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Rural Health
Resources by Topic: Legislation and regulations

Advocacy in New Hampshire Procures More Funding for Provider Recruitment
Describes how the New Hampshire Health Care Workforce Coalition lobbied for state legislation to increase the annual budget for the State Loan Repayment Program (SLRP) to enhance recruitment of healthcare providers. SLRP activities include securing hospitalists for Critical Access Hospitals, Medicaid school psychologists, and other healthcare professionals; developing loan repayment programs for dentists and behavioral health providers; and more.
Author(s): Beth Blevins
Date: 07/2020
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Experiences of Community Health Centers in Expanding Telemedicine
Presents an overview of the experiences of nine health centers in California that received funding to increase their telemedicine services. Describes barriers to implementing and sustaining expanded services, including reimbursement policies and other regulatory restrictions. Includes recommendations for health centers and policymakers to promote the use of telehealth services.
Author(s): Lori Uscher-Pines, Jessica Sousa, Alina I. Palimaru, et al.
Date: 07/2020
Type: Document
Sponsoring organization: RAND Corporation
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Evidence Briefing: Tackling the Digital Divide & Telehealth Access for Low-Income Californians
Recording of a July 28, 2020 briefing that features a panel of health care providers discussing strategies to improve access to broadband internet and telehealth services in California. Offers perspectives from a Federally Qualified Health Center and a VA health system that serve rural California residents. Transcript available by clicking the dots above the Subscribe tab, then selecting Open Transcript.
Date: 07/2020
Type: Video/Multimedia
Sponsoring organization: California Initiative for Health Equity and Action
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Medicare Beneficiary Use of Telehealth Visits: Early Data from the Start of the COVID-19 Pandemic
Examines changes in Medicare in-person primary care visits and the use of telehealth services at the start of the COVID-19 public health emergency. Discusses how Medicare telehealth flexibilities implemented in response to COVID-19 impacted access to these services. Compares the percentage of primary care telehealth visits between rural and urban providers. Includes a county-level map displaying the percentage of primary care visits conducted via telehealth services in April 2020.
Date: 07/2020
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Telepharmacy Rules and Statutes: A 3-Year Update for all 50 States
Surveys the legislative and administrative activity authorizing community-based telepharmacy. Includes a table identifying states that have permitted telepharmacy services through legislation, regulation, or waiver or pilot programs, and states with limitations, prohibitions, or no guidance on these services. Provides an overview of state rules and regulations that limit aspects of telepharmacy implementation. Explores areas for further research and evaluation, including the relationship between telepharmacy and rural pharmacy closures.
Author(s): Jason Semprini, Fred Ullrich, Keith J. Mueller
Date: 07/2020
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2021
Comments on a May 29, 2020, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems. Discusses proposals to use commercial insurer data to set Medicare severity–diagnosis related group (MS–DRG) relative weights and adopt changes to geographic area delineations to establish hospital wage indexes for the IPPS and LTCH PPS.
Date: 07/2020
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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The Impact of Medicare's Rural Add-on Payments on Supply of Home Health Agencies Serving Rural Counties
Examines how Medicare rural add-on payments affected the number of home health agencies serving rural counties between 2002-2017. Compares the population-adjusted number of home health agencies in urban, urban-adjacent non-urban-adjacent rural counties during periods with add-on payments and without add-on payments. Discusses implications for revised and future add-on payments to maintain or increase the supply of rural home health agencies.
Author(s): Tracy M. Mroz, Davis G. Patterson, Bianca K. Frogner
Citation: Health Affairs, 39(6), 949-957
Date: 06/2020
Type: Document
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COVID-19: Opportunities to Improve Federal Response and Recovery Efforts
Provides an overview of key federal actions and spending allocations in response to the health and economic effects of the COVID-19 pandemic. Identifies challenges related to federal actions including the Payment Protection Program, economic impact payments, and Medicaid's Federal Medical Assistance Percentage (FMAP) formula. Offers lesson learned from the initial pandemic response and recommends areas for further legislative action.
Additional links: Full Report
Date: 06/2020
Type: Document
Sponsoring organization: Government Accountability Office
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Out‐of‐Network Air Ambulance Bills: Prevalence, Magnitude, and Policy Solutions
Examines the prevalence and cost of surprise air ambulance bills among privately insured patients. Describes air ambulance rates for commercial payers in relation to Medicare rates. Compares the number of air ambulance claims from urban and rural locations. Offers policy solutions to address surprise and out-of-network bills for these services.
Author(s): Erin C. Fuse Brown, Erin Trish, Bich Ly, Mark Hall, Loren Adler
Citation: Milbank Quarterly
Date: 06/2020
Type: Document
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How Telehealth Policy is Structured in the United States
June 23, 2020, webinar recording provides an overview of the telehealth policy landscape on the federal and state levels. Discusses telehealth reimbursement policies. Outlines federal and state telehealth policy changes as a result of the COVID-19 pandemic.
Additional links: Presentation Slides
Date: 06/2020
Type: Video/Multimedia
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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