Rural Health Information Hub Latest News

Information Session on CMS Interoperability and Prior Authorization Final Rule Being Offered

Tuesday, March 26 at 1:00 pm Eastern

In January, the Centers for Medicare & Medicaid Services (CMS) released a final rule to enhance access to health information and streamline prior authorization processes for medical items and services.  CMS’s Office of Burden Reduction & Health Informatics is hosting an online session to educate patients, providers, and administrative, health IT, and government affairs professionals about the provisions in final rule and how it builds on current CMS interoperability policies. Questions can be submitted beforehand via the registration form.  If you register and receive a message that the event is full, you will receive an email after the event with a link to both a recording and transcript of the presentation. The use of various electronic exchange methods among hospitals and physicians has increased in recent years, but use among small and rural hospitals is lower than that of other hospitals.  Please reach out to CMSInteroperability@cms.hhs.gov with questions.

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Expanding Medicaid Skilled Professional Medical Personnel and Nurse Advice Lines

The Centers for Medicare & Medicaid Services (CMS) recently issued guidance allowing State Medicaid Directors to expand the pool of skilled professional medical personnel (SPMP) they may employ to include certain additional behavioral health professionals, such as Marriage and Family Therapists, Mental Health Counselors, and Professional Counselors. This expansion will allow states to claim higher administrative federal match and help bolster state resources to provide appropriate behavioral health care coverage and service delivery. The guidance also informs states that they may claim administrative federal match dollars for nurse advice lines, a tool that builds a lifeline between coverage and critical health services, particularly in rural areas.

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CMS Releases Updated Medicare Learning Network Information for Rural Health Clinics

The Centers for Medicare & Medicaid Services released an updated MLN booklet entitled, Information for Rural Health Clinics (RHCs) which provides updates on RHC patient services, care management services. Specifically, this MLN provides updated billing information for the following new RHC provider types and services: Marriage and Family Therapists (MFTs), Mental Health Counselors (MHCs), remote physiologic monitoring (RPM), remote therapeutic monitoring (RTM), community health integration (CHI) services, principal illness navigation (PIN), PIN-peer support (PIN-S) and Intensive Outpatient Program (IOP) services.

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CMS Provides Flexibilities in Response to Cyber Attack

Last week, the Centers for Medicare & Medicaid Services (CMS) announced increased flexibilities for processing claims as well as guidance to help providers serve patients. Hospitals affected by the cyber attack reported difficulties providing patient care, filling prescriptions, submitting insurance claims, and receiving payment for the essential health care services they provided in the weeks since the attack. The CMS guidance is intended to remove or relax prior authorization and other filing requirements for Medicare Advantage and Part D programs, as well as offer waivers or extensions to Medicare providers. Providers should contact their Medicare Administrative Contractors for details.

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CMS Releases Updated Guidance on Prospective Payment System for Certified Community Behavioral Health Clinic (CCBHC) Demonstration

In 2023, the Centers for Medicare & Medicaid Services (CMS) provided a forum for states, providers, and other stakeholders to comment on proposed changes to payment for services for individuals experiencing a crisis related to substance use and/or mental health.  In response to that feedback, CMS updated Prospective Payment System (PPS) guidance for the Certified Community Behavioral Health Clinic Demonstration addressing the high-cost and specialized care delivered through mobile and on-site crisis intervention.  This guidance was effective on January 1, 2024 for existing CCBHC Demonstration states, and on July 1, 2024 for newly selected states added to the program in 2024 and 2026. Requests for technical assistance may be submitted to CCBHCDemonstration@cms.hhs.gov.

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Report Released on Nonmetropolitan Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces in 2022

This policy brief from the RUPRI Center for Rural Health Policy Analysis describes differences in unsubsidized and net-of-subsidy premiums in 2022 between nonmetropolitan and metropolitan counties in Health Insurance Marketplace plan design and availability. Features statistics with breakdowns by metropolitan, micropolitan, and noncore areas.

Read the policy brief here.

RFI Seeking Comments on Reauthorizing the Older Americans Act

Comment by March 21.  First signed into law in 1965, the Older Americans Act (OAA) provides critical services that address the social drivers of health for older adults such as nutrition, transportation, senior centers, elder rights protections, caregiver support, and health promotion. The Senate Health, Education, Labor, and Pensions (HELP) Committee issued a Request for Information (RFI) from stakeholders on policies the Committee should consider during the reauthorization of the OAA.  Responses to the RFI must be submitted to OAA@help.senate.gov by March 21, 2024.

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