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Rural Health
Resources by Topic: Legislation and regulations

Medicare Payment Basics: Hospital Acute Inpatient Services Payment System
Overview of Medicare payments to hospitals for acute inpatient care. Includes information on rate setting, Medicare payments for medical education, payments to Medicare Disproportionate Share Hospitals (DSH), new technology payments special payments for rural hospitals, quality incentive payments and penalties, and payment rate updates.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Hospice Services Payment System
Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Home Health Care Services Payment System
Overview of Medicare payments for home health care services. Includes information on rate-setting and payments for quality reporting and performance. Describes the Patient-Driven Groupings Model (PDGM) and the home health resource groups (HHRGs) based on clinical and functional status.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Durable Medical Equipment Payment System
Overview of Medicare payments for medical equipment used to treat beneficiaries at home. Defines durable medical equipment (DME), details the DME fee schedule, and discusses the competitive bidding program (CBP) for DME. Includes information on adjustments to fee schedule payment rates outside of competitive bidding areas (CBAs).
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Ambulance Services Payment System
Provides an overview of Medicare payments for ambulance services. Discusses rural add-on payment policies, geographic categories determining payment rates, super-rural ZIP codes, and ambulance fee schedules.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Accountable Care Organizations Payment Systems
Provides an overview of Medicare's Accountable Care Organization (ACO) programs. Discusses the payment mechanics of ACOs, including the maximum shared savings and losses of Medicare Shared Savings Program ACOs by track and level.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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September 2023 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) September 2023 meeting. Covers managed care denials and appeals, Medicaid demographic data collection, the unwinding of the Medicaid continuous coverage requirement, the MACPAC hospital supplemental payment work plan, a review of the proposed rule on nursing facility staffing and payment transparency, and school-based behavioral health services for students enrolled in Medicaid, among other things. Includes rural references throughout.
Date: 09/2023
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Assessing the Impact of Medicaid Telehealth Policy Change on Equitable Access to Telehealth Services in North Carolina
Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Will Availability of Over-the-Counter Narcan Increase Access?
Highlights state policies and recent research related to over-the-counter naloxone access. Includes information on the impact of rurality on access. Also discusses insurance coverage and impact of cost.
Author(s): Heather Saunders, Robin Rudowitz
Date: 09/2023
Type: Document
Sponsoring organization: KFF
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