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Rural Health
Resources by Topic: Legislation and regulations

Tracking The Elusive Medicaid Workforce To Improve Access
Discusses challenges to evaluating Medicaid enrollees' access to primary care providers. Describes how the Fitzhugh Mullan Institute for Health Workforce Equity used the Transformed Medicaid Statistical Information System (T-MSIS) to examine the primary care workforce providing healthcare to Medicaid enrollees. Outlines Medicaid workforce policy challenges, including federal regulations, workforce composition and supply, and community and market factors.
Author(s): Candice Chen, Qian "Eric" Luo, Mandar Bodas, et al.
Citation: Health Affairs Forefront
Date: 08/2023
Type: Document
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FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1785-F and CMS-1788-F Fact Sheet
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2024 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the low-wage index hospital policy, Rural Emergency Hospitals (REHs) being allowed to receive Medicare Graduate Medical Education (GME) payments, changes to the rural wage index calculation methodology, and more.
Date: 08/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Critical Access Hospital Electronic Clinical Quality Measure (eCQM) Resource List
Resource list for electronic clinical quality measures (eCQMs), reflecting new materials and updates from the Centers for Medicare & Medicaid Services for 2022 reporting.
Date: 08/2023
Type: Document
Sponsoring organization: Stratis Health
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California Assembly Bill 2024: Report to the Legislature July 2023
Report analyzing hospital annual reports, surveys, and key informant interviews to determine the impact of California's Assembly Bill 2024 on physician recruitment and retention, discussing the benefits of employment versus contracting. Outlines how the bill addressed rural hospital-specific challenges and what challenges still remain.
Date: 07/2023
Type: Document
Sponsoring organization: California Department of Health Care Access and Information
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Improving the Social Determinants of Health in Rural America Through Medicaid Section 1115 Waivers
Policy brief discussing how Medicaid Section 1115 waivers can allow states to modify the social determinants of health in rural areas through pilot programs, delivery system reform, or enhanced benefit packages. Highlights existing Section 1115 waiver programs and recently approved and renewed waivers, as well as challenges related to improving health-related social needs and access to services in rural areas. Offers policy recommendations to improve health equity in rural areas through Medicaid programs.
Author(s): Alexandra Zimmerman
Date: 07/2023
Type: Document
Sponsoring organization: National Rural Health Association
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COVID-19 Impact on Dental Service Delivery, Financing, Regulation, and Education Systems: An Environmental Scan
Describes the immediate and longer-term impacts of the COVID-19 pandemic on dental care delivery, regulation, education, and finance. Mentions rural throughout.
Author(s): Margaret Langelier, Aubri Kottek, Theekshana Fernando, et al.
Date: 07/2023
Type: Document
Sponsoring organization: Oral Health Workforce Research Center
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Council on Graduate Medical Education (COGME) Recruitment and Retention of General Surgeons in Rural Areas Support Letter
Letter from the Council on Graduate Medical Education (COGME) regarding two pieces of legislation: 1) the Ensuring Access to General Surgery Act of 2023, which would require a report from the Health Resources and Services Administration (HRSA) on "access by underserved populations to general surgeons"; and 2) the Specialty Physicians Advancing Rural Care (SPARC) Act, which would provide financial incentives to encourage more specialty clinicians, including general surgeons, to serve in rural areas. Also proposes a new general surgery scholarship and loan repayment program based on the National Health Service Corps (NHSC) model and the establishment of a rural graduate medical education (GME) program. Provides an overview of access to general surgeons in rural areas, the legislation and proposed programs, and how these programs could help meet the need for surgeons in rural areas and improve health outcomes.
Date: 07/2023
Type: Document
Sponsoring organization: Council on Graduate Medical Education
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Delivery of High-Speed Broadband Services in Unserved and Underserved Areas of the Commonwealth (Pennsylvania): Fourth Annual Report
Provides an update on the role of broadband in education, telehealth, agriculture, and community and economic development; barriers to development; funding resources; developments in Pennsylvania state and local initiatives; and efforts to identify unserved and underserved Pennsylvania communities. Includes a discussion of the Pennsylvania Broadband Development Authority and new federal funding for expansion and development in Pennsylvania.
Additional links: Summary
Author(s): Yvonne Llewellyn Hursh, Lydia Hack, Allison N. Kobzowicz, Bryan W. DeWalt, Wendy L. Baker
Date: 07/2023
Type: Document
Sponsoring organization: Joint State Government Commission, General Assembly of the Commonwealth of Pennsylvania
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Changes in Telehealth Experienced by Advanced Practice RNs During COVID-19
Summarizes 7,467 advanced practice RNs' national survey responses from June-September 2020 about the use of telehealth before and during the pandemic, and analyzes free-text comments about how the use of telehealth changed during the pandemic. Discusses challenges in rural areas, including provider shortages and lack of broadband access.
Author(s): Mavis N. Schorn, Carole R. Myers, Julie Barroso, et al.
Citation: Computers, Informatics, Nursing, 41(7), 507–513
Date: 07/2023
Type: Document
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Expanded Report to Congress: Non-Emergency Medical Transportation in Medicaid, 2018–2021
Examines the Medicaid analysis of non-emergency medical transportation (NEMT) using Transformed Medicaid Statistical Information System (T-MSIS) data from 2018-2021. Explores the number and percentage of Medicaid beneficiaries using NEMT, the average number of NEMT "ride days" per NEMT user per month enrolled in Medicaid, the types of medical services accessed when using NEMT, monthly trends in the use of NEMT versus telehealth services before and during the COVID-19 public health emergency (PHE), and the volume of NEMT services used by type of NEMT delivery model. Offers recommendations for states and local stakeholders regarding Medicaid coverage of NEMT. Presents data by state and by beneficiary characteristics, including Medicaid eligibility category, health conditions, and urban-rural location.
Date: 07/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services
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