By January 25. The Medicaid And CHIP Payment and Access Commission (MACPAC) makes recommendations to Congress, to the Secretary of the U.S. Department of Health & Human Services, and to states on a wide array of issues affecting Medicaid and the Children’s Health Insurance Program (CHIP). The U.S. Government Accountability Office is now accepting nominations for MACPAC commissioner appointments that will be effective May 2024. Nominees may include individuals with direct experience as enrollees or as caregivers of enrollees in Medicaid or CHIP; individuals with expertise in federal safety net health programs, health finance and economics, actuarial science, health plans and integrated delivery systems, reimbursement for health care, health information technology; or other providers of health services, public health, and other related fields. The commission seeks a mix of different professions as well as urban and rural representation. Send letters of nomination and resumes to MACPACappointments@gao.gov.
CMS Accepting Applications for New Physician Residency Slots
Apply by March 31. Federal legislation under Section 126 of the Consolidated Appropriations Act, 2021, authorizes the Centers for Medicare & Medicaid Services (CMS) to distribute additional residency positions (also known as slots) for physician training in underserved areas. Eligible hospitals must use MEARIS, CMS’s online application system to apply by March 31 for 200 newly available slots. In a one-hour webinar on Wednesday, January 17, at 12:00 pm Eastern, experts will provide background information on Section 126. The session is hosted by RuralGME.org, the FORHP-supported organization that helps hospitals plan and develop rural residencies, and will focus on considerations for rural hospitals.
HHS Announces New Catalytic Program for the Climate
National Sessions Beginning January 25. The Office of Climate Change and Health Equity (OCCHE) was established in 2021 to address the impact of climate change on health in the United States and territories. The office has been coordinating efforts across 12 operating divisions, including HRSA, in the U.S. Department of Health & Human Services (HHS). From the beginning, the initiative identified rural areas as uniquely vulnerable – where people, businesses, and safety net health organizations pay disproportionately high costs to recover from storms, heat waves, and wildfires. Following on an information session in November 2023 the OCCHE is launching its Catalytic Program later this month – providing funding, tax credits, grants and other supports made available by the Inflation Reduction Act. The opportunities are meant for health care organizations – especially safety net providers – to improve energy efficiency, infrastructure resilience, and more. The Catalytic Program will be carried out through collaboration with federal partners, including the Environmental Protection Agency and Department of Energy, and reach out to ground-level partners through a series of national webinars and separate breakout sessions by provider type (e.g., rural facilities) to help organizations to assess their needs and opportunities. Sign up now to take part in sessions taking place January through April.
Investments Being Granted Supporting Partnerships in Recovery Ecosystems (INSPIRE) for the Appalachian Region
Letters of Intent February 16. The federal Appalachian Regional Commission works in partnership with 13 states to promote economic growth where one-fourth of the region’s 423 counties are rural. The INSPIRE initiative supports the post-treatment to employment continuum, which could include investments in healthcare networks that support substance use disorder recovery, recovery-focused job training programs, and other initiatives that coordinate these efforts. Successful INSPIRE grant applications will demonstrate the potential for individuals in recovery to obtain and maintain stable employment, with a focus on support services and training opportunities that lead to successful entry and re-entry into the workforce. Letters of Intent are required by February 16, 2024. The deadline for final applications is March 8, 2024. Award announcements are anticipated to be made in September 2024.
HRSA Updates HPSA Designations
HRSA’s Bureau of Health Workforce has released the current list of Health Professional Shortage Areas (HPSAs) – which can be geographic areas, populations, or facilities – that have a shortage of primary, dental, or mental health care providers. The designations are used to determine eligibility for federal programs that support the health workforce, such as the National Health Service Corps, as well as safety net programs such as HRSA’s Health Centers and CMS’s Rural Health Clinics. For more details on the information used to determine HPSAs, visit the HRSA Data Warehouse.
Rural Hospitals Are Caught in an Aging-Infrastructure Conundrum
Kevin Stansbury, the CEO of Lincoln Community Hospital in the 800-person town of Hugo, Colorado, is facing a classic Catch-22: He could boost his rural hospital’s revenues by offering hip replacements and shoulder surgeries, but the 64-year-old hospital needs more money to be able to expand its operating room to do those procedures.
“I’ve got a surgeon that’s willing to do it. My facility isn’t big enough,” Stansbury said. “And urgent services like obstetrics I can’t do in my hospital, because my facility won’t meet code.”
Rural hospitals throughout the nation are facing a similar conundrum. An increase in costs amid lower payments from insurance plans makes it harder for small hospitals to fund large capital improvement projects. And high inflation and rising interest rates coming out of the pandemic are making it tougher for aging facilities to qualify for loans or other types of financing to upgrade their facilities to meet the ever-changing standards of medical care.
February is National Children’s Dental Health Month!
February is National Children’s Dental Health Month. This month-long national health observance brings together thousands of dedicated professionals, healthcare providers, and educators to promote the benefits of good oral health to children, their caregivers, teachers, and many others. The 2024 theme is “Healthy Habits for Healthy Smiles.” The American Dental Association has free downloadable posters, postcards, and flyers available on their website. You can also order physical copies of these materials to be shipped.
Assessing Value-Based Payment Policies for Rural Areas
In 2021, the Centers for Medicare & Medicaid Services (CMS) announced a goal to have all Original Medicare (fee-for-service) beneficiaries in care relationships with health care providers that are accountable for the beneficiaries’ total cost of care and quality by 2030. This policy paper from the Rural Health Value team discusses the challenges that are particular to rural areas as well as potential opportunities.
CMS’ Proposed Rule Addresses Appeals Rights for Certain Changes in Patient Status
The proposed rule from the Centers for Medicare & Medicaid Services (CMS) is in response to a federal court ruling that affects Medicare beneficiaries who received “observation services” in a hospital as outpatients. The case of Alexander v. Azar in the U.S. District Court of Connecticut was decided by a federal judge in March 2020 and requires that beneficiaries who are initially admitted as hospital inpatients, but are subsequently reclassified as outpatients (resulting in a denial of coverage for the hospital stay under Medicare Part A), are entitled to an appeals process if they meet other eligibility criteria. CMS is requesting comment from the public on this proposal to create a standardized notice advising beneficiaries of their rights to three types of appeal – expedited, standard, or retrospective – depending on the patient’s current status.
Comment by February 22
Expanded Medicare Part D Low-Income Subsidy Begins
In compliance with the Inflation Reduction Act, the Centers for Medicare & Medicaid Services’ Low-Income Subsidy Program (also known as Extra Help) will provide full financial assistance to beneficiaries enrolled in the Medicare Part D program with incomes up to 150% of the federal poverty level. Medicare beneficiaries who are eligible and enroll in Medicare Savings Programs are automatically eligible for full low-income subsidies, the payment of Medicare Parts A and B premiums, and cost-sharing. Other Medicare beneficiaries must apply for the Extra Help program via the Social Security Administration to obtain these subsidies.