Rural Health
Resources by Topic: Legislation and regulations
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
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
Sponsoring organization: Bipartisan Policy Center
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Medicare Part D Enrollees Reaching the Out-of-Pocket Limit by June 2024
Examines the number of Medicare Part D enrollees who reached the catastrophic Inflation Reduction Act (IRA) out-of-pocket prescription drug spending cap by June 2024. Provides demographic information on enrollees who reach the catastrophic phase and the related savings, including breakdowns for state and metropolitan, micropolitan, or rural/unknown location.
Author(s): Kenneth Finegold, Kristen L. King, Bisma A. Sayed, Rachael Zuckerman
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the number of Medicare Part D enrollees who reached the catastrophic Inflation Reduction Act (IRA) out-of-pocket prescription drug spending cap by June 2024. Provides demographic information on enrollees who reach the catastrophic phase and the related savings, including breakdowns for state and metropolitan, micropolitan, or rural/unknown location.
Author(s): Kenneth Finegold, Kristen L. King, Bisma A. Sayed, Rachael Zuckerman
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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What to Know About Medicare Coverage of Telehealth
Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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Health Care Transparency: CMS Needs More Information on Hospital Pricing Data Completeness and Accuracy
Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Sponsoring organization: Government Accountability Office
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Provides an overview of the Centers for Medicare & Medicaid Services (CMS) hospital price transparency requirements before and after 2024 updates to the requirements. Describes users' experiences with hospital pricing data before the 2024 updates. Examines CMS's enforcement of hospital price transparency requirements and offers recommendations to CMS regarding the sufficiency and accuracy of the data reported. Table 3 compares CMS enforcement actions by hospitals' rural or urban designation between 2021 and 2023.
Additional links: Full Report
Date: 10/2024
Sponsoring organization: Government Accountability Office
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Leveraging Medicaid to Support Housing and Nutrition in Ohio
Describes the Ohio Medicaid program and the federal Medicaid health-related social needs (HRSN) framework. Discusses how Medicaid coverage in Ohio can cover aspects of housing and nutrition needs as of 2023. Includes county-level map depicting percent of income spent on housing in Ohio as well as examples of programs addressing HRSNs in rural areas.
Author(s): Hailey Akah, Robin Blair-Ackison, Edith Nkenganyi, et al.
Date: 09/2024
Sponsoring organization: Health Policy Institute of Ohio
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Describes the Ohio Medicaid program and the federal Medicaid health-related social needs (HRSN) framework. Discusses how Medicaid coverage in Ohio can cover aspects of housing and nutrition needs as of 2023. Includes county-level map depicting percent of income spent on housing in Ohio as well as examples of programs addressing HRSNs in rural areas.
Author(s): Hailey Akah, Robin Blair-Ackison, Edith Nkenganyi, et al.
Date: 09/2024
Sponsoring organization: Health Policy Institute of Ohio
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Nursing Home Certificate of Need Moratoria During the COVID-19 Pandemic Had Little Impact on Access
Analyzes certificate of need (CON) moratoria and healthcare supply of skilled nursing facility (SNF) beds during the COVID-19 pandemic. Utilizes 2015-2021 SNF cost report data to provide information on states that implemented CON moratoria, differences by rural versus urban counties, and impact on SNF bed supply.
Author(s): Anthony Yu, Christopher Whaley
Citation: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 61
Date: 09/2024
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Analyzes certificate of need (CON) moratoria and healthcare supply of skilled nursing facility (SNF) beds during the COVID-19 pandemic. Utilizes 2015-2021 SNF cost report data to provide information on states that implemented CON moratoria, differences by rural versus urban counties, and impact on SNF bed supply.
Author(s): Anthony Yu, Christopher Whaley
Citation: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 61
Date: 09/2024
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Rural Emergency Hospitals Fact Sheet
Provides a brief overview of the Rural Emergency Hospital (REH) provider designation. Outlines REH payment, services, eligibility requirements, and how to apply for REH designation.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides a brief overview of the Rural Emergency Hospital (REH) provider designation. Outlines REH payment, services, eligibility requirements, and how to apply for REH designation.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Ensuring Access To Care: 340B Arrangements with Community and Specialty Pharmacies Improve Access to Care for Underserved Patients
Provides an overview of the 340B Drug Pricing Program, related legislation, benefits to underserved communities, relationship to specialty and community pharmacies, and more. Includes discussion on the value of the 340B program for rural pharmacies.
Date: 09/2024
Sponsoring organization: American Hospital Association
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Provides an overview of the 340B Drug Pricing Program, related legislation, benefits to underserved communities, relationship to specialty and community pharmacies, and more. Includes discussion on the value of the 340B program for rural pharmacies.
Date: 09/2024
Sponsoring organization: American Hospital Association
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Revised: Guidance for Rural Emergency Hospital Provisions, Conversion Process and Conditions of Participation
Provides guidance regarding the enrollment and conversion processes for facilities interested in participating in the Medicare and Medicaid programs as a Rural Emergency Hospital (REH). Covers eligibility, enrollment, conversion action plans, action plans, and attestation. Includes answers to frequently asked questions about the REH program.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides guidance regarding the enrollment and conversion processes for facilities interested in participating in the Medicare and Medicaid programs as a Rural Emergency Hospital (REH). Covers eligibility, enrollment, conversion action plans, action plans, and attestation. Includes answers to frequently asked questions about the REH program.
Date: 09/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on the Payment System for End-Stage Renal Disease for CY 2025
Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 5, 2024, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing modifications to the outlier policy, updates to the low-volume payment adjustment (LVPA), and updates to the wage index methodology.
Date: 08/2024
Sponsoring organization: Medicare Payment Advisory Commission
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