ProviderBridge.org was created through the Coronavirus Aid, Relief, and Economic Security (CARES) Act by the Federation of State Medical Boards and HRSA’s Office for the Advancement of Telehealth. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.

Designed to serve Spanish-speaking communities, the online tool from the Substance Abuse and Mental Health Services Administration (SAMHSA) offers confidential and anonymous access to nearby treatment facilities and practitioners.

The report from the National Rural Health Resource Center was done in collaboration with FORHP and is a product of the May 2024 Rural Health Workforce Summit.  Each of the report’s four key strategies include specific and practical actions that can be adopted to address workforce shortages.

– Comment by November 12. This proposed rule from the Centers for Medicare & Medicaid Services (CMS) sets standards for Affordable Care Act (ACA) Marketplaces and issuers, as well as requirements for agents, brokers, web-brokers, direct enrollment entities, and assisters that help Marketplace consumers. It includes proposals to:

• prevent unauthorized activity among agents and brokers,
• mitigate health disparities by incentivizing plans that focus on underserved communities, and
• simplify plan choices.

Since 2018, the number of Marketplace plans in rural areas has grown, increasing the choices of coverage available to consumers.

Researchers from the North Carolina Rural Health Research and Policy Analysis Center created a model for predicting rural hospital closures in 2017. This update for 2024 was published last week in The Journal of Rural Health.

The latest Morbidity and Mortality Weekly Report from the Centers for Disease Control (CDC) highlights just how connected Adverse Childhood Experiences (ACEs) are to adolescent health.  Billed as the most comprehensive data yet on this subject, the report concludes that preventing ACEs could reduce suicide attempts by as much as 89 percent, prescription pain medication misuse by as much as 84 percent, and persistent feelings of sadness or hopelessness by as much as 66 percent. Earlier this year, the CDC issued a Rural Policy Brief showing suicide rates have been consistently higher in rural areas than in urban areas over the past two decades.  Between 2000-2020, suicide rates increased 46 percent in non-metro areas compared to 27.3 percent in metro areas.  A separate CDC Rural Policy Brief on suicide prevention released in July features a case study from a successful program for adolescents in tribal community in New Mexico.  In 2018, the National Advisory Committee on Rural Health and Human Services delivered an in-depth report on the rural context for ACEs, with recommendations for federal policy.

The Centers for Medicare & Medicaid Services (CMS) released guidance on state compliance with the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements under Medicaid and the Children’s Health Insurance Program (CHIP).  Current law entitles eligible children under the age of 21 to Medicaid coverage of health care, diagnostic services, treatment, and other measures described that are medically necessary.  This guidance provides an overview of EPSDT requirements and discusses policies, strategies, and best practices to maximize health care access and utilization for EPSDT-eligible children.  Strategies include promoting EPSDT awareness and accessibility, expanding and using the child-focused (EPSDT) workforce in rural areas, and improving care for EPSDT-eligible children with specialized needs, including providing behavioral health services in Rural Health Clinics. Medicaid and CHIP covers about 47 percent of children in rural areas and small towns.

The Centers for Medicare & Medicaid Services (CMS) issued a final rule addressing significant, anomalous, and highly suspect (SAHS) billing activity within Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (SSP). In 2023, CMS identified a concerning rise in urinary catheter billings, which was attributed to a small group of durable medical equipment supply companies. CMS determined that the beneficiaries did not receive catheters and were not billed directly, physicians did not order these supplies, and supplies were not needed.  This rule specifies how CMS will calculate various factors used in SSP financial calculations for 2023.  The proposed Physician Fee Schedule addresses SAHS billing activity for 2024 onwards.  As of January 2024, over 500 Critical Access Hospitals and 2,500 Rural Health Clinics participated in Medicare SSP ACOs.

– Comment by November 29. This week, the Centers for Medicare & Medicaid Services (CMS) released an interim final action with comment period (IFC) that removes the low wage index hospital policy following the appellate court decision in Bridgeport Hosp. v. Becerra. The low wage index hospital policy was implemented in FY2020 to address wage index disparities affecting low-wage index hospitals, including many rural hospitals.  The court decided that the policy and related budget neutrality adjustment must be reversed. As a result, this IFC revises the Medicare wage index values for FY 2025, establishes a transitional payment exception for low wage hospitals significantly impacted by those revisions, and makes conforming changes to the Medicare hospital Inpatient Prospective Payment System (IPPS) payment rates for FY 2025. These changes are effective September 30, 2024. To be assured consideration, comments must be received by November 29, 2024.

Among key findings in this policy brief from the University of Minnesota Rural Health Research Center:

• Health care affordability and medical debt issues differed significantly among rural residents by race and ethnicity, sexual orientation, age, income, and type of health insurance.
• Rural residents in the Western U.S. were more likely to be able to pay their medical bills than rural residents in the Northeast, North Central/Midwest, or Southern U.S.