- 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
American Heart Association Issues Call to Action for Addressing Inequities in Rural Health
The American Heart Association published a Presidential Advisory on addressing social determinants of health and improving healthcare quality and outcomes in rural America. It summarizes the existing disparities in rural communities and proposes solutions that prioritize rural health policy, research, and innovation. Read more here.
In Rural Hospitals, Telemedicine May Promote Faster, Noninvasive Stroke Treatments
This article features West Virginia University’s telestroke program that connects rural hospitals with neurologists at WVU to assist in diagnosing and treating stroke cases. Researchers analyzed data from participating hospitals and found that the use of noninvasive stroke treatments increased since the program’s implementation. Read more here.
Study: Longer Ambulance Drives as Hospitals Close in Rural Communities
This article summarizes a study that identified an increase in EMS transport times when a local hospital closes. Rural residents already face longer wait times than urban residents, and as more rural hospitals close, wait times become more dangerous for patients. Read more here.
CMS: Non-Emergent, Elective Medical Services and Treatment Recommendations
CMS recently updated recommendations to postpone non-essential surgeries and other procedures to conserve critical healthcare resources and limit exposure of patients and staff to COVID-19. Developed in collaboration with medical societies and associations, the recommendations outline a tiered approach for state and local officials, clinicians, and delivery systems to consider to prioritize services and care to those who require emergent or urgent attention to save a life, manage severe disease, or avoid further harms from an underlying condition.
CMS: Dear Clinician Letter
CMS posted a letter to clinicians that outlines a summary of actions CMS has taken to ensure clinicians have maximum flexibility to reduce unnecessary barriers to providing patient care during the unprecedented outbreak of COVID-19. The summary includes information about telehealth and virtual visits, accelerated and advanced payments, and recent waiver information.
Medicare Telehealth & What We Know Today
- The CARES Act included Medicare telehealth flexibility for FQHCs and RHCs for the duration of the crisis. It authorizes Medicare reimbursement for health centers and rural health clinics as distant sites for the duration of the emergency, not reimbursed at PPS rate but instead “such payment methods shall be based on payment rates that are similar to the national average payment rates for comparable telehealth services under the physician fee schedule under section 1848.”
- Since 2019, FQHCs could bill Medicare for virtual communication services (aka phone calls) using code GOO71. (This is in lieu of the codes 99441, 99442, and 99443, which only those providers who bill under the fee schedule can use.) The payment is around $14, and FQHCs cannot bill for it if the patient had a related evaluation/management service within the previous 7 days or has an on-site appointment within the next 24 hours. These services must be initiated by a patient and as long as the provider responding to the call is an employee or contractor of the health center, he or she does not have to be physically located at the health center while delivering these services. CMS also has an FAQ document on virtual communication.
On March 30 the Centers for Medicare & Medicaid Services (CMS) issued an array of new rules and waivers of federal requirements offering maximum flexibility to respond to the COVID-19 pandemic including a section entitled “Further Promote Telehealth in Medicare.” There is a provider-specific fact sheet on new waivers and flexibilities for FQHCs and RHCs but it does not address telehealth.
Paycheck Protection Program Application Released
The Small Business Administration (SBA) released the loan application for the Paycheck Protection Program and an information sheet containing loan guidelines. Some highlights of the guidelines:
- April 3, 2020: Loan applications will start being accepted for businesses and sole proprietors
- April 10, 2020: Loan applications will start being accepted for independent contractors and self-employed individuals
- More lenders will be added as they are approved/enrolled. To apply, you should reach out to one of the approved lenders
- There are no changes to affiliation standards from those specified in the CARES Act. However, additional guidance may be released by SBA as appropriate
- All loan terms will be the same for everyone
- Due to anticipated high demand, SBA anticipates allowing not more than 25% of the forgiven loan amount to be used for nonpayroll costs (utilities, rent and interest on a mortgage)
- Interest Rate: 1% fixed rate, lowered from 4%
- Maturity: 2 years, shortened from 10 years
Quarterly 340B Program Registration Open until April 15
Quarterly 340B Program site registration is open April 1-15. Health centers will still be able to register a site that has been verified as implemented and with a site status reflected as “active” in HRSA’s Electronic Handbook Form 5B through Friday, May 22. After that date, the system will close to prepare for the July 1 start. Email the 340B call center or call 888-340-2787 (Monday-Friday, 9:00 am – 6:00 pm) to register a new site or ask questions. Centers will need to provide the following information: health center name, site/clinic name, site IDs for all sites, HRSA/BPHC grant number, contact name and email address and authorizing official name and email address. The authorizing official will receive an email message that the account is unlocked, and a registration may be submitted.
COVID-19 Marketplace and Medicaid Enrollment
Since the beginning of this pandemic, there has been a push to establish a Health Insurance Marketplace Special Enrollment Period (SEP) due to the COVID-19 Emergency Declaration. The Trump administration has decided against reopening the Marketplace to those needing coverage during the coronavirus pandemic. The Special Enrollment Period (SEP) for loss of coverage is still available for individuals losing job-based coverage. Consumers have 60 days from the last day of coverage to sign up for an SEP. In Pennsylvania, Medicaid benefits will not be terminated for consumers as of March 18 until the end of the emergency declarations unless the individual leaves the state or voluntarily terminate their benefits. While county assistance offices remain closed to the public, consumers can still apply online and via the mobile app. Documents needed for verification can be submitted via the COMPASS webpage, mobile app or dropped off at county assistance office locations in the designated mailbox.
When It Comes to PPE Offers, Proceed with Caution
We know that the need and demand for personal protective equipment (PPE) continues to far exceed supply. There are many others who are also aware of that fact and some of them are preying on the desperation for supplies, exhaustion from juggling so many priorities in responding to the COVID-19 pandemic, and strong desire to protect our workers on the front line. Because there are many unscrupulous players in the market right now, PACHC urges caution in these desperate times when accepting offers. Here are some initial checks to evaluate offers:
- Large Minimum Order Quantities? Any provider that is established in this space would be stocking and able to ship case pack quantities. Legitimate providers would not be putting large Minimum Order Quantities (MOQs) out.
- Suspicious Pricing? Legitimate providers aren’t pricing products significantly above what you could search an item for on the internet or a previous price paid.
- Do They Have a Website? Not a foolproof check by any means because it’s easy to set up fake sites these days, but an easy rule-out if they don’t have one.
- Do They Have the Appropriate Certifications? NIOSH, CDC or other?
Can They Send You a Product Sample and/or Product Specification Sheet? If a distributor is able to do so you have another level of assurance that you are more likely to get what you’re paying for.