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Rural Health
Resources by Topic: Legislation and regulations

Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1 Million for the Same Professional Services
Results of an audit of Medicare Part B claims to determine whether Part B payments to Critical Access Hospitals (CAHs) for professional services and payments made to healthcare practitioners for the same services complied with federal requirements. Includes recommendations from the Office of Inspector General (OIG), and the response from the Centers for Medicare & Medicaid Services (CMS).
Date: 09/2022
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Health Panel Comment Letter – Medicare Shared Savings Program Requirements
Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment System and Rural Emergency Hospitals
Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Medicare's New Rural Emergency Hospital Designation — Considerations for States
Blog post providing an overview of the Rural Emergency Hospital (REH) program. Discusses the REH designation as an alternative to rural hospital closure and REH payment policy. Highlights opportunities for states to develop REH licensure requirements.
Author(s): Rebekah Falkner, Sam Mermin
Date: 09/2022
Type: Document
Sponsoring organization: National Academy for State Health Policy
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Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities
Provides an overview of rural hospital closures between 2010-2021. Discusses rural demographics and outlines trends affecting rural hospital financial sustainability, including patient volume and health, reimbursement, staffing shortages, COVID-19, new models of care, and more.
Date: 09/2022
Type: Document
Sponsoring organization: American Hospital Association
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America's Rural Roads: Beautiful and Deadly
Examines rural road fatal crashes using data for years 2016-2020. Describes where people crash on rural roads, who crashes, and what risky behaviors may contribute to crashes. Includes statistics on road fatalities, proportions of rural and urban population compared with proportions of road fatalities, fatalities per vehicle miles traveled, crash type and vehicle type, sex, race and ethnicity, age, alcohol use, drug involvement, and speeding, with breakdowns by rural or urban location. Includes state-level statistics on fatalities by state maximum speed limit.
Author(s): Paula Raymond
Date: 09/2022
Type: Document
Sponsoring organizations: Governors Highway Safety Association, State Farm
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MedPAC Comment on CMS's Proposed Rule on the ESRD PPS Update for CY 2023
Comments on a June 28, 2022, Federal Register proposed rule related to Medicare payment policies for end-stage renal disease (ESRD). Includes comments addressing the low-volume payment adjustment (LVPA) and the rural adjustment.
Date: 08/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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RHC COVID-19 Program Updates
Recording of an August 18, 2022, webinar discussing and answering questions about COVID-19 therapeutics, testing and mitigation, vaccine, and provider relief programs available to Rural Health Clinics (RHCs). Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 08/2022
Type: Video/Multimedia
Sponsoring organization: National Association of Rural Health Clinics
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for CY 2023
Comments on a June 23, 2022, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments regarding the collection of data on the use of telecommunications technology under the Medicare home health benefit and quality measure stratification as a tool to address healthcare disparities and advance health equity.
Date: 08/2022
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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