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Rural Health
Resources by Topic: Legislation and regulations

After Hospital Closure: Pursuing High Performance Rural Health Systems without Inpatient Care
Describes ways for rural communities to develop optimal healthcare delivery systems after a local hospital closure. Features 3 case studies from Arizona, Michigan, and Illinois. Includes tables showing options currently available under federal and state laws and policies under consideration.
Author(s): Keith J. Mueller, Charlie Alfero, Andrew F. Coburn, et al.
Date: 06/2017
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Telepharmacy Rules and Statutes: A 50-State Survey
Policy brief identifying state-enacted regulations and legislation authorizing use of community telepharmacy initiatives, and describing implications for patients in underserved rural communities. Includes a table listing states with telepharmacy permitted in some capacity, pilot programs that enable telepharmacy initiatives, waivers enabling telepharmacy initiatives, or no rules or legislation authorizing telepharmacy use.
Additional links: Table Supplement
Author(s): George Tzanetakos, Fred Ullrich, Keith Mueller
Date: 04/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Health Care: Telehealth and Remote Patient Monitoring Use in Medicare and Selected Federal Programs
Examines factors affecting the provision of telehealth and remote patient monitoring (RPM) in Medicare and emerging payment and delivery models that could affect its future use. Analyzes data collected through review of agency documents and regulations, and interviews with officials representing 9 general and medical specialty associations familiar with telehealth. Includes state Medicaid reimbursement examples. Rural-specific implications are discussed throughout.
Additional links: Full Report
Date: 04/2017
Type: Document
Sponsoring organization: Government Accountability Office
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State Law Fact Sheet: A Summary of State Community Health Worker Laws
Details the state laws pertaining to Community Health Workers as of June 30, 2016. Includes laws defining scope of practice, team-based care models, reimbursement, and the core certification process.
Date: 2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Availability of Buprenorphine Treatment in Kentucky
Describes availability of opioid addiction treatment in Kentucky, with breakdowns by metropolitan, micropolitan, and other non-metropolitan areas, and distribution of various medical specialists authorized to prescribe buprenorphine in these areas.
Author(s): Elijah T. Myers, Tyrone F. Borders
Date: 11/2016
Type: Document
Sponsoring organization: University of Kentucky Institute for Rural Health Policy
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Federal Requirement for Physician Supervision of CRNAs
Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Type: Document
Sponsoring organization: National Rural Health Association
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Opioid Addiction: Laws, Regulations, and Other Factors Can Affect Medication-Assisted Treatment Access
Examines current federal laws and regulations related to the medication-assisted treatment (MAT) of opioid dependency, and discusses how these laws affect access to treatment, including in rural areas. Also explores other factors that affect access to treatment such as cost, insurance coverage, practitioner availability, and perceived value. Provides detailed descriptions about the uses and concerns of the three medications currently approved by the FDA for use in opioid MAT - methadone, buprenorphine, and naltrexone.
Additional links: Full Report
Date: 09/2016
Type: Document
Sponsoring organization: Government Accountability Office
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Preparing Nurses for New Roles in Population Health Management
Report based on two meetings of the National Advisory Council on Nurse Education and Practice in 2016. Emphasizes changes in policy, legislation, and research to promote nursing's role in leading and practicing population health initiatives and addresses potential changes in nursing education to shift away from illness-focused acute care skills. Includes a section on population health in rural and underserved areas.
Date: 09/2016
Type: Document
Sponsoring organization: National Advisory Council on Nurse Education and Practice
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Telehealth Parity Laws
Policy brief discussing federal and state activities related to telehealth, as well as Medicaid and private insurer reimbursement for telehealth services. Identifies the arguments in favor of and against paying for telehealth at parity with in-person care. Discusses the role telehealth can play in rural access to healthcare.
Citation: Health Affairs
Date: 08/2016
Type: Document
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Medicaid Outpatient Payment Policy
Provides an overview of Medicaid payment policies for outpatient hospital services. Attached Excel sheet includes details for each state, including adjustments for rural geography and for Critical Access Hospitals.
Additional links: State Medicaid Payment Policies for Outpatient Hospital Services
Date: 07/2016
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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