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Rural Health
News by Topic: Medicaid

Dec 16, 2024 - Notice from the Indian Health Service (IHS) announcing the calendar year 2025 reimbursement rates for inpatient and outpatient medical care provided by IHS facilities to Medicare, Medicaid, and other federal program beneficiaries. The updated rates apply to all qualifying services provided on or after January 1, 2025.
Source: Federal Register
Dec 15, 2024 - Explores the impacts of behavioral health provider shortages on rural communities in the northwest. Notes that immigrants may face additional challenges finding care due to language barriers and some providers not accepting Medicaid. Describes strategies to increase access to behavioral health providers, including telehealth, increased reimbursement for services, and workforce programs.
Source: Northwest News Network
Dec 13, 2024 - Notice of final rule from the U.S. Department of Health and Human Services (HHS) adopting updated versions of the retail pharmacy standards for electronic transactions adopted under the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). These updated versions are modifications to the currently adopted standards for the following retail pharmacy transactions: healthcare claims or equivalent encounter information; eligibility for a health plan; referral certification and authorization; and coordination of benefits. This final rule also adopts a modification to the standard for the Medicaid pharmacy subrogation transaction. This rule is effective February 11, 2025. Compliance with this rule is required by February 11, 2028.
Source: Federal Register
Dec 12, 2024 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of the approval of the American Association for Accreditation of Ambulatory Healthcare for continued recognition as a national accrediting organization for Ambulatory Surgical Centers that wish to participate in the Medicare or Medicaid programs. This approval is applicable from November 20, 2024, through November 20, 2029.
Source: Federal Register
Dec 11, 2024 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of the approval of DNV Healthcare USA, Inc. (DNV) as a national accrediting organization for Critical Access Hospitals that wish to participate in the Medicare or Medicaid programs. This approval is applicable from December 23, 2024, through December 23, 2028.
Source: Federal Register
Dec 10, 2024 - Notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) revising the Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicaid, Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) regulations to implement changes related to Star Ratings, marketing and communications, agent/broker compensation, health equity, drug coverage, dual eligible special needs plans (D-SNPs), utilization management, network adequacy, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This proposed rule also includes proposals to codify existing subregulatory guidance in the Part C and Part D programs. Comments are due by January 27, 2025.
Source: Federal Register
Dec 2, 2024 - Notice from the Centers for Medicare and Medicaid Services announcing the application fee for providers initially enrolling in the Medicare or Medicaid programs, or the Children's Health Insurance Program (CHIP); revalidating their Medicare, Medicaid, or CHIP enrollment; or adding a new Medicare practice location. The new fee is $730 and is required for applications submitted January 1, 2025, through December 31, 2025.
Source: Federal Register
Dec 2, 2024 - Notice of proposed rule from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) that would codify changes made by the Medicaid Services Investment and Accountability Act of 2019 (MSIAA), which added exclusion authorities related to misclassification and false information about outpatient drugs. This proposed rule would also update and clarify OIG's procedures for excluding individuals and entities from participation in the federal healthcare programs, including the factors that will be considered in determining the length of exclusions, the provisions governing notices of exclusions, and certain provisions related to reinstatement into the programs. Comments are due by January 31, 2025.
Source: Federal Register
Nov 29, 2024 - Notice from the Department of Health and Human Services releasing the Federal Medical Assistance Percentages (FMAP) rates for the period of October 1, 2025, through September 30, 2026. The rates are used to determine the amount of Federal matching for state Medicaid, Temporary Assistance for Needy Family (TANF) Contingency Funds, and Enhanced Federal Medical Assistance Percentages (eFMAP) rates for the Children's Health Insurance Program (CHIP) expenditures, among other federal assistance programs.
Source: Federal Register
Nov 27, 2024 - Notice of final rule with comment period from the Centers for Medicare & Medicaid Services (CMS) revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2025. This rule also updates the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, Rural Emergency Hospital Quality Reporting (REHQR) Program, Ambulatory Surgical Center Quality Reporting (ASCQR) Program, and Hospital Inpatient Quality Reporting Program and finalizes updates to the Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services. Among other things, this rule summarizes comments received in response to an information request on potential modifications to the Safety of Care measure group in the Overall Hospital Quality Star Rating methodology. This rule also finalizes exceptions to the Medicaid clinic services benefit four walls requirement for Indian Health Service and Tribal clinics, and, at state option, for behavioral health clinics and clinics located in rural areas. The provisions of this rule are effective January 1, 2025. Comments are due by December 31, 2024.
Source: Federal Register