HRSA relies on grant reviewers to select the best programs from a competitive group of applicants. Over the coming months, the Federal Office of Rural Health Policy will be competing a number of programs, including among other things: substance use disorders and opioid use disorder, rural workforce, and rural hospitals. Having reviewers with expertise in rural health greatly benefits the review process and is also an opportunity to learn about the review process itself. Reviews are typically held remotely over a period of a few days and reviewers who participate and complete their assigned duties receive an honorarium. Registration is easy and does not commit you to serving as a reviewer. Please consider lending your expertise to these important initiatives.

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The online site is meant to help beneficiaries, provider organizations, and state-level Medicaid agencies better understand how individuals and families can renew coverage from Medicaid and the Children’s Health Insurance Program (CHIP) or find better options.  The outreach materials are tailored to reach different populations, including by state, for people in rural areas, and various racial and ethnic communities.  The site also explains key government actions taken to support Medicaid renewals and transitions, as many are losing coverage in the post-pandemic policy shift known as Unwinding.  See Events below for an upcoming learning opportunity on January 24.

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In 2021, Congress established this Federal Communications Commission program to increase access to the internet through monthly discounts for service and one-time payments to purchase a laptop, desktop computer, or tablet.  Without additional funding from Congress, the program is projected to run out of money in April 2024.  Households currently enrolled in the program will receive a notice from their internet service provider about the end of the benefit.  The FCC is still accepting applications until midnight Eastern time on February 7, but enrollees must have their eligibility approved and sign up with an internet service provider before this deadline.  Households who have applied, been approved, and are receiving the monthly internet discount before February 8, 2024 will continue to receive their ACP benefit until funds run out, as long as the household remains enrolled in the program.

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From Becker’s

CMS has finalized a rule to streamline the prior authorization process and improve the electronic exchange of health information that it estimates will save $15 billion over 10 years.

The requirements generally apply to Medicare Advantage organizations, state Medicaid and Children’s Health Insurance Program agencies, Medicaid managed care plans, CHIP-managed care entities and qualified health plan insurers on the federally facilitated exchanges, according to a Jan. 17 CMS news release. The agency proposed the rule in December 2022.

Beginning primarily in 2026, certain payers will be required to include a specific reason when denying requests, publicly report certain prior authorization metrics and send decisions within 72 hours for urgent requests and seven calendar days for standard requests.

The rule also requires affected payers to implement a Health Level 7 Fast Healthcare Interoperability Resources standard application programming interface to support electronic prior authorization.

“Together, these new requirements for the prior authorization process will reduce administrative burden on the healthcare workforce, empower clinicians to spend more time providing direct care to their patients and prevent avoidable delays in care for patients,” CMS said in the release.

The rule also finalizes API requirements to “increase health data exchange and foster a more efficient healthcare system for all.” CMS is delaying the dates for compliance from generally Jan. 1, 2026, to Jan. 1, 2027. Beginning in January 2027, affected payers will be required to expand their current patient access API to include information about prior authorizations and to implement a provider access API that providers can use to retrieve their patients’ claims, encounter, clinical and prior authorization data. CMS is requiring affected payers to exchange, with a patient’s permission, most of the same data using a payer-to-payer FHIR API when a patient moves between payers or has multiple concurrent payers.

The rule also adds a new electronic prior authorization measure for eligible hospitals and critical access hospitals under the Medicare Promoting Interoperability Program and for Merit-based Incentive Payment System eligible clinicians under the promoting interoperability performance category.

From Becker’s Hospital Review

Pittsburgh-based Duquesne University opened its College of Medicine on January 17.

The college will welcome its inaugural class of 85 students in July with plans to grow enrollment to 170 students per year beginning in 2026, according to a university news release. The college will provide doctor of osteopathic medicine degrees.

Duquesne said it received significant gifts from foundations, corporations and government entities to support building the medical college. The building includes advanced simulation, augmented reality anatomy labs and other technology.

The PA Department of Health (DOH) issued Health Advisory 733, concerning Measles cases in PA. As of Jan. 5, 2024, there have been seven cases of measles diagnosed in the commonwealth since Dec. 6, 2023. Six of these cases were epidemiologically linked and from southeastern Pennsylvania. One case was in northcentral Pennsylvania and not epidemiologically linked to the other cases. The index case in the southeastern Pennsylvania outbreak acquired measles while traveling abroad and the remaining cases were exposed via healthcare or childcare settings. The northcentral Pennsylvania case was unrelated, and the illness was acquired while living abroad. All these cases were in unvaccinated individuals. Providers should have an increased suspicion for measles in patients who are not immune and present with a febrile rash illness and follow the proper recommendations for testing and infection control measures. DOH reminds providers to immediately report suspected cases of measles to local public health authorities or to the DOH at 877-PAHEALTH (877-724-3258).

According to a new report by the Pennsylvania Health Care Cost Containment Council (PHC4) in collaboration with The Hospital and Healthsystem Association of Pennsylvania (HAP), Pennsylvania’s hospitals lost $8.1 billion during the COVID-19 pandemic but continued to provide economic value to the state. Of the expenses and lost revenue reported, the largest expense was staffing, which amounted to $1.3 billion. The report also indicates that in fiscal year 2022, hospitals provided an economic value of $182 billion in spending, an increase of $39 billion from before the pandemic in fiscal year 2019. Read the report.