Recently, the Federal Communications Commission (FCC) finalized regulations to promote transparency and predictability, and further the efficient allocation of limited Rural Health Care Program resources while guarding against waste, fraud and abuse. The FCC promotes telehealth in rural areas through the Rural Health Care Program (RHC Program), which provides financial support to help rural health care providers obtain broadband and other communications services at discounted rates. The regulations went into effect on November 12, unless noted otherwise for some specific provisions in the final rule.

Full article: https://www.govinfo.gov/content/pkg/FR-2019-10-11/pdf/2019-20173.pdf

On November 15, the Centers for Medicare & Medicaid Services (CMS) finalized policy changes to the CY 2020 Hospital Outpatient Prospective Payment System (OPPS) on price transparency requirements for hospitals. This final rule establishes requirements for hospitals, including Critical Access Hospitals (CAHs) and other rural hospitals, to make public a machine-readable file online that includes all standard charges along with discounted cash prices, payer-specific negotiated charges, and de-identified minimum and maximum negotiated charges for a set of “shoppable services.” CMS is finalizing that the effective date of the final rule will be January 1, 2021, to ensure that hospitals have the time to be compliant with these policies.

Full article: https://www.cms.gov/newsroom/fact-sheets/cy-2020-hospital-outpatient-prospective-payment-system-opps-policy-changes-hospital-price

Last week,  the Centers for Medicare & Medicaid Services (CMS) proposed changes to state Medicaid reporting and clarifications of key definitions in order to improve payment transparency and program integrity.  Proposals in this rule focus on four payment areas: fee-for-service (FFS) supplemental provider payments; disproportionate share hospital (DSH) payments; financing for the non-Federal share of payments; and health care-related taxes and provider-related donations.  CMS seeks comment on all elements of this proposal, including whether supplemental provider payments should be capped, if there should be a separate cap for rural areas and/or HRSA-designated geographic health professional shortage areas, and whether there should be other special considerations for providers in underserved areas.

Comments are due January 17th.

For more information, visit: https://www.federalregister.gov/documents/2019/11/18/2019-24763/medicaid-program-medicaid-fiscal-accountability-regulation

On November 15, the U.S. Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury proposed requirements for group health plans and health insurance issuers in the individual and group markets to disclose cost-sharing information upon request, to a participant, beneficiary, or enrollee (or his or her authorized representative), including an estimate of such individual’s cost-sharing liability for covered items or services furnished by a particular provider. If you are looking for information on health insurance in rural areas, you can find resources on RHIhub.

Comments are due by January 14th.

For more information, visit: https://www.federalregister.gov/documents/2019/11/27/2019-25011/transparency-in-coverage

In an effort to better prepare and assist small rural hospitals in moving from a fee-for-service and volume-based payment system to one that is drive by value and quality, the Federal Office of Rural Health Policy (FORHP) administers the Small Rural Hospital Transition Project (SHRT).  The program provides technical assistance through onsite consultations to eligible hospitals that have 49 beds or less and are located in a federally-designated persistent poverty county. Core areas of technical assistance include: 1) financial operational assessment, and 2) quality improvement projects. Last month, nine hospitals were identified through the objective review process to receive this assistance in the 2019-2020 cohort of the project.  Now in its fifth year, the SHRT program shares what’s learned on issues relevant to rural health stakeholders through the National Rural Health Resource Center.  See the full list of hospitals by clicking here.

This document is a practical guide for ambulance services to use in their pursuit of sustaining effective and efficient delivery of patient care and developing into an integrated system with other agencies. It provides insights from agencies to promote integration to the benefit of the agencies, the staff, and, most importantly, to the patients.   The guide can be accessed here.

The primary goal of the Rural Community Ambulance Agency Transformation Readiness Assessment and associated resources is to help ambulance agency leaders in rural America assess the state of their agency’s readiness in the core competency areas outlined below. This assessment follows the Critical Access Hospital (CAH) Blueprint for Performance Excellence, adapted specifically for rural ambulance agencies, from the Baldridge Excellence Framework for Health Care. It provides resources and tools to assist rural ambulance agency leaders to succeed with moving from volume to value in their agency’s culture and operations. Leaders are encouraged to complete the assessment periodically to monitor their progress and receive updated resources to guide their journey.  The toolkit can be accessed here.

On November 20, 2019, the Centers for Medicare and Medicaid Services (CMS) announced that 737,352 people signed up for federal exchange plans during the third week of the Affordable Care Act’s current open enrollment period, bringing total federal exchange plan signups to about 1.7 million since the open enrollment period launched Nov. 1. Total signups so far this open enrollment period are down 13% when compared with the same point in last year’s open enrollment period. (Source: Modern Healthcare, 11/20

The Centers for Medicare and Medicaid Services (CMS) on its Nursing Home Compare website has added a new icon—a red circle with a white stop hand in the center—to ratings for 760 facilities, indicating that the facilities have been cited for an incident of abuse, neglect, or exploitation. Consumer advocates have applauded the move, but some in the nursing home industry say the alerts are misleading. (Source: Wall Street Journal, 11/19)

Provides an overview of social and economic factors affecting rural America, with a focus on trends impacting rural areas after the end of the 2009 recession. Includes data on population, employment and labor force participation, poverty, and income.

Sponsoring organization: USDA Economic Research Service

Read it here: https://www.ers.usda.gov/webdocs/publications/95341/eib-212.pdf?v=5832