Bill Banning ‘Gag Clauses’ on Pharmacists Signed by Governor

Legislation that increases transparency and consumer choice in the prescription drug marketplace is now law. HB 943 (Act 67) ends the long-standing “gag clause” imposed on pharmacists, barring them from informing customers of lower-cost alternatives at the pharmacy counter. Such a prohibition stems from language contained in some pharmacy contracts that disallows pharmacists from disclosing any information to their customers that could potentially reduce their out-of-pocket costs for medications. The bill was signed into law July 23 and becomes effective in 60 days.

Governor Signs Revisions to Minor Consent Act into Law

On July 23, Gov. Wolf signed HB 672 (Act 65 of 2020) into law repealing provisions related to mental health treatment and release of medical records and adding new language providing for consent for voluntary inpatient and outpatient mental health treatment and for release of medical records. The law enables certain minors to consent to medical, dental and health services, declaring consent unnecessary under certain circumstances. The changes become effective in 60 days.

State Opens Opioid Use Disorder Center of Excellence Opportunity

The Pennsylvania Department of Human Services (DHS) reported on July 16, 2020, that it will allow additional Medicaid providers to enroll as an opioid use disorder Center of Excellence (COE). Providers who enroll in the Medicaid program as a COE will be eligible to bill managed care organizations (MCOs) for care management services. DHS will continue to monitor the COE care model to ensure that new providers are meeting the standards. For more information, see related article above on PACHC’s call on this OUD-COE opportunity. Access the DHS Opioid Use Disorder Centers of Excellence Bulletin & Application.

Cerner Launches Cloud-Based EHR System Geared for Rural and Critical Access Hospitals

Cerner, an electronic health record software company, launched a cloud-based version of its electronic health record (EHR) with the aim of helping rural and Critical Access Hospitals eliminate costs associated with traditional EHR systems. Many rural hospitals are now facing increased pressure to cut costs to stay afloat due to losses in revenue from cancelled elective procedures and patient attrition. Cloud-based EHRs help cut costs by lowering maintenance costs and fixed payments, allowing rural health systems to focus their budgets on operational costs. Many experts expect to see more rural health systems invest in this innovative technology and potentially use some of the funds from the $10 billion rural carveout of the Provider Relief Fund distributed by HHS to install cloud-based EHRs.

COVID Crisis Highlights Need for Rural Broadband

Rural hospitals are struggling during the COVID-19 pandemic, which has highlighted the importance of having adequate broadband to enable access to telehealth. As telehealth becomes more popular, broadband becomes increasingly essential. The July 15 Webinar, “COVID-19 Impacts on Rural Healthcare and Broadband,” the fourth webinar in the “From the Farmgate” series of webinars CoBank sponsors, presented speakers covering these issues. These presenters advocate for rural broadband and healthcare stabilization through policy action. In addition, this article highlights a struggling hospital and showcases communication companies that have signed the pledge to not disconnect anyone from broadband service due to the inability to pay for their service.

HHS Study: Strategies Rural Communities Use to Address Substance Misuse Among Families in The Child Welfare System

The Office for Planning and Evaluation at HHS describes nine programs serving child welfare-involved parents with substance use issues, with a focus on their applicability to rural communities. These programs offered several types of services, including parent mentoring, case management, home visiting, and treatment for opioid use disorders.

Senators Propose Bipartisan Paycheck Protection Program Fix for Rural Hospitals

Senators Roger Wicker (R-MS), Tina Smith (D-MN), Doug Jones (D-AL), and Cindy Hyde-Smith (R-MS) have introduced bipartisan legislation that would waive the Small Business Administration’s (SBA) Affiliation Rules for the small health-care facilities, the PPP Access for Rural Hospitals Act (S. 4217). This bill would enable the facilities to qualify for Paycheck Protection Program (PPP) loans. The Coronavirus Aid, Relief, and Economic Security (CARES) Act established the PPP to give immediate relief to small businesses. In addition to the more immediate concerns related to COVID-19, hospitals have lost significant revenue because of having to stop non-emergency and elective procedures. Therefore, providing PPP to smaller rural hospitals will allow them to continue to employ healthcare workers and provide access to necessary healthcare services in rural communities.

HHS Provides More Details on Provider Relief Fund Reporting

The U.S. Department of Health and Human Services (HHS) released additional reporting requirements for healthcare organizations that received financial support under the CARES Act. The notice requires healthcare organizations that received more than $10,000 to submit reports detailing the use of the funds and compliance with payment terms and conditions. Providers must report on their expenditures through the end of the December. HHS states that more details about reporting requirements will be released August 17th. This announcement comes after months of questions from providers about how to use and report the funds they received; this includes Paycheck Protection Program (PPP) dollars. NRHA is working with rural health champions in the Administration and Congress to ensure that rural providers are not disadvantaged by these new requirements due to their unique payment structures.

Senators Durbin and Lankford Take to the Senate Floor to Speak on Behalf of the Needs of Rural Hospitals

Senators Richard Durbin (D-IL) and James Lankford (R-OK) discussed the challenges facing rural hospitals in the wake of COVID-19 on the Senate floor. These senators helped secure $175 billion to protect the health care system and meet the emergency needs of health systems during the pandemic. However, hundreds of rural hospitals, especially in downstate Illinois, are continuing to struggle. Rural hospitals were facing financial uncertainty even before the pandemic, and in Illinois, rural hospitals have lost $1.4 billion during the pandemic, most of which can be attributed to the cancelation of non-emergency and elective procedures. Nationwide, 76 percent of revenue for rural hospitals comes from these procedures. To address the closure crisis, Sens. Durbin and Lankford have introduced the Rural Hospital Closure Relief Act of 2019 (S. 3103). Their bill, which is strongly supported by NRHA, would allow a limited number of the nation’s most financially vulnerable rural Prospective Payment System (PPS) hospitals to convert to Critical Access Hospitals (CAH), even if they do not meet the 35-mile distance requirement.

Case Study: Iowa’s I-Smile Program Promoting Dental Care

A unique partnership between the Iowa Medicaid and public health agencies, Iowa’s I-Smile program addresses the disproportionate impact of dental disease on low-income individuals and families.  The initiative is supported through cooperative agreement between the National Organizations of State and Local Health Officials and the Health Resources and Services Administration. Read more here.