On December 1^st, we commemorate World AIDS Day. The 2019 theme is “Ending the HIV/AIDS Epidemic: Community by Community.” The purpose of World AIDS Day is to bring attention to the HIV epidemic, endeavor to increase HIV awareness and knowledge, show support and commitment to helping those living with the disease, and remember those who have died from HIV/AIDS in our country and around the world.

HIV has transformed from what was once a deadly disease to now a manageable, chronic condition if there is access to high-quality health care, critical support services, and appropriate medications. People with HIV who take HIV medication daily as prescribed and reach and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.

This World AIDS Day, HRSA remains committed to ending the HIV epidemic. Earlier this year, the Trump Administration announced the “Ending the HIV Epidemic: A Plan for America” (EHE) initiative. Through HRSA’s Ryan White HIV/AIDS Program and the HRSA-funded Health Center Program, the agency will play a leading role in helping diagnose, treat, prevent and respond to end the HIV epidemic. Learn more about HRSA’s role in the initiative.

Recently, the Federal Communications Commission (FCC) finalized regulations to promote transparency and predictability, and further the efficient allocation of limited Rural Health Care Program resources while guarding against waste, fraud and abuse. The FCC promotes telehealth in rural areas through the Rural Health Care Program (RHC Program), which provides financial support to help rural health care providers obtain broadband and other communications services at discounted rates. The regulations went into effect on November 12, unless noted otherwise for some specific provisions in the final rule.

Full article: https://www.govinfo.gov/content/pkg/FR-2019-10-11/pdf/2019-20173.pdf

On November 15, the Centers for Medicare & Medicaid Services (CMS) finalized policy changes to the CY 2020 Hospital Outpatient Prospective Payment System (OPPS) on price transparency requirements for hospitals. This final rule establishes requirements for hospitals, including Critical Access Hospitals (CAHs) and other rural hospitals, to make public a machine-readable file online that includes all standard charges along with discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges for a set of “shoppable services.” CMS is finalizing that the effective date of the final rule will be January 1, 2021, to ensure that hospitals have the time to be compliant with these policies.

Full article: https://www.cms.gov/newsroom/fact-sheets/cy-2020-hospital-outpatient-prospective-payment-system-opps-policy-changes-hospital-price

Last week,  the Centers for Medicare & Medicaid Services (CMS) proposed changes to state Medicaid reporting and clarifications of key definitions in order to improve payment transparency and program integrity.  Proposals in this rule focus on four payment areas: fee-for-service (FFS) supplemental provider payments; disproportionate share hospital (DSH) payments; financing for the non-Federal share of payments; and health care-related taxes and provider-related donations.  CMS seeks comment on all elements of this proposal, including whether supplemental provider payments should be capped, if there should be a separate cap for rural areas and/or HRSA-designated geographic health professional shortage areas, and whether there should be other special considerations for providers in underserved areas.

Comments are due January 17th.

For more information, visit: https://www.federalregister.gov/documents/2019/11/18/2019-24763/medicaid-program-medicaid-fiscal-accountability-regulation

On November 15, the U.S. Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury proposed requirements for group health plans and health insurance issuers in the individual and group markets to disclose cost-sharing information upon request, to a participant, beneficiary, or enrollee (or his or her authorized representative), including an estimate of such individual’s cost-sharing liability for covered items or services furnished by a particular provider. If you are looking for information on health insurance in rural areas, you can find resources on RHIhub.

Comments are due by January 14th.

For more information, visit: https://www.federalregister.gov/documents/2019/11/27/2019-25011/transparency-in-coverage

In an effort to better prepare and assist small rural hospitals in moving from a fee-for-service and volume-based payment system to one that is drive by value and quality, the Federal Office of Rural Health Policy (FORHP) administers the Small Rural Hospital Transition Project (SHRT).  The program provides technical assistance through onsite consultations to eligible hospitals that have 49 beds or less and are located in a federally-designated persistent poverty county. Core areas of technical assistance include: 1) financial operational assessment, and 2) quality improvement projects. Last month, nine hospitals were identified through the objective review process to receive this assistance in the 2019-2020 cohort of the project.  Now in its fifth year, the SHRT program shares what’s learned on issues relevant to rural health stakeholders through the National Rural Health Resource Center.  See the full list of hospitals by clicking here.

This document is a practical guide for ambulance services to use in their pursuit of sustaining effective and efficient delivery of patient care and developing into an integrated system with other agencies. It provides insights from agencies to promote integration to the benefit of the agencies, the staff, and, most importantly, to the patients.   The guide can be accessed here.