Call for Nominations to the CMS Health Equity Advisory Committee 

– December 12.  The Centers for Medicare & Medicaid Services (CMS) requests nominations for members to their newly formed Health Equity Advisory Committee (HEAC).  This Committee will advise and make recommendations to CMS on how they can promote quality and access for beneficiaries in all CMS programs, like Medicare and Medicaid. Nominations must be submitted by email to HEAC@cms.hhs.gov with the subject line “HEAC Nomination” by December 12.

Re-imagining Rural Health: The CMS Innovation Center “Hackathon” Series

In August of this year, the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medication Innovation (“Innovation Center”) borrowed an idea-generating concept from the tech industry to come up with actionable steps for tough challenges in rural health care.  A new report describes what CMS learned from three sessions – Bozeman, MT; Dallas, TX; and Wilson, NC – and how they might use this input for current and future programs.  The Innovation Center at CMS was created to develop and test alternative payment models that improve quality while reducing costs in Medicare, Medicaid, and Children’s Health Insurance Programs (CHIP) – public health insurance programs that play a critical role in providing coverage in rural areas where people are more likely to face challenges accessing health care.

CMS: Rural Urban Disparities in Health Care in Medicare

The Centers for Medicare & Medicaid Services (CMS) Office of Minority Health presents summary information on the quality of health care received by people with Medicare nationwide, highlighting (1) rural-urban differences in health care experiences and clinical care, (2) how rural-urban differences in health care experiences and clinical care vary by race and ethnicity, and (3) historical trends in quality of care for rural and urban residents.

HRSA’s National Rural Health Day 2024 Agenda

Take part in a dynamic series of events to celebrate National Rural Health Day on November 21. This year’s theme is “Advancing Maternal Health in Rural Communities” as we highlight how federal agencies, rural health care providers and state and community-based organizations work to enhance maternal health services through workforce training, hospital technical assistance, telehealth initiatives, and flexible and innovative care coordination.  Visit HRSA’s National Rural Health Day Agenda page to view the full schedule of events and join discussions with rural researchers, federal and community leaders, and health professionals dedicated to making a difference for rural mothers and families.

Equitable Pain Management and Addiction Treatment Blog Available

Communication between patients and care teams about medical, behavioral health (including substance use), and social service needs is essential to ensuring equitable, quality care and cultivating trusting relationships. For patients who speak English less than “very well,” also known as Limited English Proficiency or LEP, the inability to communicate effectively and confidently with care teams is a significant barrier and undermines the ability to build trust in providers and the health system as a whole. In the area of pain management and substance use disorder treatment, these disparities are exacerbated by the lack of language-appropriate care, leading to untreated or undertreated conditions. Read the full blog post.

Report Released on Substance Use and Mental Health Services

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released the National Substance Use and Mental Health Services Survey 2023: Data on Substance Use and Mental Health Treatment Facilities. The report provides findings on key operational characteristics of substance use disorder and mental health treatment facilities, including use of pharmacotherapies, language assistance provided, and suicide prevention services. Learn more and download the report on SAMHSA’s website.

Pennsylvania Medicaid Program Answers Questions Telehealth Billing

The Pennsylvania Department of Human Services (DHS) has been receiving questions regarding opting in to Alternative Payment Methodology (APM) choices that are currently active. There are three active APMs for Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC), issued through Medical Assistance Bulletins (MAB):

MAB 08-16-30 -Effective December 1, 2016. Federally Qualified Health Center Alternative Payment Methodologies for Delivery Services.

MAB 08-17-17 -further clarification Effective June 1, 2017. Discontinuance of Federally Qualified Health Center Alternative Payment Methodologies for Delivery Services in the Federally Qualified Health Center Setting.

MAB 07-17-01, 08-17-22 -Effective June 1, 2017. Opt-In Procedures for Federally Qualified Health Centers and Rural Health Clinics to receive the Prospective Payment System Rate from Managed Care Organizations.

MAB 08-24-15 -Effective October 1, 2024. Federally Qualified Health Center and Rural Health Clinic Payment for SARS-CoV-2 Vaccine Administration.

The Rate Setting Division under the Bureau of Fiscal Management maintains a list of those site locations that have opted in to the above APMs. When an FQHC or RHC opens additional sites, please inform the Division if the site is choosing to opt-in to an APM.

A few reminders:

·     The opt-in decision is a “by site,” not “by organization,” decision

·     The opt-out procedure is the same as opt-in

·     Health centers may opt-in or opt-out at any time, that is, the decision is not permanent

If you have new site location and would like confirmation of your clinic’s opt-in statuses, please inquire at RA-PWOMAPFQHC-RHC@pa.gov. Requests for Opt-In, or Out, should also go to this email address. Be sure to include the Medicaid provider i.d. number, site location number(s), provider name, and type of APM you are requesting.