- 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
- Safe and Stable Housing Is a Foundation of Successful Recovery
- Rural RPM Program Is a Lifeline for Pregnant Women
- Expert: Rural Hospitals Are Particularly Vulnerable to Increasing Cyberattacks Targeting Healthcare Facilities
- Biden-Harris Administration Invests Over $200 Million to Help Primary Care Doctors, Nurses, and Other Health Care Providers Improve Care for Older Adults
New Report Projects Primary Care Slowing as CVS, Amazon, Walmart Pose Growing Threat
Fierce Healthcare reports that patient demand for primary care and surgical care services remains below pre-pandemic levels, and patient visits “delayed” or “deferred” during the COVID-19 pandemic may be permanently lost, according to a new analysis. At the same time, the number of commercially insured patients decreases while healthcare costs continue to rise. In a 146-page report, Trilliant Health, a healthcare analytics company, outlines 13 macro trends influencing the healthcare industry including population migration, telehealth adoption, competition from new entrants, and healthcare costs. The company’s analysis is based on third-party data resources and the company’s proprietary all-payer claims database that informs longitudinal patient journeys for more than 300 million Americans. Read more.
ACA’s Preventive Care Requirement is Under Attack
Plaintiffs in an Affordable Care Act lawsuit are now asking a federal judge to toss all parts of the law requiring coverage of preventive health services. The filing raises the stakes in the closely watched case, Kelley v. Becerra. If U.S. District Court Judge Reed O’Connor sides with the plaintiffs, millions of Americans could lose coverage for cancer screenings, behavioral counseling, and other recommendations made by the U.S. Preventive Services Task Force. Read more.
Pennsylvania is Rolling Out Online Mental Health Care for K-12
The state of Pennsylvania is piloting digital mental health services in 30 districts for a year, working with the U.K.-based company Kooth to offer access to self-therapy, peer support, and professional support. Read more.
Pennsylvania Begins to Study Medicaid Addiction Treatment Reimbursement Rates
The Pennsylvania Senate Health and Human Services Committee passed a resolution to order a study of Medicaid reimbursement rates for addiction treatment services. The study, which would aim to determine if rates are keeping up with increased demand, would be conducted by the Joint State Government Commission in 2023. Read More.
CMS Announces Progress in Promoting Health Equity in Rural Care Access Through Outpatient Hospital and Surgical Center Payment System Final Rule
Critical Access Hospitals and Small Rural Hospitals Can Convert to Rural Emergency Hospitals, Allowing Them to Remain Open to Serve Their Communities
The U.S. Department of Health and Human Services (HHS), through its Centers for Medicare & Medicaid Services (CMS), is improving access to health care — including behavioral health services — in rural communities. CMS is releasing the calendar year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule with comment period. This final rule will allow Critical Access Hospitals (CAHs) and small rural hospitals to convert to a Rural Emergency Hospital (REH), which may be a more sustainable option for rural hospitals facing closure and supports access to care in rural and underserved communities. An REH is a new Medicare provider type that furnishes outpatient services, emergency services, and observation care. In this rule, Medicare will also pay hospital outpatient departments to provide remote behavioral health services to people at home, which will improve access to care in rural communities and promote health equity.
“The Biden-Harris Administration continues to take steps to ensure all Americans, regardless of where they live, have access to high-quality, affordable health care, and this is especially important in rural America, where many hospitals have closed over the past two decades,” said HHS Secretary Xavier Becerra. “By helping rural hospitals stay open, we are helping residents of rural areas get the care they need close to home. Having access to care nearby is not only more convenient, but also leads to better health outcomes — and boosts local economies.”
“CMS is committed to expanding access to care in rural communities and ensuring people with Medicare get the high-quality care they need,” said CMS Administrator Chiquita Brooks-LaSure. “Through the establishment of Rural Emergency Hospitals, supporting clinic visits at rural sole community hospitals and enabling people with Medicare to remotely access behavioral health services in their homes, today’s actions promote patient safety, equity, and quality for these underserved communities. We received broad support for the role Rural Emergency Hospitals can play in advancing health equity and thank stakeholders for their thoughtful input during the public comment period.”
“Establishing Rural Emergency Hospitals can help ensure continued access to critical medical facilities in rural communities,” said Deputy Administrator and Director for the Center for Medicare, Dr. Meena Seshamani. “These facilities are often backbones of communities, but maintaining these businesses and keeping doors open can be challenging. Under today’s final rules regarding this new provider type, we hope to preserve and improve access to care in rural areas and take important steps toward advancing health equity nationwide.”
Updates to OPPS and ASC Payment Rates
CMS is updating the CY 2023 OPPS payment rates and ASC payment rates by 3.8%
Rural Emergency Hospitals
CMS is finalizing conditions of participation, payment rates, and Medicare enrollment requirements for Rural Emergency Hospitals, a new type of Medicare provider that Congress created in the Consolidated Appropriations Act, 2021. These policies for the newly created provider type takes effect on January 1, 2023. Rural hospitals are essential for providing health care in their communities, and the closure of these hospitals limits access to care in areas that are often already underserved. The availability of the REH designation will help support access to health care, particularly emergency services and outpatient services. The REH requirements in this final rule establish a full range of health and safety standards, requirements for services offered, staffing requirements, and physical environment and emergency preparedness standards. REHs will receive additional Medicare payments to help maintain access to a wide array of services in rural areas.
Improving Access to Behavioral Health Services in Rural Areas
CMS is establishing a policy that permits clinical staff of hospital outpatient departments to provide behavioral health services remotely to patients in their homes. CMS first implemented this policy through emergency rulemaking in response to the COVID-19 public health emergency. By making this policy permanent, CMS will ensure access to behavioral health services particularly for rural and other underserved communities, furthering health equity goals.
Enhanced Payment for Non-Opioid Pain Management Drugs and Biologicals
Consistent with the CMS opioid strategy, CMS is finalizing to separately pay for five qualifying non-opioid pain management drugs when administered in ambulatory surgical centers in CY 2023. This ensures that Medicare beneficiaries have access to non-opioid pain management drugs and encourages providers to use non-opioids rather than opioids for pain management.
Payment Adjustments for Additional Costs of Domestic NIOSH-Approved N95 Surgical Respirators
In a future pandemic or increase in community spread of COVID-19, hospitals need to be able to access a reliable supply of NIOSH-approved surgical N95 respirators to protect health care workers and their patients. Sustaining domestic production of these products is important for helping to maintain that reliability. CMS recognizes that hospitals may incur additional costs when purchasing domestically made NIOSH-approved surgical N95 respirators, so this final rule establishes additional hospital payments that would account for these costs.
For a fact sheet on the CY 2023 OPPS/ASC Payment System Final Rule (CMS-1772-FC), please visit: https://www.cms.gov/newsroom/fact-sheets/cy-2023-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-2
For a fact sheet on Rural Emergency Hospitals, please visit: https://www.cms.gov/newsroom/fact-sheets/cy-2023-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-1
For a CMS blog on the behavioral health polices in the CY 2023 Physician Fee Schedule and Outpatient Prospective Payment System final rules, please visit: https://www.cms.gov/blog/strengthening-behavioral-health-care-people-medicare-0?check_logged_in=1
The CY 2023 OPPS/ASC Payment System Final Rule can be viewed here: https://www.cms.gov/files/document/cy2023-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-final-rule.pdf
CMS Issues Final Rule on Medicare Enrollment and Eligibility Rules to Advance Health Equity
The Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare enrollment and eligibility rules to expand coverage for people with Medicare and advance health equity. The final rule, which implements changes made by the Consolidated Appropriations Act, 2021 (CAA), makes it easier for people to enroll in Medicare and eliminates delays in coverage. Among these changes, individuals will now have Medicare coverage the month immediately after their enrollment, thereby reducing any delays in coverage. In addition, the rule expands access through Medicare special enrollment periods (SEPs) and allows certain eligible beneficiaries to receive Medicare Part B coverage without a late enrollment penalty. The FACT SHEET attached details the SEPS.
To view a fact sheet on the final rule, visit: https://www.cms.gov/newsroom/fact-sheets/implementing-certain-provisions-consolidated-appropriations-act-2021-and-other-revisions-medicare-2
To view the final rule, visit: https://www.federalregister.gov/public-inspection
Healthy Eating for Healthy Children: A Course for Dental Hygienists
The Oral Health Program at the Rhode Island Department of Health released a new online course to teach dental hygienists how to talk to parents and caregivers about food choices for children. This innovative approach focuses on using accessible and encouraging language as well as providing talking points and conversation starters to use with parents during dental visits. The course is free and takes approximately 80 minutes to complete.
American Dental Association Launches Health Equity Initiative
The American Dental Association (ADA) launched a new Health Equity Action Team to help reduce disparities in oral health. Among the panelists is Dr. James Mancini, a Pennsylvania dentist and PA Coalition for Oral Health stakeholder. The ADA also published a Healthy Equity Resources webpage with resources for dentists to use to take action in their own communities.
CDC Issues Health Advisory For Dental Health Care Personnel
The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network Health Advisory regarding nontuberculous Mycobacteria infections associated with contaminated dental unit waterlines and the need for dental health care personnel (DHCP) to follow established recommendations to ensure the safety of their patients. While rare, there have been multiple documented cases of disease transmission from dental unit waterlines. Dental unit waterlines promote bacterial growth and development of biofilm, thus all dental unit waterlines must be treated regularly with chemical germicides. The health advisory contains recommendations and a list of resources for DHCP to visit to learn more information.
American Institute of Public Health Releases Dental Workforce Report
The American Institute of Public Health (AIDPH) released a research brief, “The Financial and Policy Impacts of the COVID-19 Pandemic on U.S. Dental Care Workers.”
The brief evaluates trends and differences of the dental health care workforce before and after the onset of the COVID-19 pandemic and assesses the impact of dental health care worker shortages by state and geographic region. Executive Director Helen Hawkey and Dr. Sean Boynes are among the authors. An interactive dashboard is being developed to map the changes among dental health care workers.