Updates Announced on the Definition of “Rural Area”

HRSA published a final notice with updates to the criteria for defining rural areas. This notice responds to comments on the proposed inclusion of terrain factors published in April 2024. Changes implemented by this final notice took effect Nov. 21st, 2024. FORHP uses this rural definition for determining rural health grant eligibility. This update incorporates a new Road Ruggedness Scale (RRS) from the Economic Research Service in the U.S. Department of Agriculture. The update also includes a technical clarification about treatment of Census Bureau-defined urban areas in the definition given the removal of the term Urbanized Areas following the 2020 Census. See How We Define Rural for more information. We are updating the Rural Health Grants Eligibility Analyzer at the end of the day on Nov. 21st.

Pennsylvania Starts Process to Drive Out Broadband Money

The start of a process to drive out a large amount of money in Pennsylvania’s broadband expansion program is underway. This involves spending the $1.16 billion in federal money available to Pennsylvania through the Broadband Equity, Access, and Deployment (BEAD) program to deliver broadband and connect an estimated 300,000 households to the internet. The Pennsylvania Broadband Development Authority (PBDA) announced Friday that an initial 60-day round of applications for the funding will run through Jan. 21, 2025. A second round for applications will be held next year. The Shapiro administration said Pennsylvania will become the 10th state to accept BEAD applications. “My administration is moving quickly to solicit applications and drive out this historic funding, so we can extend high-speed, affordable internet all across our Commonwealth by the end of this decade,” said Gov. Josh Shapiro. Click here to read more.

Pennsylvania Awards $120 Million in School-Based Mental Health and Safety Grants

Hundreds of private schools across Pennsylvania will receive nearly $20 million in state grants for mental health programs and building safety improvements. “I’ve listened to our kids as they’ve told me about their mental health struggles – that’s why my Administration is getting real help to students all across Pennsylvania quickly,” Pennsylvania Governor Josh Shapiro said in a statement. Read more.

CMS Finalizes New Model to Improve Access to Kidney Transplants

On November 26th, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized a rule establishing a new, six-year mandatory model aimed at increasing access to kidney transplants. Starting in July 2025, selected transplant hospitals will receive financial incentives to perform more kidney transplants. The final rule also includes standard provisions for all mandatory CMS innovation center models starting after January 1, 2025.

OIG Updating Antikickback Safe Harbor Provisions

– Comment by January 27.  The Office of the Inspector General (OIG) at the U.S. Department of Health & Human Services is seeking recommendations for developing new, or modifying existing, safe harbor provisions under the federal anti-kickback statute, as well as developing new OIG Special Fraud Alerts. The federal anti-kickback statute specifies criminal penalties for knowingly and willfully offering, paying, soliciting, or receiving payment to induce or reward referrals for or purchases of items or services reimbursable under any of the federal health care programs. Safe harbor provisions specify payment and business practices that would not be subject to sanctions under the federal anti-kickback statute, even though they could induce referrals of business for which payment may be made under a federal health care program. Safe harbors currently exist for value-based arrangements and local transportation in rural areas. Rural stakeholders should send recommendations to https://www.regulations.gov, follow the “Submit a comment” instructions, and refer to file code OIG-1124-N.

CMS Awards Third Round of Medicare-funded Residency Slots to Hospitals

The Centers for Medicare & Medicaid Services (CMS) announced the allocation of 200 new Medicare-funded residency slots to more than 100 teaching hospitals. The slots are the third allocation from 1,000 new Medicare-funded residency positions authorized over five years under Section 126 of the Consolidated Appropriations Act of 2021. The application period for the fourth round will open in January 2025 and will close March 31, 2025.

CMS Proposed Changes to Medicare Part C and D 

– Comment by January 27. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would revise the Medicare Advantage (MA) Program and Medicare Prescription Drug Benefit Program (Part D).  Proposals include permitting Medicare and Medicaid coverage of anti-obesity medications, further clarifications to the rules on what MA plans must cover, limits on enrollee cost-sharing for behavioral health, expanded topics that agents/brokers must cover when assisting beneficiaries, parameters around the use of debit cards for supplemental MA benefits, codifying requirements for the Medicare Prescription Payment Plan, and integrating member identification cards for individuals dually eligible for Medicare and Medicaid. As of January 2023, about 45 percent of rural Medicare beneficiaries were enrolled in an MA plan.

CMS Seeks Feedback on Quality Measures for Medicare Hospitals, including REHs

 Comment by December 30.  The Centers for Medicare & Medicaid Services (CMS) would like public feedback on 41 Measures Under Consideration for quality reporting and value-based programs before the measures are formally proposed through the rulemaking process. Categories of quality measures for hospitals receiving payment through Medicare, including CMS-designated Rural Emergency Hospitals (REHs), are:

  • Post-Acute Care/Long-Term Care Measures
  • Clinician Measures
  • Hospital Measures

For example, CMS would like early feedback on including the measure Median Time to Pain Medication for Patients with a Diagnosis of Sickle Cell Disease with Vaso-Occlusive Episode in the Rural Emergency Hospital Quality Reporting Program, and the measure Proportion of Patients who Died from Cancer Admitted to Hospice for Less than 3 Days in the Hospital Inpatient Quality Reporting Program. CMS will hold three listening sessions, one for each of these categories, December 17-19.  Register to make live comments or ask questions during these sessions.  You may also enter a comment for public viewing on a form halfway down the page in the headline link.