Rural Health
Resources by Topic: Legislation and regulations
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 & 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 & 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 & 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 & 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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Where Is Buprenorphine Dispensed to Treat Opioid Use Disorders? The Role of Private Offices, Opioid Treatment Programs, and Substance Abuse Treatment Facilities in Urban and Rural Counties
Examines the impact of 2006 federal legislation allowing waivered physicians to prescribe and expand FDA approved buprenorphine as a treatment for opioid use disorder to a maximum of 100 patients. Discusses buprenorphine distribution by both urban and rural waivered physicians, opioid treatment programs, and treatment facilities for substance use.
Author(s): Bradley D. Stein, Rosalie Liccardo Pacula, Adam J. Gordon, et al.
Citation: The Milbank Quarterly, 93(3), 561-583
Date: 09/2015
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Examines the impact of 2006 federal legislation allowing waivered physicians to prescribe and expand FDA approved buprenorphine as a treatment for opioid use disorder to a maximum of 100 patients. Discusses buprenorphine distribution by both urban and rural waivered physicians, opioid treatment programs, and treatment facilities for substance use.
Author(s): Bradley D. Stein, Rosalie Liccardo Pacula, Adam J. Gordon, et al.
Citation: The Milbank Quarterly, 93(3), 561-583
Date: 09/2015
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Rural Health Care Disparities Created by Medicare Regulations
Transcript of a July 28, 2015, U.S. House of Representatives Ways and Means Committee, Subcommittee on Health hearing concerning rural healthcare disparities created by Medicare regulations. Features testimony from the Arizona Center for Rural Health and leaders from two Critical Access Hospitals and one rural hospital. Covers physician shortages; graduate medical education; the impact of regulatory changes such as the 96-hour rule, the two-midnight rule, and physician supervision requirements; and more.
Additional links: Carrie Saia, Holton Community Hospital - Testimony, Daniel Derksen, Arizona Center for Rural Health - Testimony, Shannon Sorensen, Brown County Hospital - Testimony, Tim Joslin, Community Regional Medical Centers - Testimony
Date: 07/2015
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Transcript of a July 28, 2015, U.S. House of Representatives Ways and Means Committee, Subcommittee on Health hearing concerning rural healthcare disparities created by Medicare regulations. Features testimony from the Arizona Center for Rural Health and leaders from two Critical Access Hospitals and one rural hospital. Covers physician shortages; graduate medical education; the impact of regulatory changes such as the 96-hour rule, the two-midnight rule, and physician supervision requirements; and more.
Additional links: Carrie Saia, Holton Community Hospital - Testimony, Daniel Derksen, Arizona Center for Rural Health - Testimony, Shannon Sorensen, Brown County Hospital - Testimony, Tim Joslin, Community Regional Medical Centers - Testimony
Date: 07/2015
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10)
Full text of the Medicare Access and CHIP Reauthorization Act of 2015, commonly referred to as MACRA. MACRA seeks to transition healthcare from fee-for-service to value-based care by repealing the Sustainable Growth Rate (SGR) formula and replacing it with the Quality Payment Program (QPP). The QPP streamlines data collection efforts and rewards providers based on value instead of volume through the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs).
Date: 04/2015
Sponsoring organization: U.S. Congress
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Full text of the Medicare Access and CHIP Reauthorization Act of 2015, commonly referred to as MACRA. MACRA seeks to transition healthcare from fee-for-service to value-based care by repealing the Sustainable Growth Rate (SGR) formula and replacing it with the Quality Payment Program (QPP). The QPP streamlines data collection efforts and rewards providers based on value instead of volume through the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs).
Date: 04/2015
Sponsoring organization: U.S. Congress
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LSC Agricultural Worker Population Estimate Update
Identifies the population of agricultural workers and their dependents, and provides an estimate of the size and distribution of this population to be used as a basis for allocating resources supported by federal programs targeting farmworkers, including health and human services programs.
Date: 01/2015
Sponsoring organization: Legal Services Corporation
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Identifies the population of agricultural workers and their dependents, and provides an estimate of the size and distribution of this population to be used as a basis for allocating resources supported by federal programs targeting farmworkers, including health and human services programs.
Date: 01/2015
Sponsoring organization: Legal Services Corporation
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International Classification of Disease: CMS's Efforts to Prepare for the New Version of the Disease and Procedure Codes
Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Sponsoring organization: Government Accountability Office
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Review of the efforts undertaken by the Centers for Medicare and Medicaid Services (CMS) to prepare for the transition to the 10th revision of the International Classification of Diseases (ICD-10) codes. Evaluates the materials developed and activities undertaken by CMS to help providers' transition and describes concerns of stakeholder organizations, including rural-specific considerations.
Additional links: Full Report
Date: 01/2015
Sponsoring organization: Government Accountability Office
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