Rural Health
Resources by Topic: Legislation and regulations
Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR
Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides updates for RHCs and FQHCs that are submitting claims to Medicare Administrative Contractors (MACs) for services to Medicare beneficiaries.
Date: 12/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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January 2025 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount
Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2025.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Presents the monthly Rural Emergency Hospital (REH) monthly facility payment amount for Calendar Year 2025.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Final CY 2025 Medicare Physician Fee Schedule: Fact Sheet
Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2025 as outlined in the final calendar year (CY) 2025 Physician Fee Schedule. Covers audio-only telehealth; eligible services that can be delivered by telehealth; frequency limitations for inpatient visits, nursing facilities, and critical care consults; direct supervision through the use of live video; payment to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs); opioid treatment programs; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Fact sheet covering Centers for Medicare & Medicaid Services (CMS) telehealth policy changes for 2025 as outlined in the final calendar year (CY) 2025 Physician Fee Schedule. Covers audio-only telehealth; eligible services that can be delivered by telehealth; frequency limitations for inpatient visits, nursing facilities, and critical care consults; direct supervision through the use of live video; payment to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs); opioid treatment programs; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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2023 Summer Non-Congregate Meal Service: Results from the 2023 Summer Non-Congregate Sponsor Survey
Evaluates the implementation of the 2023 Consolidated Appropriations Act, which permanently allowed for rural non-congregate meal service as part of the U.S. Department of Agriculture (USDA) Summer Meal Programs. Provides 2023 survey data from State agency sponsors operating summer non-congregate meal service for children, with a focus on site participation, sponsor experiences, meal pick up sites, meal delivery, and future plans for non-congregate meal service.
Additional links: Appendix A - Survey, Data Tables
Author(s): Susannah Barr
Date: 10/2024
Type: Document
Sponsoring organization: USDA Food and Nutrition Service
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Evaluates the implementation of the 2023 Consolidated Appropriations Act, which permanently allowed for rural non-congregate meal service as part of the U.S. Department of Agriculture (USDA) Summer Meal Programs. Provides 2023 survey data from State agency sponsors operating summer non-congregate meal service for children, with a focus on site participation, sponsor experiences, meal pick up sites, meal delivery, and future plans for non-congregate meal service.
Additional links: Appendix A - Survey, Data Tables
Author(s): Susannah Barr
Date: 10/2024
Type: Document
Sponsoring organization: USDA Food and Nutrition Service
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CMS-Approved Waivers Break New Ground for Medicaid Coverage of American Indian and Alaska Native Traditional Health Care Practices
Provides an overview of Centers for Medicare & Medicaid Services (CMS) approved 1115 waivers that allow Medicaid agencies to cover American Indian and Alaska Native (AI/AN) traditional healthcare practices in four states: Arizona, California, New Mexico, and Oregon. Describes who can access traditional healthcare practices under these waivers, where traditional healthcare services can be provided, who will be certified to provide these services, and implementation support.
Author(s): Anne Smithey
Date: 10/2024
Type: Document
Sponsoring organization: Center for Health Care Strategies
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Provides an overview of Centers for Medicare & Medicaid Services (CMS) approved 1115 waivers that allow Medicaid agencies to cover American Indian and Alaska Native (AI/AN) traditional healthcare practices in four states: Arizona, California, New Mexico, and Oregon. Describes who can access traditional healthcare practices under these waivers, where traditional healthcare services can be provided, who will be certified to provide these services, and implementation support.
Author(s): Anne Smithey
Date: 10/2024
Type: Document
Sponsoring organization: Center for Health Care Strategies
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As Pandemic-Era Policies End, Medicaid Programs Focus on Enrollee Access and Reducing Health Disparities Amid Future Uncertainties: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2024 and 2025
Examines changes taking place in Medicaid programs in the 50 states and the District of Columbia. Features sections on delivery systems, provider rates and taxes, benefits, and pharmacy and prescription drugs. Highlights challenges and priorities related to state workforce shortages, systems issues, emerging state budget pressures, and more.
Author(s): Elizabeth Hinton, Elizabeth Williams, Jada Raphael, et al.
Date: 10/2024
Type: Document
Sponsoring organization: KFF
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Examines changes taking place in Medicaid programs in the 50 states and the District of Columbia. Features sections on delivery systems, provider rates and taxes, benefits, and pharmacy and prescription drugs. Highlights challenges and priorities related to state workforce shortages, systems issues, emerging state budget pressures, and more.
Author(s): Elizabeth Hinton, Elizabeth Williams, Jada Raphael, et al.
Date: 10/2024
Type: Document
Sponsoring organization: KFF
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The Rural Emergency Hospital Model: Year Two Progress Report
Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Type: Document
Sponsoring organization: Bipartisan Policy Center
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