Rural Health
Resources by Topic: Legislation and regulations
MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS for FY 2024
Comments on a May 1, 2023, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Offers comments on future hospital safety-net policies, including a potential safety-net adjustment for Medicare inpatient hospital payments; a potential health equity adjustment bonus to the hospital value-based purchasing program; recent case law on rural reclassification and estimated implications; and supplemental uncompensated care payments to Puerto Rico.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a May 1, 2023, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Offers comments on future hospital safety-net policies, including a potential safety-net adjustment for Medicare inpatient hospital payments; a potential health equity adjustment bonus to the hospital value-based purchasing program; recent case law on rural reclassification and estimated implications; and supplemental uncompensated care payments to Puerto Rico.
Date: 06/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Training the Primary Care Workforce to Deliver Team-Based Care in Underserved Areas: The Teaching Health Center Program
Provides an overview of the Teaching Health Center Graduate Medical Education (THCGME) program. Describes the THCGME program's outcomes in training primary care medical and dental providers, the practice settings of THCGME family medicine graduates, and services provided by program graduates. Profiles four THCGME programs, including three programs that serve tribal or rural areas. Discusses challenges facing Teaching Health Centers, proposed solutions, and key takeaways and recommendations for policymakers.
Author(s): Emily Hawes, Jacob Rains, Candice Chen, Erin Fraher
Date: 06/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Provides an overview of the Teaching Health Center Graduate Medical Education (THCGME) program. Describes the THCGME program's outcomes in training primary care medical and dental providers, the practice settings of THCGME family medicine graduates, and services provided by program graduates. Profiles four THCGME programs, including three programs that serve tribal or rural areas. Discusses challenges facing Teaching Health Centers, proposed solutions, and key takeaways and recommendations for policymakers.
Author(s): Emily Hawes, Jacob Rains, Candice Chen, Erin Fraher
Date: 06/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Rural Track Programs: A Guide to the Updated Medicare Requirements
An overview of the requirements to participate in the Centers for Medicare & Medicaid Services (CMS) Rural Track Program (RTP), which is a partnership between an urban hospital - the primary clinical site - and rural site(s) for medical residency training. Describes how the RTP program differs from the earlier rural training track (RTT) program.
Date: 05/2023
Type: Document
Sponsoring organization: Association of American Medical Colleges
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An overview of the requirements to participate in the Centers for Medicare & Medicaid Services (CMS) Rural Track Program (RTP), which is a partnership between an urban hospital - the primary clinical site - and rural site(s) for medical residency training. Describes how the RTP program differs from the earlier rural training track (RTT) program.
Date: 05/2023
Type: Document
Sponsoring organization: Association of American Medical Colleges
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State Medicaid Telehealth Coverage Policy Decisions Since the COVID-19 Public Health Emergency
Describes changes to state Medicaid telehealth policy flexibilities and/or new policies enacted during the COVID-19 PHE as of April–May 2022. Focuses on flexibilities that were rolled back, as well as those made permanent in whole or in part. Examines the decision-making processes behind Medicaid telehealth policy changes. Summarizes findings from guided discussions with state Medicaid representatives across four domains: 1) state attitudes and perspectives on telehealth and telehealth policies; 2) state telehealth policy decision-making processes; 3) states' future plans for telehealth; and 4) challenges and lessons learned. Outlines potential opportunities for the future of telehealth. Includes rural references throughout.
Additional links: Executive Summary
Author(s): Peggy G. Chen, Sara E. Heins, Stephanie Dellva
Date: 05/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Describes changes to state Medicaid telehealth policy flexibilities and/or new policies enacted during the COVID-19 PHE as of April–May 2022. Focuses on flexibilities that were rolled back, as well as those made permanent in whole or in part. Examines the decision-making processes behind Medicaid telehealth policy changes. Summarizes findings from guided discussions with state Medicaid representatives across four domains: 1) state attitudes and perspectives on telehealth and telehealth policies; 2) state telehealth policy decision-making processes; 3) states' future plans for telehealth; and 4) challenges and lessons learned. Outlines potential opportunities for the future of telehealth. Includes rural references throughout.
Additional links: Executive Summary
Author(s): Peggy G. Chen, Sara E. Heins, Stephanie Dellva
Date: 05/2023
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs): CMS Flexibilities to Fight COVID-19
Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines specific regulatory waivers and Medicare flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) issued in response to the COVID-19 pandemic. Includes information on payments for telehealth services, COVID-19 vaccines, therapeutics, and more. Identifies whether each waiver or flexibility was terminated, ended at the conclusion of the public health emergency, was extended, or became permanent.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Community Health Centers Seek to Prepare Medicaid Beneficiaries, and Themselves, for the Risks Ahead
Explores how Federally Qualified Health Centers (FQHCs), including an FQHC serving rural North Carolina, are helping Medicaid beneficiaries stay enrolled or find alternate coverage during the post-COVID-19 redetermination process. Describes how operations of these FQHCs have been changed by funding from the Coronavirus Aid, Relief, and Economic Security (CARES) Act and pandemic-related regulatory flexibilities.
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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Explores how Federally Qualified Health Centers (FQHCs), including an FQHC serving rural North Carolina, are helping Medicaid beneficiaries stay enrolled or find alternate coverage during the post-COVID-19 redetermination process. Describes how operations of these FQHCs have been changed by funding from the Coronavirus Aid, Relief, and Economic Security (CARES) Act and pandemic-related regulatory flexibilities.
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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New England Health System CEOs Address Rural Healthcare Crisis In A Live Conversation
Recording of a May 22, 2023, roundtable discussion with the chief executive officers (CEOs) of Dartmouth Health, MaineHealth, and the University of Vermont Health Network regarding the challenges rural healthcare providers face. Covers workforce challenges, regulatory and inflation challenges, and innovations to preserve access to care. Transcript is available in the video description.
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Dartmouth Health
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Recording of a May 22, 2023, roundtable discussion with the chief executive officers (CEOs) of Dartmouth Health, MaineHealth, and the University of Vermont Health Network regarding the challenges rural healthcare providers face. Covers workforce challenges, regulatory and inflation challenges, and innovations to preserve access to care. Transcript is available in the video description.
Date: 05/2023
Type: Video/Multimedia
Sponsoring organization: Dartmouth Health
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State Medicaid and Private Telemedicine Coverage Requirements and Telemedicine Use, 2013–2019
Examines the association between state Medicaid and private telemedicine coverage requirements and live video-based telemedicine use by analyzing nationally representative survey data from the 2013–2019 Association of American Medical Colleges Consumer Survey of Health Care Access. Evaluates the impact of these requirements by rurality. Explores whether telemedicine coverage requirements were associated with healthcare access.
Author(s): Brandy J. Lipton, Michael F. Pesko
Citation: Health Services Research, 2023
Date: 05/2023
Type: Document
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Examines the association between state Medicaid and private telemedicine coverage requirements and live video-based telemedicine use by analyzing nationally representative survey data from the 2013–2019 Association of American Medical Colleges Consumer Survey of Health Care Access. Evaluates the impact of these requirements by rurality. Explores whether telemedicine coverage requirements were associated with healthcare access.
Author(s): Brandy J. Lipton, Michael F. Pesko
Citation: Health Services Research, 2023
Date: 05/2023
Type: Document
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340B Drug Discount Program: Information about Hospitals That Received an Eligibility Exception as a Result of COVID-19
Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Provides an overview of a provision of the Consolidated Appropriations Act, 2022, that allowed hospitals to request an exception to the disproportionate share hospital (DSH) percentage eligibility requirement if they were unable to meet it due to the COVID-19 pandemic. Explores the exception process and provides information on hospitals that received the exception. Discusses the amount of 340B drug purchases and discounts that excepted hospitals indicated they had in 2020 and 2021; the extent to which excepted hospitals indicated providing discounts on 340B drugs to low-income, uninsured patients; and results of the Health Resources and Services Administration's audits and oversight activities to assess program compliance.
Additional links: Full Report
Date: 05/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Guidance for the Expiration of the COVID-19 Public Health Emergency (PHE)
Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that are expiring at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines the emergency waivers related to the minimum health and safety requirements for long-term care and acute continuing care providers that are expiring at the end of the COVID-19 public health emergency (PHE). Describes the timelines for certain regulatory requirements issued during the PHE through interim final rules.
Date: 05/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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