youngest Adults are Overweight

According to new research conducted by Johns Hopkins and published in the Journal of the American Medical Association, 56% of American adults ages 18 to 25 are overweight or obese. Using data from a nationally representative sample of 8,015 people in that age bracket, the researchers compared average weights over the past four decades. In that time, that population’s average body mass index, a measure of body fat based on a person’s height and weight, had increased by 4.6 points – from 23.1 (considered normal weight) to 27.7 (considered overweight). That shifted the number of overweight young adults from about 18% in the late 1970’s to nearly 24% by 2018.


No Changes for Pennsylvania HealthChoices Physical Plans

The Pennsylvania Department of Human Services (DHS) has confirmed that there will be no changes to the Physical HealthChoices managed care organization (MCO) assignments in early 2022. Results of two of the four MCO challenges to DHS’ decisions in response to the 2021 RFP process have been announced. The Commonwealth Court of Pennsylvania upheld on November 17, 2021, the state’s decision to deny protests filed by Aetna Better Health of Pennsylvania and Centene/Pennsylvania Health & Wellness after the two plans failed to win contracts in the state’s recent Medicaid managed care procurement. Rulings on protests from Gateway Health Plan and UnitedHealthCare have not been released publicly. Implementation of the new contracts, originally slated for January 1, 2022, have been suspended until the protests are resolved. In Behavioral HealthChoices, Magellan will change to CCBH in Delaware County effective July 1, 2022.

The list of MCO assignments are:





Strategies to Prepare for Public Health Emergency Unwinding

The Centers for Medicare and Medicaid Services (CMS) released a “punch list” of strategies states and the U.S. territories can adopt to maintain coverage of eligible individuals as they return to normal operations after the end of the public health emergency. The strategies are organized around seven topics areas:

  1. strengthening renewal processes
  2. updating mailing addresses
  3. improving consumer outreach, communication, and assistance
  4. promoting seamless coverage transitions
  5. improving coverage retention
  6. addressing strains on the eligibility and enrollment workforce
  7. enhancing oversight of eligibility and enrollment operations

In the resource, CMS also flagged strategies expected to have the biggest impact on mitigating coverage losses.