Rural Health
Resources by Topic: Legislation and regulations
Federal Requirement for Physician Supervision of CRNAs
Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Sponsoring organization: National Rural Health Association
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Discusses the federal requirement affecting participation in the Medicare program by Critical Access Hospitals (CAHs) or Ambulatory Surgical Centers (ASCs) regarding physician supervision of Certified Registered Nurse Anesthetists (CRNAs). Addresses the conditions for states to opt out of the physician supervision Medicare rule if they meet certain conditions and the research comparing the outcomes between states that opt-out and those that do not.
Author(s): Steve Barnett, John H Everett, Pat Schou
Date: 11/2016
Sponsoring organization: National Rural Health Association
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Opioid Addiction: Laws, Regulations, and Other Factors Can Affect Medication-Assisted Treatment Access
Examines current federal laws and regulations related to the medication-assisted treatment (MAT) of opioid dependency, and discusses how these laws affect access to treatment, including in rural areas. Also explores other factors that affect access to treatment such as cost, insurance coverage, practitioner availability, and perceived value. Provides detailed descriptions about the uses and concerns of the three medications currently approved by the FDA for use in opioid MAT - methadone, buprenorphine, and naltrexone.
Additional links: Full Report
Date: 09/2016
Sponsoring organization: Government Accountability Office
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Examines current federal laws and regulations related to the medication-assisted treatment (MAT) of opioid dependency, and discusses how these laws affect access to treatment, including in rural areas. Also explores other factors that affect access to treatment such as cost, insurance coverage, practitioner availability, and perceived value. Provides detailed descriptions about the uses and concerns of the three medications currently approved by the FDA for use in opioid MAT - methadone, buprenorphine, and naltrexone.
Additional links: Full Report
Date: 09/2016
Sponsoring organization: Government Accountability Office
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Preparing Nurses for New Roles in Population Health Management
Report based on two meetings of the National Advisory Council on Nurse Education and Practice in 2016. Emphasizes changes in policy, legislation, and research to promote nursing's role in leading and practicing population health initiatives and addresses potential changes in nursing education to shift away from illness-focused acute care skills. Includes a section on population health in rural and underserved areas.
Date: 09/2016
Sponsoring organization: National Advisory Council on Nurse Education and Practice
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Report based on two meetings of the National Advisory Council on Nurse Education and Practice in 2016. Emphasizes changes in policy, legislation, and research to promote nursing's role in leading and practicing population health initiatives and addresses potential changes in nursing education to shift away from illness-focused acute care skills. Includes a section on population health in rural and underserved areas.
Date: 09/2016
Sponsoring organization: National Advisory Council on Nurse Education and Practice
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Telehealth Parity Laws
Policy brief discussing federal and state activities related to telehealth, as well as Medicaid and private insurer reimbursement for telehealth services. Identifies the arguments in favor of and against paying for telehealth at parity with in-person care. Discusses the role telehealth can play in rural access to healthcare.
Citation: Health Affairs
Date: 08/2016
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Policy brief discussing federal and state activities related to telehealth, as well as Medicaid and private insurer reimbursement for telehealth services. Identifies the arguments in favor of and against paying for telehealth at parity with in-person care. Discusses the role telehealth can play in rural access to healthcare.
Citation: Health Affairs
Date: 08/2016
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Medicaid Outpatient Payment Policy
Provides an overview of Medicaid payment policies for outpatient hospital services. Attached Excel sheet includes details for each state, including adjustments for rural geography and for Critical Access Hospitals.
Additional links: State Medicaid Payment Policies for Outpatient Hospital Services
Date: 07/2016
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Provides an overview of Medicaid payment policies for outpatient hospital services. Attached Excel sheet includes details for each state, including adjustments for rural geography and for Critical Access Hospitals.
Additional links: State Medicaid Payment Policies for Outpatient Hospital Services
Date: 07/2016
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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FQHC and RHC Supplemental Payment Requirements and FQHC, RHC, and FBC Network Sufficiency under Medicaid and CHIP Managed Care
Provides state health officials with guidance on Federally-qualified Health Center (FQHC) and Rural Health Clinic (RHC) payment methodologies under both Medicaid and Children's Health Insurance Program (CHIP) managed care delivery systems. Also provides guidance on FQHC, RHC, and freestanding birth center (FBC) network sufficiency standards applicable to a Medicaid managed care delivery system.
Date: 04/2016
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides state health officials with guidance on Federally-qualified Health Center (FQHC) and Rural Health Clinic (RHC) payment methodologies under both Medicaid and Children's Health Insurance Program (CHIP) managed care delivery systems. Also provides guidance on FQHC, RHC, and freestanding birth center (FBC) network sufficiency standards applicable to a Medicaid managed care delivery system.
Date: 04/2016
Sponsoring organization: Centers for Medicare and Medicaid Services
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Entry Regulation and Rural Health Care: Certificate-of-Need Laws, Ambulatory Surgical Centers, and Community Hospitals
Examines the effect of regulations on entry and expansion of "hospital substitutes," including ambulatory surgical centers (ASCs), and analyzes whether certificate-of-need (CON) programs have achieved their goal of protecting access to hospitals in rural areas. Features demographics on ASC patients, and state-level information on CON regulations and requirements for ASCs.
Date: 02/2016
Sponsoring organization: Mercatus Center
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Examines the effect of regulations on entry and expansion of "hospital substitutes," including ambulatory surgical centers (ASCs), and analyzes whether certificate-of-need (CON) programs have achieved their goal of protecting access to hospitals in rural areas. Features demographics on ASC patients, and state-level information on CON regulations and requirements for ASCs.
Date: 02/2016
Sponsoring organization: Mercatus Center
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CMS Manual System: Revisions to Medicare State Operations Manual, Chapter 9 - Critical Access Hospital (CAH) Recertification Checklist: Rural and Distance or Necessary Provider Verification
Provides a list of the necessary components to be confirmed when Critical Access Hospitals (CAHs) are surveyed for recertification to determine if they meet the rural location and distance or necessary provider requirements to maintain their CAH status. Identifies the procedures used by the CMS Regional Office and state survey agencies to determine if CAHs meet the necessary requirements.
Date: 02/2016
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides a list of the necessary components to be confirmed when Critical Access Hospitals (CAHs) are surveyed for recertification to determine if they meet the rural location and distance or necessary provider requirements to maintain their CAH status. Identifies the procedures used by the CMS Regional Office and state survey agencies to determine if CAHs meet the necessary requirements.
Date: 02/2016
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Behavioral Health: Telehealth Challenges and Opportunities
Reviews the barriers to mental and substance use disorder treatment and services in rural communities. Presents ways telehealth can address these barriers and discusses the challenges in implementing telehealth services in rural areas. Addresses differences in state policies for telemedicine coverage through private insurance.
Citation: SAMHSA In Brief, 9(2)
Date: 2016
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Reviews the barriers to mental and substance use disorder treatment and services in rural communities. Presents ways telehealth can address these barriers and discusses the challenges in implementing telehealth services in rural areas. Addresses differences in state policies for telemedicine coverage through private insurance.
Citation: SAMHSA In Brief, 9(2)
Date: 2016
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Grandfathered Tribal (GFT) Federally Qualified Health Center (FQHC) Training: Overview of Requirements and Policies
Provides a summary of the requirements and policies, effective January 1, 2016, for Indian Health Services (IHS), and tribal facilities and organizations when a change in status may allow the healthcare facility to become certified as a Grandfathered Tribal FQHC.
Date: 12/2015
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides a summary of the requirements and policies, effective January 1, 2016, for Indian Health Services (IHS), and tribal facilities and organizations when a change in status may allow the healthcare facility to become certified as a Grandfathered Tribal FQHC.
Date: 12/2015
Sponsoring organization: Centers for Medicare and Medicaid Services
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