Rural Health
Resources by Topic: Legislation and regulations
Medicare Claims Processing Manual Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS)
Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Learning Network: Rural Emergency Hospitals
Details the regulatory requirements for providers to become a Rural Emergency Hospital (REH). Provides information on REH billing for Medicare services, Medicare payments for REH services, and the additional monthly facility payment.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Details the regulatory requirements for providers to become a Rural Emergency Hospital (REH). Provides information on REH billing for Medicare services, Medicare payments for REH services, and the additional monthly facility payment.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Price Transparency: What Hospitals Need to Know – Part 2
Webinar recording presents part two of a discussion on the Centers for Medicare and Medicaid Services (CMS) hospital price transparency requirements that went into effect on July 1, 2024. Features a presentation and discussion from a CMS representative.
Date: 10/2024
Sponsoring organization: Rural Health Information Hub
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Webinar recording presents part two of a discussion on the Centers for Medicare and Medicaid Services (CMS) hospital price transparency requirements that went into effect on July 1, 2024. Features a presentation and discussion from a CMS representative.
Date: 10/2024
Sponsoring organization: Rural Health Information Hub
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Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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2023 Summer Non-Congregate Meal Service: Results from the 2023 Summer Non-Congregate Sponsor Survey
Evaluates the implementation of the 2023 Consolidated Appropriations Act, which permanently allowed for rural non-congregate meal service as part of the U.S. Department of Agriculture (USDA) Summer Meal Programs. Provides 2023 survey data from State agency sponsors operating summer non-congregate meal service for children, with a focus on site participation, sponsor experiences, meal pick up sites, meal delivery, and future plans for non-congregate meal service.
Additional links: Appendix A - Survey, Data Tables
Author(s): Susannah Barr
Date: 10/2024
Sponsoring organization: USDA Food and Nutrition Service
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Evaluates the implementation of the 2023 Consolidated Appropriations Act, which permanently allowed for rural non-congregate meal service as part of the U.S. Department of Agriculture (USDA) Summer Meal Programs. Provides 2023 survey data from State agency sponsors operating summer non-congregate meal service for children, with a focus on site participation, sponsor experiences, meal pick up sites, meal delivery, and future plans for non-congregate meal service.
Additional links: Appendix A - Survey, Data Tables
Author(s): Susannah Barr
Date: 10/2024
Sponsoring organization: USDA Food and Nutrition Service
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CMS-Approved Waivers Break New Ground for Medicaid Coverage of American Indian and Alaska Native Traditional Health Care Practices
Provides an overview of Centers for Medicare & Medicaid Services (CMS) approved 1115 waivers that allow Medicaid agencies to cover American Indian and Alaska Native (AI/AN) traditional healthcare practices in four states: Arizona, California, New Mexico, and Oregon. Describes who can access traditional healthcare practices under these waivers, where traditional healthcare services can be provided, who will be certified to provide these services, and implementation support.
Author(s): Anne Smithey
Date: 10/2024
Sponsoring organization: Center for Health Care Strategies
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Provides an overview of Centers for Medicare & Medicaid Services (CMS) approved 1115 waivers that allow Medicaid agencies to cover American Indian and Alaska Native (AI/AN) traditional healthcare practices in four states: Arizona, California, New Mexico, and Oregon. Describes who can access traditional healthcare practices under these waivers, where traditional healthcare services can be provided, who will be certified to provide these services, and implementation support.
Author(s): Anne Smithey
Date: 10/2024
Sponsoring organization: Center for Health Care Strategies
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As Pandemic-Era Policies End, Medicaid Programs Focus on Enrollee Access and Reducing Health Disparities Amid Future Uncertainties: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2024 and 2025
Examines changes taking place in Medicaid programs in the 50 states and the District of Columbia. Features sections on delivery systems, provider rates and taxes, benefits, and pharmacy and prescription drugs. Highlights challenges and priorities related to state workforce shortages, systems issues, emerging state budget pressures, and more.
Author(s): Elizabeth Hinton, Elizabeth Williams, Jada Raphael, et al.
Date: 10/2024
Sponsoring organization: KFF
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Examines changes taking place in Medicaid programs in the 50 states and the District of Columbia. Features sections on delivery systems, provider rates and taxes, benefits, and pharmacy and prescription drugs. Highlights challenges and priorities related to state workforce shortages, systems issues, emerging state budget pressures, and more.
Author(s): Elizabeth Hinton, Elizabeth Williams, Jada Raphael, et al.
Date: 10/2024
Sponsoring organization: KFF
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The Rural Emergency Hospital Model: Year Two Progress Report
Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Sponsoring organization: Bipartisan Policy Center
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Provides an overview of the Rural Emergency Hospital (REH) payment designation, including the growth in REHs through September 1, 2024, factors that contribute to a hospital seeking REH conversion, and the impacts of REH conversion. Outlines concerns identified by REH leaders, facilities considering converting to REH status, and other rural stakeholders related to the REH designation, as well as policy recommendations to address these concerns.
Author(s): Emma Sheffert, Julia Harris, Marilyn Werber Serafini
Date: 10/2024
Sponsoring organization: Bipartisan Policy Center
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Medicare Part D Enrollees Reaching the Out-of-Pocket Limit by June 2024
Examines the number of Medicare Part D enrollees who reached the catastrophic Inflation Reduction Act (IRA) out-of-pocket prescription drug spending cap by June 2024. Provides demographic information on enrollees who reach the catastrophic phase and the related savings, including breakdowns for state and metropolitan, micropolitan, or rural/unknown location.
Author(s): Kenneth Finegold, Kristen L. King, Bisma A. Sayed, Rachael Zuckerman
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines the number of Medicare Part D enrollees who reached the catastrophic Inflation Reduction Act (IRA) out-of-pocket prescription drug spending cap by June 2024. Provides demographic information on enrollees who reach the catastrophic phase and the related savings, including breakdowns for state and metropolitan, micropolitan, or rural/unknown location.
Author(s): Kenneth Finegold, Kristen L. King, Bisma A. Sayed, Rachael Zuckerman
Date: 10/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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What to Know About Medicare Coverage of Telehealth
Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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Discusses telehealth use by Medicare patients before, during, and after declaration of the COVID-19 public health emergency. Notes temporary telehealth provisions set to expire December 31, 2024, telehealth provisions made permanent, and trends in use since 2020. Includes rural and urban comparisons of telehealth use since 2020. Discusses payment models for Medicare and Medicare Advantage, current policies related to telehealth, fraud, and the cost of coverage through Medicare.
Author(s): Alex Cottrill, Juliette Cubanski, Tricia Neuman
Date: 10/2024
Sponsoring organization: KFF
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