A recording of the nearly three-hour focus on rural in the House Committee on Appropriations.  Testimony and discussion include access to health care, labor/workforce development, and education.

  On April 10, 2023, CMS issued proposed changes to Medicare’s inpatient prospective payments made to acute care and long-term care hospitals.  Specifically, CMS proposes a 2.8% increase to hospitals that successfully participate in the Inpatient Quality Reporting program and are meaningful electronic health record (EHR) users. They also propose to continue policies that support low-wage index hospitals, many of which are rural, and to include data for hospitals that reclassify from urban to rural (42 CFR §412.103) in other wage index calculations.  There is a proposal to adjust payments when homelessness is indicated and a Request for Information on the unique challenges faced by safety-net hospitals and the patients they serve.  Finally, CMS has proposed to allow Rural Emergency Hospitals (REH), a Medicare new provider type, to serve as training sites for Medicare Graduate Medical Education (GME) payment purposes, and they provided proposed regulations on what information must be submitted to CMS when a hospital applies to become an REH.  Comments are due by June 9, 2023.

 On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2024. In addition to the rate updates, the proposed rule includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program for FY 2024 and future years. Also, effective with services furnished on or after January 1, 2024, CMS proposes to add marriage and family therapists and mental health counselors to the list of practitioners whose services are excluded from the consolidated billing provision and is seeking comments identifying HCPCS codes that might meet the criteria for exclusion from SNF consolidated billing.  Comments are due by June 5, 2023.

 On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare payment policies and rates for the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for fiscal year (FY) 2024. The proposed rule includes updates to the inpatient psychiatric payment rates and a request for information to about future payment changes and data collection for inpatient psychiatric services. Comments are due by June 5, 2023.

  On April 3, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare payment policies and rates for Inpatient Rehabilitation Facilities (IRF) for fiscal year (FY) 2024. The proposed rule would also update reporting requirements for the IRF Quality Reporting Program. Comments are due by June 2, 2023.

On March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2024. The proposed rule would include a 5-percent cap on wage index decreases and require hospice-certifying physicians to be Medicare-enrolled or to have validly opted out as a prerequisite for payment for the hospice period of care in question. Also, this rule includes information on hospice utilization trends and solicits comments regarding information related to the provision of higher levels of hospice care. Comments are Due by May 30, 2023.

 The Economic Research Service at the U.S. Department of Agriculture updated its statistics on several socioeconomic factors: people, jobs, rural-urban county classifications, income, and veterans.

Researchers compared county-level data broadband capacity with telehealth use among Medicare Fee-for-Service beneficiaries from January through September 2020. The association between broadband access and telehealth utilization and the decreased telehealth utilization in rural areas highlights the importance of broadband access for healthcare access and the need to continue investing in broadband infrastructure to promote equitable healthcare access across populations.

This week, the Substance Abuse and Mental Health Services Administration (SAMHSA) alerted the public to the noticeable rise of xylazine, a non-opioid agent increasingly found in combination with opioids such as fentanyl.  Known by its street name, “tranq” or “tranq dope,” the drug is approved only for veterinary use; in humans, the powerful sedative, analgesic, and muscle relaxant can depress breathing, blood pressure, heart rate, and body temperature to critical levels.  The overdose antidote naloxone does not reverse its effects. Additionally, people who inject drugs containing xylazine can develop severe skin wounds that easily become infected and, if left untreated, may lead to amputation.