Community health centers are often the first line of defense during health crises in America, including the opioid and HIV epidemics, operating as a safety net for 30 million patients who would otherwise struggle to access primary care, including 13 million patients living in poverty, 6 million uninsured patients, and 1 million patients experiencing homelessness. Despite their vital role, health centers are in a precarious financial position. Operating within tight financial margins leaves them with little room for investments in technology, staffing, and other resources and when financial uncertainty grows, health centers often impose hiring freezes or reduce services. Read more in Underfunded and Overburdened: The Toll of the COVID-19 Pandemic on Community Health Centers.
One Third of Pennsylvania’s May Medicaid Reapplications Ineligible
New data from the Pennsylvania Department of Human Services show that 43,546, or 32%, of the 137,611 Pennsylvanians who completed the reapplication process in the first month were slated to lose Medicaid, declared ineligible because their income was too high or due to a procedural problem, such as not returning documentation, The Philadelphia Inquirer reports.
New Brief Highlights State Opioid Settlement Spending Decisions
In order to spend funding received through the national settlement and other opioid-related settlements, states have developed legislative and legal frameworks that distribute funds and decision-making authorities between the state government, local governments, and/or special abatement funds or trusts. States are in different stages in the process of receiving money, deciding how to spend it, implementing funded programs, and reporting on spending and outcomes. However, 17 states have now approved and published their plans for a first year of spending, which often include priority areas or approved uses for funds. A smaller subset of states have awarded settlement funds to specific abatement programs. Many of these plans were published in the final months of 2022 or first months of 2023 as part of annual reports on settlement spending activity.
This issue brief provides an overview of published statewide opioid settlement spending plans and appropriations made to date and highlights initial priorities and investments outlined in these plans.
National Rural Leaders Program Accepting Applications
The National Rural Health Association’s (NRHA) Rural Health Fellows Program is a yearlong, intensive training program that develops leaders who can articulate a clear and compelling vision for rural America. The goal of the fellows program is to educate and develop a network of diverse rural leaders that will step forward to serve in key positions in the association, affiliated advocacy groups, and local and state legislative bodies with health equity as a main focus.
Each year, NRHA selects 10 to 15 highly motivated individuals who have proven their dedication to improving the health of rural Americans through their educational or professional experience.
The submission period for 2024 Rural Health Fellows applications is now open. For more information, contact Ally Zimmerman.
USDA Partners with Agricultural Producers to Strengthen Markets and Create Jobs for Producers in 19 States
U.S. Department of Agriculture (USDA) Secretary Tom Vilsack announced today that USDA is making investments that will create new and better markets for agricultural producers and food businesses in 19 states across rural America.
“The Biden-Harris Administration and USDA are standing up for America’s farmers and ranchers by expanding processing capacity, creating fairer markets, more revenue streams and market opportunities which help bring down food costs for families at the grocery store,” Secretary Vilsack said. “We are partnering with entrepreneurs in rural areas to build brighter futures, connect business owners to new markets and create good jobs for generations to come. These investments reflect the goals of President Biden’s Investing in America agenda to rebuild our economy from the bottom up and middle out and make our communities more resilient.”
USDA is making investments worth $320 million to strengthen food supply chains and create more opportunities for producers and entrepreneurs in 19 states: Alabama, California, Connecticut, Iowa, Idaho, Kentucky, Massachusetts, Michigan, Minnesota, Montana, North Carolina, North Dakota, New Hampshire, New York, Ohio, Oklahoma, Pennsylvania, Texas and Virginia.
To learn more, read the full news release.
KFF Launches Medicaid Enrollment and Unwinding Tracker
The Medicaid Enrollment and Unwinding Tracker presents the most recent data on monthly Medicaid enrollment, renewals, disenrollments, and other key indicators reported by states during the unwinding of the Medicaid continuous enrollment provision. The unwinding data are pulled from state websites, where available, and from the Centers for Medicare & Medicaid Services (CMS).
To view data for specific states, click on the State Enrollment and Unwinding Data tab.
Pennsylvania Governor’s Administration Eliminates Medicaid Provider Enrollment Application Backlog
Pennsylvania Governor Josh Shapiro’s administration announced it has completely eliminated a backlog of Medicaid provider enrollment and revalidation applications, paving the way for more health care providers to become part of the Medicaid program, and giving Medicaid recipients more options for care. As of January 2023, there was a backlog of more than 35,000 provider applications and revalidation applications that were more than 30 days old. By federal law, organizations are not able to offer care to patients under the Medicaid program unless they are enrolled providers. In addition, the Department of Human Services must revalidate Medicaid service providers every five years.
Any backlogs in processing applications means that providers who want to offer services to Medicaid recipients cannot do so until their applications are approved.
2021 Pennsylvania Dentist and Dental Hygienist Workforce Survey Report Released
The Pennsylvania Department of Health has published the final “2021 Pennsylvania’s Dentist and Dental Hygienist Workforce Survey Report” based on the State Board of Dentistry data from the 2021 licensure renewals. In 2021, 9,174 dentists renewed their license with 8,456 being employed in dentistry. Over 65% of Pennsylvania dentists identified as male and nearly 70% identified as White. There were 7,530 dental hygienists that renewed their licenses with 24% working in rural counties.
No Surprises Act – New Consumer-Friendly Resources
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.
Unexpected medical bills are a significant source of stress, frustration, and confusion for people in the United States. The No Surprises Act gives them new rights to prevent, navigate, and find resolutions to many of these “surprise” bills.
To help consumers understand their rights, consumer-friendly web pages are now available for people with easy-to-read information and actionable guidance. The webpages’ design and content were informed by human-centered design research and user testing with patients, caregivers, patient advocates, and others.
The webpage aims to be inclusive and accessible by:
- Meeting Web Content Accessibility Guidelines (WCAG 2.1 AA)
- Providing all information in both English and Spanish
- Using plain language and clean design
- Centering the human experience with diverse and colorful illustrations
- Building the site to be responsive to different devices, including mobile phones and tablets
- Offering clear and multiple pathways for people to learn about their rights
When people visit the consumer website, they’ll be guided through:
- Understanding their rights under the No Surprises Act, including out-of-network billing protections and good faith estimates for future care
- Identifying actions they can take to exercise their rights and find a resolution if they receive an unexpected medical bill, using a Q&A tool that asks about their situation
- Submitting a complaint if they think their provider, facility, or insurance company didn’t follow the rules of the No Surprises Act through an optimized process and redesigned form
- Disputing a bill if they are uninsured or didn’t use insurance and they were charged more than their good faith estimate
- Finding guides that will help them navigate medical billing questions, as well as learning how to connect with the No Surprises Help Desk
Resources:
- No Surprises Act Consumer Webpage: https://www.cms.gov/medical-bill-rights as well as en Español: https://www.cms.gov/derechos-facturas-medicas
- New Protections for Consumers: https://www.cms.gov/medical-bill-rights/know-your-rights
Payment Dispute Webpage: https://www.cms.gov/medical-bill-rights/help/dispute-a-bill - Submit a Complaint: https://www.cms.gov/medical-bill-rights/help/submit-a-complaint
- Find an Action Plan: https://www.cms.gov/medical-bill-rights/help/plan
- Resources for providers can still be found at: https://www.cms.gov/nosurprises
U.S. Supreme Court Preserves Rights for Medicaid Patients in Landmark Decision
In a significant win for Community Health Centers and Medicaid recipients, the Supreme Court of the United States has ruled in favor of the right of people in safety net programs to seek federal court protection if their health care and other essential benefits are jeopardized. The Supreme Court overturned a lower court ruling in Health and Hospital Corporation of Marion County v. Talevski that curbed the rights of Medicaid beneficiaries to sue states. This landmark ruling has far-reaching implications for Community Health Centers and the millions of Medicaid patients who rely on them for medical care. The National Association of Community Health Centers (NACHC) played a key role in the case, filing an amicus brief urging the Court to uphold section 1983 and recognize its significance for the nation’s health centers.