With the signing of Executive Order 2022-01 by Pennsylvania Governor Wolf, Pennsylvania joined New York, New Jersey, and Connecticut in action to protect abortion seekers traveling from other states. The states anticipate more out-of-state people seeking an abortion, as roughly half of U.S. states ban or impose restrictions on the services. The EO and its protections are set to take immediate effect. The order bars any agency, board, or commission that answers to the governor’s office from using Pennsylvania resources to help another state’s investigation into a patient seeking reproductive health services, or the providers helping them. This protection does not apply if cooperation is required by court order or if the actions being investigated broke laws in the commonwealth. The governor will also deny any request to arrest or extradite someone who received reproductive health services in Pennsylvania or assisted in these services. Unlike some states that have passed laws to protect abortion access, Pennsylvania only has the EO, which means the gubernatorial election in November will determine whether it remains in place.

Recently, Congress created the Affordable Connectivity Program, a $14 billion program that may help people in rural communities get the internet connections they need for work, school, health care, and more. Eligible households can enroll through a participating broadband provider or directly with the Universal Service Administrative Company (USAC) using an online or mail-in application. This benefit provides a discount of up to $30 per month toward broadband service for eligible households and up to $75 per month for households on qualifying Tribal lands. Eligible households can also receive a one-time discount of up to $100 to purchase a laptop, desktop computer, or tablet from participating providers. To apply or ask questions, visit affordableconnectivity.gov or call the ACP Support Center at (877) 384-2575.

On July 7, HRSA published the complete lists of all geographic areas, population groups, and facilities designated as primary medical care, dental health, and mental health professional shortage areas (HPSAs) as of April 29, 2022.  In this notice, HRSA also indicated that the agency will be providing a longer transition time for jurisdictions and facilities to prepare for potential changes to HPSA designations given the impact of the COVID-19 pandemic.  Specifically, HPSA designations that are currently proposed for withdrawal will remain designated in “proposed for withdrawal” status until they are reevaluated in preparation for the publication of the 2023 HPSA notice. This additional time will allow jurisdictions to re-evaluate their HPSAs against the designation criteria, and plan for potential changes in staffing.

CMS is proposing actions to advance health equity and improve access to care in rural communities by establishing policies for Rural Emergency Hospitals (REH) and providing for payment for certain behavioral health services furnished via communications technology. Additionally, in line with President Biden’s Executive Order on Promoting Competition in the American Economy, the calendar year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System proposed rule includes proposed enhanced payments under the OPPS and the Inpatient Prospective Payment System for the additional costs of purchasing domestically made NIOSH-approved surgical N95 respirators and a comment solicitation on competition and transparency in our nation’s health care system.

More Information:

• Press release
• Proposed rule fact sheet
• REH fact sheet
• Proposed rule

On July 7, CMS published a proposed rule updating payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule. Included in this rule are updates to Accountable Care Organization (ACO) policies under the Medicare Shared Savings Program designed to increase participation among rural and underserved communities, including proposals to provide Advance Investment Payments building on lessons learned from CMS’s ACO Investment Model and to smooth the transition to performance-based risk. Additionally, CMS is extending telehealth regulatory flexibilities beyond the pandemic in line with the Consolidated Appropriations Act of 2022 and incorporating new chronic pain management and behavioral health integration services to the Rural Health Clinic and Federally Qualified Health Center codes– Comment by September 6.

Rural residents who are Black, Indigenous, and People of Color (BIPOC) experience even poorer pregnancy-related health outcomes. Racial disparities in rural maternal and infant health outcomes may be related to limited accessibility of clinical care and pregnancy/postnatal support programs and services in rural communities. This policy brief from the University of Minnesota Rural Health Research Center describes these differences between majority-BIPOC versus majority-white rural counties’ available maternal and infant health evidence-based supports.

Researchers looked at survey responses from women of reproductive age across eight rural U.S. regions to determine the association between contraceptive use and SUD treatment, healthcare utilization, and substance use.  They found that less than 40 percent of respondents to the Rural Opioid Initiative (ROI) survey reported contraceptive use, compared to 66 percent responding to a more general survey on families, fertility, and health from the Centers for Disease Control and Prevention.  Odds of contraceptive use increased, however, for ROI women who had received treatment for substance use disorder within the last 30 days.

On Monday, HHS announced new guidance on the Emergency Medical Treatment and Active Labor Act that protects providers when offering life- or health-saving abortion services in emergency situations.  The statute requires Medicare hospitals to provide all patients an appropriate medical screening, examination, stabilizing treatment, and transfer, if necessary, irrespective of any state laws or mandates that apply to specific procedures.

The U.S. Department of Health & Human Services (HHS) seeks input from individuals; paid and unpaid caregivers; community-based organizations; health care providers; professional societies; community health centers and Rural Health Clinics; state, local, tribal, and territorial governments, and public health departments; educators; academic researchers; global partners; health insurance payers and purchasers; health technology developers; and policy experts.  Respondents are asked to provide information on successful models or innovations that improve primary health care and successful strategies to engage communities.

Comments Requested by August 1

Using data from the Centers for Disease Control and Prevention, the national nonprofit Kaiser Family Foundation reports that suicide death rates in 2020 were highest among American Indian and Alaska Native people, males, and people who live in rural areas.  While women are more likely to report mental illness and are more likely to attempt suicide, suicide death rates for men are four times higher.  The report comes ahead of the launch of a new crisis line, 988, that goes live this Saturday.  The Bipartisan Policy Center provides details on the funding and policy steps taken to implement 988 and identifies three areas – federal interagency collaboration, the behavioral health workforce, and financing – essential to its success.