Rural Health
Resources by Topic: Legislation and regulations
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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
view details
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)
view details
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)
view details
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
view details
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
view details