The USDA Rural Development Rural Utilities Service (RUS) is providing a three-day workshop for those interested in applying for ReConnect Program funding. The ReConnect Program offers loans, grants, and loan/grant combinations to facilitate broadband deployment in areas of rural America without sufficient access to broadband. To learn more about the ReConnect Program, please visit: https://www.usda.gov/reconnect.

The workshop will take place in-person at Silver Legacy located at 407 N. Virgina Street, Reno, NV.

The three-day workshop will provide attendees with an understanding of the ReConnect program application system and program requirements for FY2024. Topics will include:

• Program Eligibility
• Live Demonstrations of the Application System
• Evaluation Criteria
• Overview and deep dive sessions on financial, network, environmental, and mapping requirements

Dates and Times

• February 27-29, 2024
• Tuesday, February 27th, 8:30 a.m.- 5:30 p.m.
• Wednesday, February 28th, 8:30 a.m.- 5:00 p.m.
• Thursday, February 29th, 8:30 a.m.- 12:00 p.m.

Register Here!

Please Note: Registration should only be submitted once and is not required for each day. After registering you will not receive an email confirmation. The workshop agenda is now available and has been posted to the Events Page on the ReConnect website.

Contact

Please submit any ReConnect questions using the Contact Us Form on the ReConnect website.

We added an additional webinar for those who could not previously attend. No new information will be provided.

Presented by USDA Rural Development’s Rural Utilities Service, the webinar will provide information about the ReConnect Program and help prepare applicants ahead of the next Notice of Funding Opportunity (NOFO).

This webinar will include:

• What applicants can do now to prepare for the next NOFO.
• Registration and system requirements.
• A high-level look at ReConnect Program eligibility requirements.
• Tips on using the Application System.
• An opportunity to ask RUS staff questions about the application preparation.

We’ll address as many questions as time permits during each session. Once the NOFO is published, RUS will host a NOFO Overview webinar and include an updated list of the most common questions on our frequently asked questions page on the ReConnect website.

Date and Time:

February 7, 2024 from 1:00 PM-2:30 PM EST

Register Here

Contact

If you have questions after the event, please submit them using Contact Us.

From Healthcare Dive

The rule marks the first substantial changes to treatment and delivery standards at opioid treatment programs in more than 20 years, the government said.

Dive Brief:

• The HHS on Thursday finalized a rule that will allow opioid treatment programs to begin some medication treatment via telehealth.
• Under the rule, these providers will be able to initiate treatment with buprenorphine through audio-only or audio-visual telehealth. They can begin methadone treatment via an audio-visual platform — but not through an audio-only option due to its higher risk profile, the Substance Abuse and Mental Health Services Administration said.
• The regulation makes permanent telehealth flexibilities that began during the COVID-19 pandemic to preserve access to care and tackle a worsening opioid epidemic.

Dive Insight:

The rule marks the first substantial changes to treatment and delivery standards at opioid treatment programs in more than 20 years, SAMHSA said.

The updates — which also include expanding eligibility for patients to receive take-home doses of methadone and allowing more provider types to order medications — aim to reduce stigma and expand care access, which can be challenges to treating people with substance use disorders.

Telehealth could be a significant aid on that front, experts say. Virtual care use soared during the COVID pandemic, helped by loosened regulations that allowed patients to receive care while maintaining social distance.

Some research has shown telehealth can expand who can access mental healthcare and opioid use disorder treatment, potentially preventing overdoses. Provisional data suggests drug overdose deaths reached nearly 107,000 during the 12 months ending in August 2023, according to the Centers for Disease Control and Prevention.

“While this rule change will help anyone needing treatment, it will be particularly impactful for those in rural areas or with low income for whom reliable transportation can be a challenge, if not impossible,” Miriam Delphin-Rittmon, the HHS assistant secretary for mental health and substance use, said in a statement.

Regulators have made other changes that could improve access to substance use disorder treatment. During the pandemic, the Drug Enforcement Administration granted exceptions to the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which required most practitioners to have at least one in-person evaluation before prescribing controlled substances.

The DEA and the HHS announced in the fall that they would extend pandemic-era prescribing rules through 2024. Advocates cheered the extension, arguing in-person requirements limited access, particularly for opioid use disorder care.

The Biden-Harris Administration announced today that sickle cell disease (SCD) will be the first focus of the Cell and Gene Therapy (CGT) Access Model, which was initially announced in February 2023. The model is designed to improve health outcomes, increase access to cell and gene therapies, and lower health care costs for some of the nation’s most vulnerable populations.

Sickle cell disease is an extremely painful condition, which disproportionately impacts Black Americans and has had limited treatment options. In the United States, more than 100,000 people live with SCD. Individuals with the disease have a shorter life expectancy, by more than 20 years, compared to someone living without SCD. Additionally, many long-term health complications from SCD — including stroke, acute chest syndrome, and chronic end-organ damage — can lead to higher rates of emergency department visits and hospitalizations. Patients with SCD experience challenges with access to quality and affordability of care. This model has the potential to help improve health outcomes for patients and families with SCD while also ensuring taxpayer dollars are being used more effectively.

“HHS is using every tool available to us to increase access to high-quality, affordable health care and lower health care costs,” said HHS Secretary Xavier Becerra. “Many of the more than 100,000 Americans with sickle cell disease face difficulty accessing effective health care and groundbreaking treatments. While medical advancements bring us closer to cures, too many individuals with sickle cell disease and their loved ones still face challenges obtaining the care they need. With increased investment, we can improve the quality of life for people affected by this disease and find new, potentially transformative treatments.”

The CGT Access Model is part of the Administration’s broader effort to further drive down prescription drug costs and was developed in response to an executive order that President Biden issued in October 2022 directing the Department of Health and Human Services to consider developing models that increase access to novel therapies and lower the high cost of drugs. The model, led by the Centers for Medicare & Medicaid Services’ (CMS’) Innovation Center, will test outcomes-based agreements (OBAs) for groundbreaking CGTs. Successful OBAs will increase affordable access to potentially lifesaving and life-changing treatment. This model will begin in 2025 and may be expanded to other types of CGTs in the future.

“Gene therapies for sickle cell disease have the potential to treat this devastating condition and transform people’s lives, offering them a chance to live healthier and potentially avoid associated health issues,” said CMS Administrator Chiquita Brooks-LaSure. “Increasing access to these promising therapies will not only help keep people healthy, but it can also lead to savings for states and taxpayers as the long-term costs of treating sickle cell disease may be avoided.”

Approximately 50% to 60% of people living with SCD are enrolled in Medicaid. Hospitalizations and other health episodes related to SCD cost the health system almost $3 billion per year. Gene therapies for the treatment of SCD, as well as other complex conditions, hold significant potential to improve patient outcomes and therefore reduce long-term health spending, but they can also pose challenges to state budgets due to the high cost of the therapy.

Over the next year, CMS will partner with participating states and manufacturers to build a framework that expands access to gene therapies for the treatment of SCD. Under the model, CMS will negotiate an OBA with participating manufacturers, which will tie pricing for SCD treatments to whether the therapy improves health outcomes for people with Medicaid. Negotiations will also include additional pricing rebates and a standardized access policy. Participating states will then decide whether to enter into an agreement with manufacturers based on the negotiated terms and offer the agreed-upon standard access policy in exchange for rebates as negotiated by CMS. As part of the CGT Access Model, CMS will negotiate financial and clinical outcome measures with drug manufacturers and then reconcile data, monitor results, and evaluate outcomes. The CGT Access Model will begin in January 2025, and states may choose to begin participation at a time of their choosing between January 2025 and January 2026.

“The goal of the Cell and Gene Therapy Access Model is to increase access to innovative cell and gene therapies for people with Medicaid by making it easier for states to pay for these therapies,” said Liz Fowler, CMS Deputy Administrator and Director of the CMS Innovation Center. “By negotiating with manufacturers on behalf of states, CMS can ease the administrative burden on state Medicaid programs so they can focus on improving access and health outcomes for people with sickle cell disease.”

CMS anticipates addressing additional care delivery gaps and other hurdles for people receiving cell and gene therapy during the OBA negotiation process, including requiring manufacturers to include a defined scope of fertility preservation services when individuals receive gene therapy for treatment of SCD. CMS will also offer optional funding to states that engage in activities that increase equitable access to cell and gene therapies and promote multi-disciplinary, comprehensive care for people with Medicaid with SCD receiving gene therapy. These activities may include expanding or increasing reimbursement rates for optional Medicaid benefits and services, such as behavioral health or care management services.

For additional information see the fact sheet and CGT model page.

The Centers for Medicare & Medicaid Services (CMS) announced increased participation in CMS’ accountable care organization (ACO) initiatives in 2024, which will increase the quality of care for more people with Medicare. Of note, CMS is announcing that 19 newly formed accountable care organizations (ACOs) in the Medicare Shared Savings Program (Shared Savings Program) are participating in a new, permanent payment option beginning in 2024 that is enabling these ACOs to receive more than $20 million in advance investment payments (AIPs) for caring for underserved populations. An additional 50 ACOs are new to the program in 2024, and 71 ACOs renewed their participation, bringing the total to 480 ACOs now participating in the Shared Savings Program, the largest ACO program in the country. CMS also announced that 245 organizations are continuing their participation in two CMS Innovation Center models — ACO Realizing Equity, Access, and Community Health (ACO REACH) and the Kidney Care Choices (KCC) models.

“One of CMS’ top priorities is to expand access to quality, affordable health coverage and care,” said CMS Administrator Chiquita Brooks-LaSure. “Accountable care initiatives – which give more tools to health care providers to deliver better care and help people receive more coordinated care – through programs like the Medicare Shared Savings Program and the Innovation Center accountable care initiatives are critical to achieving this vision.”

Accountable care organizations are groups of doctors, hospitals, and other health care professionals that work together to give patients high-quality, coordinated service and health care, improve health outcomes, and manage costs. ACOs receiving AIPs are required to invest in health care infrastructure, staffing, and providing accountable care for underserved beneficiaries. These 19 new ACOs are hiring community health workers, utilizing health assessment and screening tools, and implementing quality improvement activities, such as case management systems, patient registries, and electronic quality reporting.

In 2024, three innovative ACO initiatives continue to grow, enabling higher quality care for people with Traditional Medicare: The Shared Savings Program, the permanent ACO program; the ACO REACH Model, which intends to increase access to and improve care for underserved populations, including those in rural areas; and the Kidney Care Choices model, which focuses on coordinating care for people with Medicare with chronic kidney disease and end-stage renal disease so more people can live fuller and longer lives.

Overall, in 2024 there are about 13.7 million people with Traditional Medicare aligned to an ACO. ACOs are now serving nearly half of the people with Traditional Medicare, a 3% increase since 2023. This growth in ACOs is important since ACOs have been shown to have superior quality performance compared to similar physician groups not participating in an ACO, and ACOs have generated year-over-year savings for the Medicare Trust Fund.

In the 2023 Physician Fee Schedule final rule, CMS took several actions in the Shared Savings Program to better align value-based programs, drive growth in accountable care, and create a more equitable health care system including scaling components from an Innovation Center model test that was shown to produce savings and maintain quality in the Medicare program writ large. After CMS observed that the ACO Investment Model drove increased ACO participation in rural and underserved areas and saved dollars for the Medicare Trust Funds, CMS incorporated the most important elements into the Shared Savings Program as AIPs. Already in the first year of implementation, CMS is seeing increased participation among health care providers from rural and underserved areas, just like in the model test — yet another example of the value that the Innovation Center brings to CMS and the public.

These actions build on parts of previous ACO model tests, such as the Pioneer ACO Model and the Medicare ACO Track 1+ Model (Track 1+ Model), that have already been incorporated into the Shared Savings Program by informing the development of the higher risk tracks, which are selected by 65% of ACOs in the Shared Savings Program today.

As a result, for 2024, the Shared Savings Program has 480 ACOs with 634,657 health care providers and organizations providing care to over 10.8 million people with Traditional Medicare. With the addition of the ACOs receiving AIPs, ACOs are delivering care to people with Traditional Medicare in 9,032 Federally Qualified Health Centers, Rural Health Clinics, and critical access hospitals, an increase of 27% from 2023.

“The new advance investment payments will enable health care providers in rural and other underserved areas to build the staffing, infrastructure, and care delivery improvements they need to succeed as ACOs providing high quality, equitable, accountable care to their communities,” said Meena Seshamani, M.D., PhD, Deputy Administrator and Director of the Center for Medicare. “Everyone deserves access to the type of whole-person care delivered by ACOs.”

For 2024, the ACO REACH Model has 122 ACOs with 173,004 health care providers and organizations providing care to an estimated 2.6 million people with Traditional Medicare. This model has 1,042 Federally Qualified Health Centers, Rural Health Clinics, and Critical Access Hospitals participating in 2024 — more than a 25% increase from 2023. Increasing the number and reach of ACOs in underserved communities will help close racial and ethnic disparities that have been identified among people with Traditional Medicare in accountable care relationships.

For 2024, the KCC model includes 123 Kidney Contracting Entities (KCEs) and CMS Kidney Care First (KCF) Practices, which are accountable for the quality and care of their aligned people with Medicare. The KCC Model has more than 9,227 participating health care providers and organizations, a 10% increase from 2023, serving 282,335 people with Medicare who have chronic kidney disease and end stage renal disease in 2024.

“The strong participation in our accountable care models in 2024 will help more people access high-quality, coordinated health care that will improve their quality of life,” said CMS Deputy Administrator and Innovation Center Director Liz Fowler. “The ACO REACH and KCC models are a cornerstone of our strategy to transform the health care system, focus on equity in everything we do, and deliver person-centered care that meets people where they are.”

• To view the Shared Savings Program Public Use Files, visit: Data.cms.gov
• The Shared Savings Program is releasing Public Use files on  ACOs,  ACO Participants, ACO SNF Affiliates and Advance Investment Payment Spend Plans.
• To view the Shared Savings Program fast fact sheet, visit: https://www.cms.gov/files/document/2024-shared-savings-program-fast-facts.pdf
• To view the ACO REACH Participants List, visit: https://www.cms.gov/files/document/aco-reach-py2024-participants.pdf
• To view the ACO REACH Quarterly Summary of Quality Performance, Financial Performance, and Model Payments, visit: https://www.cms.gov/priorities/innovation/media/document/aco-reach-gpdc-quarterly-transp-report
• To view the KCC Model Fact Sheet, visit: https://www.cms.gov/files/document/kcc-model-fs-cy2024.pdf
• To view the KCC Model Participants List, visit: https://www.cms.gov/files/document/kcc-model-participants-cy2024.pdf
• To view the KCC Participants Lists and Dialysis Facility Affiliation, visit: https://www.cms.gov/files/document/kcc-model-participants-affiliations-cy2024.pdf

From Healthcare Dive

Dive Brief:

• The HHS released voluntary cybersecurity goals for healthcare and public health organizations on Wednesday, as the industry grapples with increasing large data breaches and ransomware attacks.
• The performance goals, broken down into essential and enhanced safeguards, aim to help organizations prevent cyberattacks, improve their response if an incident occurs and minimize remaining risk after security measures are applied.
• The resources come after the HHS released a concept paper in December, which detailed plans to create hospital cybersecurity requirements through Medicare and Medicaid and eventually update the HIPAA rule.

Dive Insight:

Healthcare data breaches — particularly those stemming from hacking — have risen over the past decade, exposing hundreds of millions of patients’ sensitive personal information or protected health data.

Breaches can be costly for healthcare organizations to manage, but cyberattacks that interrupt hospital operations are also a risk to patient safety.

Ransomware, where criminals demand payment in exchange for restored access to sensitive information and critical systems, can disrupt normal care for weeks.

Ardent Health Services, which runs facilities in multiple states, was hit by a ransomware attack on Thanksgiving, forcing the hospital operator to take its network offline and divert incoming ambulances. Ardent restored access to its electronic health record in early December and fully recovered its patient portal in January.

The new cybersecurity goals from the HHS aim to help healthcare organizations build layered protection against cyberattacks — so if one defense fails, another can serve as a backup — which the agency said is key to building resilience and protecting patients.

“We have a responsibility to help our health care system weather cyber threats, adapt to the evolving threat landscape, and build a more resilient sector,” HHS Deputy Secretary Andrea Palm said in a statement. “The release of these cybersecurity performance goals is a step forward for the sector as we look to propose new enforceable cybersecurity standards across HHS policies and programs that are informed by these CPGs.”

The essential goals, which include safeguards like email security, multifactor authentication and basic cybersecurity training for employees, create a base to help organizations manage common vulnerabilities.

The enhanced protections, like establishing processes to discover and address threats at vendors, separating critical assets into discrete network segments and cybersecurity testing, aim to help health systems mature their defenses.

Hospitals cheered the voluntary goals, with American Hospital Association president and CEO Rick Pollack recommending in an email statement that “all components of the healthcare sector implement these practices including third party technology providers and business associates.”

But the trade and lobbying group has previously argued that mandated cybersecurity standards tied to funding — which media reports suggest could be coming down the pike soon — could remove hospital resources that could be used to shore up their cyber defenses.

U.S. Department of Agriculture (USDA) Rural Development Pennsylvania State Director Bob Morgan announced investments of more than $211,000 in four Community Facilities or CF projects in four counties in Pennsylvania.

“These investments in public safety and healthcare are vital to the quality of life for rural Pennsylvanians in these communities,” Morgan said. “We are glad we can play a small part in providing these facilities and law enforcement organizations the equipment they need to provide the best services possible.”

The healthcare project at the Fulton County Medical Center was awarded a $60,000 CF grant to purchase new exercise and education equipment for the wellness and clinical center.

The public safety projects were awarded in Mercer, Allegheny, and Mifflin counties.

Greenville Borough in Mercer County received a CF loan and grant of $38,500 and $83,600 to purchase three new police interceptor utility vehicles for the borough’s police department.

Munhall Borough in Allegheny County received a CF grant of $19,500 to purchase a new police responder vehicle. The vehicle is needed to replace one of the borough’s current vehicles that has reached the end of its useful life. This equipment will allow the police department to provide better public services and safety to the community.

Armagh Township in Mifflin County received a CF grant of $47,900 to two new police vehicles with necessary accessories.

In 2023, USDA Rural Development in Pennsylvania invested $119 million through its Community Facilities programs.

Rural Development provides loans, grants and loan guarantees to help expand economic opportunities, create jobs and improve the quality of life for millions of Americans in rural areas. This assistance supports infrastructure improvements; business development; housing; community facilities such as schools, public safety and health care; and high-speed internet access in rural, Tribal and high-poverty areas.

To subscribe to USDA Rural Development updates, visit GovDelivery subscriber page.