Rural Health
Resources by Topic: Legislation and regulations
Medicare Accountable Care Organizations: Beneficiary Assignment Update
Clarifies the changes issued in June 2015 regarding Accountable Care Organization's (ACO) beneficiary assignment under the Centers for Medicare and Medicaid Services (CMS) ACO regulations. Addresses how the changes make it easier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to participate in ACOs.
Author(s): Thomas Vaughn, A. Clinton MacKinney, Keith J. Mueller, Fred Ullrich, Xi Zhu
Date: 06/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Clarifies the changes issued in June 2015 regarding Accountable Care Organization's (ACO) beneficiary assignment under the Centers for Medicare and Medicaid Services (CMS) ACO regulations. Addresses how the changes make it easier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to participate in ACOs.
Author(s): Thomas Vaughn, A. Clinton MacKinney, Keith J. Mueller, Fred Ullrich, Xi Zhu
Date: 06/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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FQHC and RHC Supplemental Payment Requirements and FQHC, RHC, and FBC Network Sufficiency under Medicaid and CHIP Managed Care
Provides state health officials with guidance on Federally-qualified Health Center (FQHC) and Rural Health Clinic (RHC) payment methodologies under both Medicaid and Children's Health Insurance Program (CHIP) managed care delivery systems. Also provides guidance on FQHC, RHC, and freestanding birth center (FBC) network sufficiency standards applicable to a Medicaid managed care delivery system.
Date: 04/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides state health officials with guidance on Federally-qualified Health Center (FQHC) and Rural Health Clinic (RHC) payment methodologies under both Medicaid and Children's Health Insurance Program (CHIP) managed care delivery systems. Also provides guidance on FQHC, RHC, and freestanding birth center (FBC) network sufficiency standards applicable to a Medicaid managed care delivery system.
Date: 04/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Entry Regulation and Rural Health Care: Certificate-of-Need Laws, Ambulatory Surgical Centers, and Community Hospitals
Examines the effect of regulations on entry and expansion of "hospital substitutes," including ambulatory surgical centers (ASCs), and analyzes whether certificate-of-need (CON) programs have achieved their goal of protecting access to hospitals in rural areas. Features demographics on ASC patients, and state-level information on CON regulations and requirements for ASCs.
Date: 02/2016
Type: Document
Sponsoring organization: Mercatus Center
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Examines the effect of regulations on entry and expansion of "hospital substitutes," including ambulatory surgical centers (ASCs), and analyzes whether certificate-of-need (CON) programs have achieved their goal of protecting access to hospitals in rural areas. Features demographics on ASC patients, and state-level information on CON regulations and requirements for ASCs.
Date: 02/2016
Type: Document
Sponsoring organization: Mercatus Center
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CMS Manual System: Revisions to Medicare State Operations Manual, Chapter 9 - Critical Access Hospital (CAH) Recertification Checklist: Rural and Distance or Necessary Provider Verification
Provides a list of the necessary components to be confirmed when Critical Access Hospitals (CAHs) are surveyed for recertification to determine if they meet the rural location and distance or necessary provider requirements to maintain their CAH status. Identifies the procedures used by the CMS Regional Office and state survey agencies to determine if CAHs meet the necessary requirements.
Date: 02/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides a list of the necessary components to be confirmed when Critical Access Hospitals (CAHs) are surveyed for recertification to determine if they meet the rural location and distance or necessary provider requirements to maintain their CAH status. Identifies the procedures used by the CMS Regional Office and state survey agencies to determine if CAHs meet the necessary requirements.
Date: 02/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Behavioral Health: Telehealth Challenges and Opportunities
Reviews the barriers to mental and substance use disorder treatment and services in rural communities. Presents ways telehealth can address these barriers and discusses the challenges in implementing telehealth services in rural areas. Addresses differences in state policies for telemedicine coverage through private insurance.
Citation: SAMHSA In Brief, 9(2)
Date: 2016
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Reviews the barriers to mental and substance use disorder treatment and services in rural communities. Presents ways telehealth can address these barriers and discusses the challenges in implementing telehealth services in rural areas. Addresses differences in state policies for telemedicine coverage through private insurance.
Citation: SAMHSA In Brief, 9(2)
Date: 2016
Type: Document
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Grandfathered Tribal (GFT) Federally Qualified Health Center (FQHC) Training: Overview of Requirements and Policies
Provides a summary of the requirements and policies, effective January 1, 2016, for Indian Health Services (IHS), and tribal facilities and organizations when a change in status may allow the healthcare facility to become certified as a Grandfathered Tribal FQHC.
Date: 12/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides a summary of the requirements and policies, effective January 1, 2016, for Indian Health Services (IHS), and tribal facilities and organizations when a change in status may allow the healthcare facility to become certified as a Grandfathered Tribal FQHC.
Date: 12/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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OIG Advisory Opinion No. 15-13
Advisory opinion from the Office of Inspector General (OIG) concerning a proposal for free transportation services between certain medical facilities as a part of a rural, integrated health system.
Date: 10/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Advisory opinion from the Office of Inspector General (OIG) concerning a proposal for free transportation services between certain medical facilities as a part of a rural, integrated health system.
Date: 10/2015
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Where Is Buprenorphine Dispensed to Treat Opioid Use Disorders? The Role of Private Offices, Opioid Treatment Programs, and Substance Abuse Treatment Facilities in Urban and Rural Counties
Examines the impact of 2006 federal legislation allowing waivered physicians to prescribe and expand FDA approved buprenorphine as a treatment for opioid use disorder to a maximum of 100 patients. Discusses buprenorphine distribution by both urban and rural waivered physicians, opioid treatment programs, and treatment facilities for substance abuse.
Author(s): Bradley D. Stein, Rosalie Liccardo Pacula, Adam J. Gordon, et al.
Citation: The Milbank Quarterly, 93(3), 561-583
Date: 09/2015
Type: Document
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Examines the impact of 2006 federal legislation allowing waivered physicians to prescribe and expand FDA approved buprenorphine as a treatment for opioid use disorder to a maximum of 100 patients. Discusses buprenorphine distribution by both urban and rural waivered physicians, opioid treatment programs, and treatment facilities for substance abuse.
Author(s): Bradley D. Stein, Rosalie Liccardo Pacula, Adam J. Gordon, et al.
Citation: The Milbank Quarterly, 93(3), 561-583
Date: 09/2015
Type: Document
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Rural Health Care Disparities Created by Medicare Regulations
Transcript of a July 28, 2015, U.S. House of Representatives Ways and Means Committee, Subcommittee on Health hearing concerning rural healthcare disparities created by Medicare regulations. Features testimony from the Arizona Center for Rural Health and leaders from two Critical Access Hospitals and one rural hospital. Covers physician shortages; graduate medical education; the impact of regulatory changes such as the 96-hour rule, the two-midnight rule, and physician supervision requirements; and more.
Additional links: Carrie Saia, Holton Community Hospital - Testimony, Daniel Derksen, Arizona Center for Rural Health - Testimony, Shannon Sorensen, Brown County Hospital - Testimony, Tim Joslin, Community Regional Medical Centers - Testimony
Date: 07/2015
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Transcript of a July 28, 2015, U.S. House of Representatives Ways and Means Committee, Subcommittee on Health hearing concerning rural healthcare disparities created by Medicare regulations. Features testimony from the Arizona Center for Rural Health and leaders from two Critical Access Hospitals and one rural hospital. Covers physician shortages; graduate medical education; the impact of regulatory changes such as the 96-hour rule, the two-midnight rule, and physician supervision requirements; and more.
Additional links: Carrie Saia, Holton Community Hospital - Testimony, Daniel Derksen, Arizona Center for Rural Health - Testimony, Shannon Sorensen, Brown County Hospital - Testimony, Tim Joslin, Community Regional Medical Centers - Testimony
Date: 07/2015
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Realizing the Promise of Telehealth: Understanding the Legal and Regulatory Challenges
Describes federal and state compliance issues and regulatory challenges specific to the implementation of telehealth technologies in hospitals, healthcare systems, and with providers, and how they will affect telehealth services, particularly in rural healthcare facilities. Includes discussion on coverage and payment including Medicare and Medicaid, health professional licensure and credentialing, online prescribing, patient privacy, fraud, and medical malpractice and professional liability insurance.
Date: 05/2015
Type: Document
Sponsoring organization: American Hospital Association
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Describes federal and state compliance issues and regulatory challenges specific to the implementation of telehealth technologies in hospitals, healthcare systems, and with providers, and how they will affect telehealth services, particularly in rural healthcare facilities. Includes discussion on coverage and payment including Medicare and Medicaid, health professional licensure and credentialing, online prescribing, patient privacy, fraud, and medical malpractice and professional liability insurance.
Date: 05/2015
Type: Document
Sponsoring organization: American Hospital Association
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