- Senator Baldwin Introduces HSHS Act to Protect Communities from Hospital Closures
- What to Know about Smoke, Heat and Health
- Tribal Partnership With UW-Madison Combines Ag Research With Indigenous Food Knowledge
- The Rewards of Working as Rural Docs
- Request for Information (RFI): Evolving the Network of the National Library of Medicine
- Dental Therapists, Who Can Fill Cavities and Check Teeth, Get the OK in More States
- Colorectal Cancer Is Rising among Younger Adults. Some States Want to Boost Awareness.
- Rural Hospitals Built During Baby Boom Now Face Baby Bust
- Food Stamps Go Further in Rural Areas — Until You Add Transportation Costs
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Texas
- CMS Proposes New Payments for Digital Health Under CY2025 PFS Draft Rule
- Improving Public Health by Strengthening Community Infrastructure
- Biden Harris Administration Proposes Policies to Reduce Maternal Mortality, Advance Health Equity, and Support Underserved Communities
- Nearly Half of U.S. Counties Don't Have a Single Cardiologist
- Randolph County, Ill. Turns Unused Part of Nursing Home Into State-Of-The-Art Behavioral Health Center
No Surprises Act – New Consumer-Friendly Resources
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.
Unexpected medical bills are a significant source of stress, frustration, and confusion for people in the United States. The No Surprises Act gives them new rights to prevent, navigate, and find resolutions to many of these “surprise” bills.
To help consumers understand their rights, consumer-friendly web pages are now available for people with easy-to-read information and actionable guidance. The webpages’ design and content were informed by human-centered design research and user testing with patients, caregivers, patient advocates, and others.
The webpage aims to be inclusive and accessible by:
- Meeting Web Content Accessibility Guidelines (WCAG 2.1 AA)
- Providing all information in both English and Spanish
- Using plain language and clean design
- Centering the human experience with diverse and colorful illustrations
- Building the site to be responsive to different devices, including mobile phones and tablets
- Offering clear and multiple pathways for people to learn about their rights
When people visit the consumer website, they’ll be guided through:
- Understanding their rights under the No Surprises Act, including out-of-network billing protections and good faith estimates for future care
- Identifying actions they can take to exercise their rights and find a resolution if they receive an unexpected medical bill, using a Q&A tool that asks about their situation
- Submitting a complaint if they think their provider, facility, or insurance company didn’t follow the rules of the No Surprises Act through an optimized process and redesigned form
- Disputing a bill if they are uninsured or didn’t use insurance and they were charged more than their good faith estimate
- Finding guides that will help them navigate medical billing questions, as well as learning how to connect with the No Surprises Help Desk
Resources:
- No Surprises Act Consumer Webpage: https://www.cms.gov/medical-bill-rights as well as en Español: https://www.cms.gov/derechos-facturas-medicas
- New Protections for Consumers: https://www.cms.gov/medical-bill-rights/know-your-rights
Payment Dispute Webpage: https://www.cms.gov/medical-bill-rights/help/dispute-a-bill - Submit a Complaint: https://www.cms.gov/medical-bill-rights/help/submit-a-complaint
- Find an Action Plan: https://www.cms.gov/medical-bill-rights/help/plan
- Resources for providers can still be found at: https://www.cms.gov/nosurprises
Important Updates on Medicaid and CHIP Renewals, Including Partner Call to Action, New Resources, and More
NEW: CMS UNWINDING ANNOUNCEMENTS
CMS is committed to maximizing the number of people with affordable, high-quality coverage. We want to make sure people stay covered whether that’s through Medicaid, Medicare, the Marketplace, or employer-sponsored coverage. This work is all hands-on-deck and will continue to be. These announcements and resources below will help you reach Medicaid enrollees and help them complete their renewals and help connect them to other coverage as appropriate.
- CMS Press Release: HHS Takes Additional Action to Keep People Covered as States Resume Medicaid, CHIP Renewals
- Secretary Letter to Governors: This letter discusses HHS’ role in monitoring progress and enforcing compliance as well as flexibilities available for states to help ensure the process runs smoothly.
- Strategies to Prevent Procedural Terminations: This document describes multiple strategies states are encouraged to adopt to streamline renewals during the Unwinding period, minimize terminations for procedural reasons, and quickly reenroll eligible families who have lost coverage. It also highlights several new strategies CMS has recently made available to states.
- All Hands On-Deck: This fact sheet includes an update on Unwinding and strategies to help keep people covered.
PARTNER CALL TO ACTION
We are calling on states, members of Congress, the health care industry, community organizations, advocacy coalitions, and other public and private partners to do everything in their power to help people stay covered. Read more: All Hands On Deck: What YOU Can Do
NEW: MEDICAID.GOV UPDATES AND PARTNER RESOURCES
The Outreach and Educational Resources Page on Medicaid.gov/Unwinding has been updated to make it easier for partners to locate resources. Each resource includes recommendations on how they can be used to educate people about Medicaid and CHIP renewals. With the website update, you can find new resources for kids and families, fraud/scams, and educational videos included below.
Messaging and Resources for Kids and Families
- Post Card for Kids with Medicaid or CHIP (English and Spanish)
- Fillable Post Card for Kids with Medicaid or CHIP (English and Spanish)
- Post Card for Renewing Kids’ Medicaid or CHIP (English and Spanish)
- Fillable Post Card for Renewing Kids’ Medicaid or CHIP (English and Spanish)
Resources on Fraud/Scams
Educational Videos
Note: These videos can be used through February 22, 2024 and they cannot be used as PSAs.
Don’t Wait! Update! Get Ready to Renew Your Medicaid or CHIP Coverage (:30 Seconds):
- https://youtu.be/MFaBCH-hVB8 (English)
- https://youtu.be/atBHw_GD1ls (Español/Spanish)
Don’t Wait! Update! Get Ready to Renew Your Medicaid or CHIP Coverage (:15 Seconds):
- https://youtu.be/d5CAlr8PGl8 (English)
- https://youtu.be/cWj_5clH1Rc (Español/Spanish)
Don’t Wait! Update! Get Ready to Renew Your Medicaid or CHIP Coverage (:06 Seconds):
- https://www.youtube.com/watch?v=Rn3EjrxokxQ (English)
- https://www.youtube.com/watch?v=v2zziuthgjA (Español/Spanish)
UPCOMING PARTNER WEBINARS
HHS and CMS continue to host a series of monthly webinars on Medicaid and CHIP Continuous Enrollment Unwinding to educate partners. Topics covered during the webinar vary each month. Webinars take place the fourth Wednesday of each month from 12:00pm – 1:00pm ET. Register for upcoming webinars through September 2023 here.
Recordings, transcripts, and slides from past webinars can be found on the CMS National Stakeholder Calls webpage.
Brookings’ Reimagine Rural Launches Podcasts
Across the United States, rural communities are transforming. Whether they’re lifting up local entrepreneurs, embracing art and beauty, or leaning into outdoor recreation to attract tourists, there are numerous examples of positive change. To share these stories, Tony Pipa hit the road and spoke with the people that are making it all happen.
Listen to the complete first season of Reimagine Rural wherever you get your podcast.
Looking for more?
Stories from the listeners. Only eight episodes of Reimagine Rural were planned, but we heard from so many listeners across the country that we had to release another one. Listen to a bonus episode with more stories of community revitalization.
Policy lessons and surprises. In this recap blog post, Tony Pipa shares some of the key takeaways from his conversations with local leaders, investors, and small-business owners.
Children Advocacy Group Releases KIDS COUNT® Data Center Updates
Check out our data webpage for recent Pennsylvania KIDS COUNT® Data Center updates!
We have updated information from the 2020 Census release this past week for our population and housing indicators and the most recent information on births from the state Department of Health!
New Data on Appalachia’s Economy, Income, Education
ARC has released the 13th update of The Appalachian Region: A Data Overview from the 2017-2021 American Community Survey, also known as “The Chartbook.” The report, written in partnership with the Population Reference Bureau, features more than 300,000 data points comparing Appalachia’s economy, income, education, and more with the rest of the nation.
The 2023 report shows that Appalachia continued to make progress in educational attainment, labor force participation, income levels, and poverty rates from 2017-2021. Despite positive trends, work remains for the Appalachian Region — particularly its oldest, youngest, and most rural residents — to achieve parity with the nation.
To address Appalachia’s key vulnerabilities, ARC launched the Appalachian Regional Initiative for Stronger Economies (ARISE) for large-scale economic transformation. The funding opportunity has a new application process that will be reviewed in detail during ARC’s pre-application webinar on June 22.
CMS Announces Making Care Primary (MCP) Model
The Centers for Medicare & Medicaid Services (CMS) announced a new primary care model – the Making Care Primary (MCP) Model – that will be tested in eight states. Access to high-quality primary care is associated with better health outcomes and equity for people and communities. The model seeks to improve care for people with Medicare and Medicaid by equipping primary care clinicians with tools to form partnerships with specialists and leverage community-based connections to address patients’ health and health-related social needs.
CMS plans to partner with State Medicaid Agencies in the eight states to engage in full care transformation across payers. The model will support participants with varying levels of accountable care experience, including Federally Qualified Health Centers (FQHCs) and physician practices with limited experience in value-based care, in driving toward a system that reduces disparities in care and results in better patient experience and outcomes.
CMS will test this advanced primary care model in Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. CMS will work with model participants to address priorities specific to their communities, including care management for chronic conditions, behavioral health services, and health care access for rural residents.
Primary care organizations within participating states may apply when the application opens in late summer 2023. The model will launch on July 1, 2024.
For more information, review the detailed official press release.
To view the MCP webpage, visit: https://innovation.cms.gov/making-care-primary.
To view a model key highlights video, visit: https://youtu.be/8vy3PHHlCe4.
Highmark Foundation Announces Bright Blue Futures Award Opportunity
The Highmark Bright Blue Futures Awards is an exciting new grant awards and recognition program, and is now accepting nominations! As part of the accolade, this program will allocate grant awards ranging from $25,000 to $100,000 and honor outstanding organizations, programs, collaborative efforts, and philanthropic initiatives. The theme for the inaugural year is “A Look at Health Equity, Social Determinants of Health and Philanthropy to Advance Community Health.”
Submit nominations by July 10 for the Highmark Bright Blue Futures Awards here.
This program is made possible by the Highmark Foundation and is an expansion of Highmark’s corporate giving and community involvement program, Highmark Bright Blue Futures. Highmark Bright Blue Futures is designed to ensure healthier, brighter, stronger futures for all. The focus is on improving equitable access to care, quality of life, and economic resilience in the communities the enterprise serves. Specifically, it aims to improve outcomes in two critical areas: Community Health and Community and Economic Resilience.
This is an amazing opportunity to further highlight impactful initiatives across our enterprise footprint that are helping to build healthier, brighter futures. Additional information about the awards can be found here.
PA WalkWorks Announces Funding Opportunity
Walking, biking, using a wheelchair, and accessing transit are independent, reliable, and resilient transportation modes that are healthy for our minds, bodies, finances, communities, and the environment. We look forward to a time when everyone in Pennsylvania has a full range of transportation options available to them.
To that end, WalkWorks is pleased to announce a new program to assist low-capacity, high interest municipalities with the pre-planning steps they must undertake in order to be ready to apply for funding to develop active transportation plans in 2024. A small amount of money and structured pre-planning assistance will be available to selected municipal applicants. Eligible municipalities must be located either in the newly updated list of State Physical Activity and Nutrition target counties identified by the Department of Health or in an Environmental Justice area as designated by the Department of Environmental Protection, both of which are shown on this map. In addition, applicants should have an interest in applying for funding to develop an active transportation plan but lack the knowledge, professional support, or resources needed to assemble an application. Barriers may include lack of clarity among elected officials about the goals/results of developing a plan, lack of understanding among the public of the relevance of such a plan for their community, and/or an inability to establish a reasonable scope and budget for the plan.
Mini-grants and structured assistance will be offered to a limited number of municipalities between September of 2023 and March of 2024. The long term goal is to prepare additional communities to apply to develop active transportation plans which is necessary for the establishment of activity-friendly routes that connect people to everyday destinations, expanding opportunities for physical activity and improving public health.
An informational webinar reviewing the FOA will take place on Thursday, June 22, at noon, on zoom. Register at this link.
Click here to learn more.
New Resource Released: Adopting Oral Health to Advance Minimally-Invasive Care
Community Catalyst released a new resource, “Adopting Oral Health Integration to Advance Minimally-Invasive Care.” The resource provides information about how minimally invasive health care can be used in conjunction with the integration of oral health care and medical care to improve oral health and overall health, as well as people’s experiences with receiving oral health care.
Click here to view the resource.
HHS Finalizes End of COVID-19 Vaccination Rule for Hospitals
From Becker’s
The federal government is formally withdrawing the COVID-19 vaccine mandate for employees of CMS-certified healthcare facilities that was enacted in November 2021 and moving to treat the virus, from an oversight standpoint, more like the flu.
The Biden administration announced on May 1 that HHS would begin the process to end the COVID-19 vaccine requirement for employees of CMS-certified healthcare facilities. Requirements under the Omnibus COVID-19 Health Care Staff Vaccination rule were no longer enforced at the end of the day May 11, 2023, the same day the COVID-19 PHE ended, a CMS spokesperson told Becker’s.
While CMS might be done enforcing the rule, it still needs to come off the books. To do so, CMS has issued an 82-page final rule formalizing the end of the vaccination requirement. In the final rule set to be published in the Federal Register June 5, HHS and CMS withdraw the 2021 vaccination requirement, outline reasoning for its end, and note upcoming plans to regulate healthcare workers’ protections against COVID-19 as part of certain Medicare quality programs.
The final rule is set to take effect 60 days after the date it is published in the federal register. As scheduled, that would be Aug. 4. CMS told Becker’s it will not enforce the vaccination requirement before the effective date of the rule — it is no longer in effect as of May 11.
“As conditions and circumstances of the COVID-19 PHE have evolved, so too has CMS’ response. At this point in time, we believe that the risks targeted by the staff vaccination [interim final rule with comment] have been largely addressed, so we are now aligning our approach with those for other infectious diseases, specifically influenza,” the 82-page final rule states. “Accordingly, CMS intends to encourage ongoing COVID-19 vaccination through its quality reporting and value-based incentive programs in the near future.”
Hospitals’ COVID-19 vaccination rates will effectively go from being a condition of participation in Medicare to being part of a quality reporting process, which hospitals are familiar with.
“CMS has been pretty clear that it no longer needs the condition of participation mechanism to follow through on the vaccination process,” Mark Howell, director of policy and patient safety for the American Hospital Association, told Becker’s. “It feels comfortable with the outlook that the quality measures provide. The [public health emergency] is over and COVID-19 has moved from pandemic to endemic stage, but that doesn’t mean COVID is gone. It makes sense [CMS] would want some measurement there.”
Hospitals and health systems would learn of the vaccination-related measures under consideration for inclusion in CMS programs by Dec. 1, the deadline by which HHS is required to publicly release a list of measures on the table for adoption in certain Medicare programs.
CMS, in its Hospital Inpatient Prospective Payment System proposed rule for fiscal year 2024, had proposed adjusting the measure for COVID-19 vaccination among healthcare personnel to go from reporting on the primary vaccination series only to reporting on the cumulative number of healthcare personnel who are up to date with recommended COVID-19 vaccinations.
Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said the association is prepared to give CMS feedback that recommends the shift from primary series to up-to-date vaccination reporting coincide with improvements to the recommended cadence of COVID-19 vaccinations. U.S. health officials proposed simplifications to COVID-19 vaccine protocol, making it more like the routine process for annual flu shots, earlier this year.
“There is a challenge with the measure right now in trying to figure out if someone is up to date in their vaccination,” Ms. Foster told Becker’s. “It is so haphazard. When we know everyone should have gotten their shot sometime between September and December, for instance, that will make it administratively much easier to know who has been vaccinated if they are up to date.”
In the new final rule from HHS and CMS, the agencies note that withdrawal of the vaccination rule does not prohibit healthcare organizations from instating their own COVID-19 vaccination requirements for staff, consistent with other federal, state and local laws. It is likely that hospitals and health systems are in internal conversations and decision-making about what changes, if any, to make to their own individual COVID-19 vaccination requirements in light of the federal-level change.
The final rule from HHS and CMS also requires long-term care facilities to educate and offer the COVID-19 vaccine to residents, resident representatives and staff, as well as perform the appropriate documentation for these activities, as terms of participation in Medicare and Medicaid.