Rural Health
Resources by Topic: Legislation and regulations
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Factors Associated with Compliance to the Hospital Price Transparency Final Rule: A National Landscape Study
Examines 3,558 short-term acute-care hospitals' compliance with the Hospital Price Transparency Rule, which requires that hospitals publicly post a machine-readable file containing commercial negotiated prices for 300 services. Compares hospital compliance by state and hospital referral region. Describes factors associated with compliance, including health information technology preparedness, profit status, system affiliation, hospital size, and rural location.
Author(s): John Xuefeng Jiang, Daniel Polsky, Jeff Littlejohn, et al.
Citation: Journal of General Internal Medicine, 37(14), 3577–3584
Date: 11/2022
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Examines 3,558 short-term acute-care hospitals' compliance with the Hospital Price Transparency Rule, which requires that hospitals publicly post a machine-readable file containing commercial negotiated prices for 300 services. Compares hospital compliance by state and hospital referral region. Describes factors associated with compliance, including health information technology preparedness, profit status, system affiliation, hospital size, and rural location.
Author(s): John Xuefeng Jiang, Daniel Polsky, Jeff Littlejohn, et al.
Citation: Journal of General Internal Medicine, 37(14), 3577–3584
Date: 11/2022
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Virtual Communication Services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides information for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) regarding billing and payment for virtual communication services as established in the 2019 Physician Fee Schedule Final Rule.
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Teledentistry Trends in the United States During the COVID-19 Pandemic
Reviews the use of teledentistry during and following the COVID-19 pandemic in California, Maine, Pennsylvania, and Wisconsin, and examines reimbursement issues and supports needed to enhance dental care in a post-COVID-19 world. Mentions rural throughout.
Author(s): Miranda Werts, Prashanta Patel, Elizabeth Mertz
Date: 10/2022
Sponsoring organization: Oral Health Workforce Research Center
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Reviews the use of teledentistry during and following the COVID-19 pandemic in California, Maine, Pennsylvania, and Wisconsin, and examines reimbursement issues and supports needed to enhance dental care in a post-COVID-19 world. Mentions rural throughout.
Author(s): Miranda Werts, Prashanta Patel, Elizabeth Mertz
Date: 10/2022
Sponsoring organization: Oral Health Workforce Research Center
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The Future of Telehealth After COVID-19: New Opportunities and Challenges
Provides an overview of the current evidence regarding telehealth's impact on equitable access to care and on quality of care, patient outcomes, and cost. Describes the COVID-19 pandemic-related regulatory flexibilities for mental health and substance use disorder services. Discusses the importance of telehealth on primary and specialty care during the public health emergency (PHE). Offers recommendations for Medicare telehealth policies to promote better outcomes for Medicare beneficiaries and value for the Medicare program.
Additional links: Medicare Telehealth Utilization and Spending Impacts 2019-2021, Webinar Recording
Author(s): Julia Harris, Sabah Bhatnagar, Brady Newell, et al.
Date: 10/2022
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of the current evidence regarding telehealth's impact on equitable access to care and on quality of care, patient outcomes, and cost. Describes the COVID-19 pandemic-related regulatory flexibilities for mental health and substance use disorder services. Discusses the importance of telehealth on primary and specialty care during the public health emergency (PHE). Offers recommendations for Medicare telehealth policies to promote better outcomes for Medicare beneficiaries and value for the Medicare program.
Additional links: Medicare Telehealth Utilization and Spending Impacts 2019-2021, Webinar Recording
Author(s): Julia Harris, Sabah Bhatnagar, Brady Newell, et al.
Date: 10/2022
Sponsoring organization: Bipartisan Policy Center
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Rural Health Clinics: Focusing on the Patient
Brief overview of the history of Rural Health Clinics (RHCs), from their origins in the Rural Health Clinic Services Act of 1977, and into the present, as they continue to provide an array of vital services to rural communities.
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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Brief overview of the history of Rural Health Clinics (RHCs), from their origins in the Rural Health Clinic Services Act of 1977, and into the present, as they continue to provide an array of vital services to rural communities.
Date: 10/2022
Sponsoring organization: Rural Health Information Hub
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Key Considerations for a Rural Hospital Assessing Conversion to Rural Emergency Hospital
Offers a conceptual framework of key considerations for rural hospitals contemplating conversion to a rural emergency hospital (REH). Covers financial feasibility, workforce, community impact, partnerships, and regulatory considerations.
Author(s): Kristin Reiter, T.J. Grant, Susie Gurzenda, et al.
Date: 10/2022
Sponsoring organization: North Carolina Rural Health Research Program
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Offers a conceptual framework of key considerations for rural hospitals contemplating conversion to a rural emergency hospital (REH). Covers financial feasibility, workforce, community impact, partnerships, and regulatory considerations.
Author(s): Kristin Reiter, T.J. Grant, Susie Gurzenda, et al.
Date: 10/2022
Sponsoring organization: North Carolina Rural Health Research Program
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Home Health Agencies Used Multiple Strategies to Respond to the COVID-19 Pandemic, Although Some Challenges Persist
Presents results of a survey of home health agencies (HHAs) conducted between September through December 2021 to explore the challenges they faced during the COVID-19 pandemic. Discusses challenges related to staffing, infection control, the use of telehealth, and the adequacy of emergency preparedness plans, as well as challenges specific to rural HHAs. Provides recommendations for how the Centers for Medicare & Medicaid Services (CMS) can help HHAs prepare for and respond to current and future infectious disease outbreaks and changes to the home health care landscape.
Date: 10/2022
Sponsoring organization: Office of Inspector General (HHS)
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Presents results of a survey of home health agencies (HHAs) conducted between September through December 2021 to explore the challenges they faced during the COVID-19 pandemic. Discusses challenges related to staffing, infection control, the use of telehealth, and the adequacy of emergency preparedness plans, as well as challenges specific to rural HHAs. Provides recommendations for how the Centers for Medicare & Medicaid Services (CMS) can help HHAs prepare for and respond to current and future infectious disease outbreaks and changes to the home health care landscape.
Date: 10/2022
Sponsoring organization: Office of Inspector General (HHS)
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RHC Policies & Procedures
Recording of an October 6, 2022, webinar on Rural Health Clinic (RHC) policies and procedures. Discusses regulatory requirements for RHC policies and procedures, including patient care, medical record, and emergency preparedness policies and procedures. Describes new requirements, including the COVID-19 vaccine mandate, the transition out of the COVID-19 public health emergency, and potential changes that may occur in 2023. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 10/2022
Sponsoring organization: National Association of Rural Health Clinics
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Recording of an October 6, 2022, webinar on Rural Health Clinic (RHC) policies and procedures. Discusses regulatory requirements for RHC policies and procedures, including patient care, medical record, and emergency preparedness policies and procedures. Describes new requirements, including the COVID-19 vaccine mandate, the transition out of the COVID-19 public health emergency, and potential changes that may occur in 2023. Part of the Rural Health Clinic Technical Assistance Series.
Additional links: Presentation Slides, Transcript
Date: 10/2022
Sponsoring organization: National Association of Rural Health Clinics
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