Rural Health Information Hub Latest News

HHS Finalizes Section 1557 Nondiscrimination Rule – Impacts for RHCs

– Monday, July 15 at 2:00 pm Eastern. The National Association of Rural Health Clinics (NARHC) will host the free, FORHP-supported webinar, with information on the Department of Health and Human Services (HHS) Office of Civil Rights and the Centers for Medicare & Medicaid Services final rule under Section 1557 of the Affordable Care Act Nondiscrimination in Health Programs and Activities and the RHC impacts, including:

  • Requirement to post a notice of nondiscrimination.
  • Requirements to post notice of availability of translation and auxiliary aid services in top 15 foreign languages.
  • Requirement to establish and train employees on policies and procedures related to nondiscrimination.

Additional time for Q&A will be provided. Advanced registration is required.

CMS Proposed Rule on Anomalous DME Spending and MSSP Financial Calculations 

– Comment by July 29. This week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for mitigating the impact of significant, anomalous, and highly suspect (SAHS) billing activity on the Medicare Shared Savings Program financial calculations in calendar year 2023. This proposed rule is part of a larger strategy to address significant, anomalous, and highly suspect (SAHS) within ACO reconciliation, and additional information will be forthcoming in the Physician Fee Schedule. Due to a recent, observed increase in Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) billing to Medicare for selected intermittent urinary catheter supplies in CY 2023, CMS  proposes to exclude use of these codes from any supplier in 2023 from ACO expenditure and revenue calculations.

New Funding Opportunity: Technology-Enabled Collaborative Learning Program 

– Apply by August 2.  HRSA’s Office for the Advancement of Telehealth will invest approximately $3,800,000 for up to eight new cooperative agreements. Awarded entities will evaluate, develop, and expand the use of technology-enabled learning models to build capacity, improve retention of health care providers, and increase access to services.  Eligible applicants include entities that provide, or support the provision of, health care services in rural areas, frontier areas, health professional shortage areas, or medically underserved areas, or to medically underserved populations or Native Americans, including Indian Tribes, Tribal organizations, and urban Indian organizations.

Maternal Mortality Rates Released, State by State

KFF has released a new analysis outlining maternal mortality rates for every state and Washington, D.C.

KFF used 2018-22 data from the CDC’s National Center for Health Statistics to compile maternal deaths and mortality rates. Maternal deaths are defined as deaths of women while pregnant or within 42 days of pregnancy termination. Only causes of death from or aggravated by pregnancy are included.

Nationwide, 4,295 maternal deaths were reported between 2018 and 2022, resulting in a maternal mortality rate of 23.2 deaths per 100,000 live births. The U.S. has the highest maternal mortality rate of any developed nation, according to The Commonwealth Fund.

To address this issue, CMS has proposed adding obstetrical standards for hospitals as part of its conditions of participation requirements. Hospitals and physicians have pushed back on the suggestion, arguing the approach is too punitive and could inadvertently hinder access to obstetrical care.

Below is a breakdown of maternal mortality rates by state.

Note: KFF expressed caution at making comparisons between states, as data for many states are based on small numbers and could be statistically unreliable. The organization suppressed data for several states, if mortality rates were based on fewer than 20 deaths. Variation in state rates is likely due to differences in the quality of maternal mortality data, KFF said.

Tennessee
Maternal mortality rate: 41.1
Number of deaths: 166

Mississippi
Maternal mortality rate: 39.1
Number of deaths: 70

Alabama
Maternal mortality rate: 38.6
Number of deaths: 112

Arkansas
Maternal mortality rate: 38.3
Number of deaths: 69

Louisiana
Maternal mortality rate: 37.3
Number of deaths: 108

Kentucky
Maternal mortality rate: 34.6
Number of deaths: 91

Virginia
Maternal mortality rate: 32.7
Number of deaths: 158

South Carolina
Maternal mortality rate: 32.3
Number of deaths: 92

Georgia
Maternal mortality rate: 32.1
Number of deaths: 201

Indiana
Maternal mortality rate: 30.9
Number of deaths: 124

Arizona
Maternal mortality rate: 30
Number of deaths: 118

Oklahoma
Maternal mortality rate: 29.6
Number of deaths: 72

Texas
Maternal mortality rate: 28.2
Number of deaths: 532

New Mexico
Maternal mortality rate: 28
Number of deaths: 31

North Carolina
Maternal mortality rate: 26.7
Number of deaths: 159

New Jersey
Maternal mortality rate: 26
Number of deaths: 131

Nebraska
Maternal mortality rate: 25.1
Number of deaths: 31

Ohio
Maternal mortality rate: 24.5
Number of deaths: 161

Florida
Maternal mortality rate: 24.1
Number of deaths: 263

West Virginia
Maternal mortality rate: 23.9
Number of deaths: 21

Missouri
Maternal mortality rate: 23.8
Number of deaths: 84

Kansas
Maternal mortality rate: 22.8
Number of deaths: 40

New York
Maternal mortality rate: 22.4
Number of deaths: 241

Maryland
Maternal mortality rate: 21.3
Number of deaths: 74

Nevada
Maternal mortality rate: 20.4
Number of deaths: 35

Idaho
Maternal mortality rate: 20
Number of deaths: 22

Iowa
Maternal mortality rate: 19.5
Number of deaths: 36

Michigan
Maternal mortality rate: 19.1
Number of deaths: 101

Illinois
Maternal mortality rate: 18.1
Number of deaths: 123

Washington
Maternal mortality rate: 18
Number of deaths: 76

Pennsylvania
Maternal mortality rate: 17.5
Number of deaths: 116

Oregon
Maternal mortality rate: 16.6
Number of deaths: 34

Massachusetts
Maternal mortality rate: 16.4
Number of deaths: 56

Colorado
Maternal mortality rate: 16
Number of deaths: 50

Connecticut
Maternal mortality rate: 15.6
Number of deaths: 27

Utah
Maternal mortality rate: 15.5
Number of deaths: 36

Wisconsin
Maternal mortality rate: 13.2
Number of deaths: 41

Minnesota
Maternal mortality rate: 12.3
Number of deaths: 40

California
Maternal mortality rate: 10.5
Number of deaths: 228

Alaska
Maternal mortality rate: Data suppressed
Number of deaths: 12

Delaware
Maternal mortality rate: Data suppressed
Number of deaths: 9

District of Columbia
Maternal mortality rate: Data suppressed
Number of deaths: 12

Hawaii
Maternal mortality rate: Data suppressed
Number of deaths: 13

Maine
Maternal mortality rate: Data suppressed
Number of deaths: 7

Montana
Maternal mortality rate: Data suppressed
Number of deaths: 17

New Hampshire
Maternal mortality rate: Data suppressed
Number of deaths: 11

North Dakota
Maternal mortality rate: Data suppressed
Number of deaths: 11

Rhode Island
Maternal mortality rate: Data suppressed
Number of deaths: 9

South Dakota
Maternal mortality rate: Data suppressed
Number of deaths: 16

Vermont
Maternal mortality rate: Data suppressed
Number of deaths: 1

Wyoming
Maternal mortality rate:  Data suppressed
Number of deaths: 7

Pennsylvania Fluoride Study Featured in Journal of the American Dental Association

A Pennsylvania-based study will be featured in the upcoming August issue of the Journal of the American Dental Association (JADA). “Cross-sectional study of association between caries and fluoridated water among third-grade students in Pennsylvania,” authored by Pennsylvania Department of Health Oral Health Program epidemiologist Dr. Jun Yang, also features PCOH Executive Director Helen Hawkey as a co-author. The study found that community water fluoridation was significantly associated with a reduced risk of developing caries among Pennsylvania children.

Click here to read the article.

Oral Health and Nicotine/Tobacco Updates Available

The Association of State and Territorial Dental Directors (ASTDD) Dental Public Health Policy Committee announced a new policy statement on preventing tobacco/oral nicotine use to promote oral health. The statement provides information on the impacts to oral and overall health as well as guidance identifying effective strategies in prevention.

Click here to read the statement.

The World Health Organization (WHO) released the first-ever “Clinical Treatment Guidelines for Tobacco Cessation in Adults.” The guidelines include a set of cessation interventions for adults seeking to quit all kinds of tobacco products. These guidelines are designed to help communities and governments provide the best possible support for adults trying to quit tobacco products.

Click here to read the guidelines.

Free Clinic Association Rebrands as Pennsylvania Charitable Healthcare Coalition; Launches GiveCare Now

GiveCare Now, a statewide call for volunteer talent, including medical & dental professionals

Launching a statewide call for volunteer talent and medical professionals, the Free Clinic Association of Pennsylvania today announced a rebrand, as the organization is relaunched as the Pennsylvania Charitable Healthcare Coalition.

The organization represents charitable healthcare providers across Pennsylvania that fill a critical role, providing high-quality, free care for people who are under-insured or uninsured and lack access to care.

“Today, we’ve announced a rebrand that captures the essence of our life-changing work and launched a statewide call for volunteers to help us meet the growing needs of our communities,” said executive director Kristen Houser Rapp. “With more than 50 providers operating in the Commonwealth, free and charitable clinics deliver hope to people across Pennsylvania who lack access to healthcare. Without them, thousands of people would not have access to any type of care at all.”

Charitable healthcare providers are integral to keeping Pennsylvanians who do not qualify for Medicaid healthy, and help avoid medical debt from urgent care, emergency visits, and medications, as families move between health plans or lack other options.  While some clinics employ limited staff, the majority of clinical care is provided by volunteer talent.  

“Right now, and in the weeks and months to come, opportunities are available for volunteers to help provide care and give back to others,” said Rapp.  Anyone interested in volunteering should visit pacharitablehealth.org/volunteer, where PCHC can then connect them with a local clinic. PCHC is currently seeking volunteers that include:

  • Doctors
  • Nurses
  • Pharmacists
  • Dentists, dental assistants, & dental hygienists
  • Mental health professionals
  • Volunteers with administrative skills

Volunteer opportunities vary from clinic to clinic and by position.  All volunteers meet strict credentialing and background checks and receive training and support.

“I find that the best part of my day is always that I served in the clinic,” said Ridge Salter, M.D., a volunteer at Katallasso Family Health Center in York. “Volunteering my expertise has added so much professional fulfillment, and I know it has been an antidote — and a bit of an immunization — to burnout.”

In 2023 alone, PCHC member clinics provided at least 114,000 appointments for patients, averaging more than 3,000 per clinic.

“In the last year, hundreds of thousands of people in our state have lost their Medicaid coverage,” said Mary Herbert, MPH, MS, Clinical Director at The Program for Health Care to Underserved Populations/Birmingham Free Clinic in Pittsburgh.  “Despite their lack of state funding, free providers face the need to accommodate a major shift in the number of patients we serve, doing more than ever with limited resources.”

“PCHC’s member clinics and charitable providers fill a growing gap that many of our most vulnerable neighbors rely on for basic care, and volunteers are critical to this work,” said Highmark Foundation President Yvonne Cook. “The Highmark Foundation recognizes the vital work of charitable clinics and is proud to continue our partnership with PCHC through a $172,700 grant to further its mission to provide equitable, quality health care for all Pennsylvanians.”

 ABOUT THE PENNSYLVANIA CHARITABLE HEALTHCARE COALITION (PCHC)

PCHC is the support and advocacy organization for free and charitable healthcare providers who make up the healthcare safety net for uninsured and underinsured Pennsylvanians. Free and charitable clinics provide primary and preventative care such as medical screenings, chronic disease management, medication assistance, dental care and connections to other social services. Clinics do not receive state or federal funding and rely on community support. For information, testimonials from volunteers, and a searchable database of clinic locations, go to www.pacharitablehealth.org.

Courts Become the New Health Policy Arena

From Axios

If courts weren’t already exerting outsized influence over health policy, they’re much closer to being final arbiters now that the Supreme Court has scrapped the decades-old doctrine that gave the Food and Drug Administration, Centers for Medicare and Medicaid Services and other health agencies the power to interpret vague or ill-defined laws.

Why it matters: Judges could get the final say on Medicare payment rates, drug and device regulation and even what constitutes a public health emergency.

The big picture: We’ve already seen courts shape the rules of the road on matters like access to abortion pills, surprise billing disputes and how certain hospitals access discounted drugs.

Read more.

National Telecommunications and Information Administration Digital Equity Competitive Grant Program Announced

The PA Broadband Development Authority (PBDA) would like to remind you the National Telecommunications and Information Administration (NTIA) will be releasing the Notice of Funding Opportunity (NOFO) for the Digital Equity Competitive Grant Program. This program will be facilitated through the NTIA, the PBDA will not be responsible for receiving, reviewing, nor determining allocations for this program.

The Digital Equity Competitive Grant Program’s goal is to fund initiatives that will ensure communities across the Nation have the access and skills to fully participate in the digital world. This program is intended to compliment those digital equity activities that will be funded by the Digital Equity Capacity Grant Program, which the PBDA has applied and is awaiting approval for. The Digital Equity Competitive Grant Program provides $1.25 billion Nationwide and NTIA anticipates releasing the NOFO by end of July.

The NTIA has a number of resources available on their website to include a “Get Ready” one-pager as well as an opportunity to sign-up for updates from the NTIA regarding this program. PBDA encourages you to visit the NTIA website and review these resources.