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Rural Health
Resources by Topic: Reimbursement and payment models

Estimated Reduction in CAH Profitability from Loss of Cost-Based Reimbursement for Swing Beds
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Telehealth Implementation Quick Guide – COVID-19 Resource Packet
Provides an overview of reimbursement and legal considerations for telehealth use during the COVID-19 pandemic. Presents operational guides for telemedicine and telephonic visit implementation and sample workflows. Includes links to technical assistance and federal information resources.
Date: 05/2020
Type: Document
Sponsoring organization: National Association of Community Health Centers
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State Telehealth Laws & Reimbursement Policies
Summary of telehealth-related policies, laws, and regulations for the 50 states and the District of Columbia. Focuses on Medicaid fee-for-service policies and includes the most recent policy language in each state as of February 2020.
Additional links: Infographic, Interactive Map - Current State Laws & Reimbursement Policies, Interactive Map - Legislation and Regulation Tracking
Date: 05/2020
Type: Document
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Removing Regulatory Barriers to Telehealth Before and After COVID-19
Explores historical state and federal barriers to implementing telehealth services to their full capabilities. Examines how regulatory flexibilities provided for telehealth services during the COVID-19 pandemic may impact the use of telehealth service delivery in the future. Discusses rural access to broadband internet and includes other rural references throughout. Offers policy recommendations and lessons learned during the pandemic response.
Author(s): Nicol Turner Lee, Jack Karsten, Jordan Roberts
Date: 05/2020
Type: Document
Sponsoring organizations: Brookings Institution, John Locke Foundation
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CMS Expands Telehealth, Tweaks Medicare ACOs in Latest Regulatory Package
Provides an overview of proposed CMS regulations regarding COVID-19 and their impact on ACOs. Discusses deferring risk level increases for 2021, suspending the 2021 application cycle, disregarding COVID-19 costs in financial calculations, and more.
Date: 05/2020
Type: Document
Sponsoring organization: Caravan Health
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CMS COVID-19 Telehealth Policy Updates to Medicare
Recording from a May 1, 2020 webinar provides an overview of telehealth policy changes made in response to the COVID-19 pandemic, including the CARES Act, Medicare updates, and state actions. Describes Medicare guidance to FQHCs and RHCs regarding telehealth services. Transcript available by clicking the dots above the Subscribe tab, then selecting Open Transcript.
Date: 05/2020
Type: Video/Multimedia
Sponsoring organization: Center for Connected Health Policy: The National Telehealth Policy Resource Center
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Special Coding Advice During COVID-19 Public Health Emergency
Provides coding scenarios designed to apply best coding practices, to help ensure that payors are applying flexibility to physicians providing care to patients during the COVID-19 pandemic. Includes key changes to Medicare and telehealth regulations.
Date: 05/2020
Type: Document
Sponsoring organization: American Medical Association
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Medicaid: State Views on Program Administration Challenges
Describes four federal Medicaid policies that pose barriers to effective program administration. Highlights the requirement for states to pay Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) under the prospective payment system as a challenge for states. Identifies three issues for federal policymakers to consider when addressing these administrative challenges.
Additional links: Full Report
Date: 04/2020
Type: Document
Sponsoring organization: Government Accountability Office
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COVID-19: Understanding New Telehealth Flexibilities for RHCs & FQHCs
Discusses anticipated clarification regarding telehealth flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Features answers to frequently asked questions on the telehealth flexibilities for RHCs and FQHCs, specifically on billing for telehealth services. Includes information on conducting annual wellness visits through telemedicine.
Date: 04/2020
Type: Document
Sponsoring organization: Caravan Health
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Selected Health Provisions in Title III of the CARES Act (P.L. 116-136)
Provides an overview of the healthcare-related provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed in response to the COVID-19 pandemic. Focuses on sections of the law addressing medical supply shortages, testing and preventative services, and support for the healthcare workforce. Discusses provisions related to telehealth services and rural healthcare systems.
Date: 04/2020
Type: Document
Sponsoring organization: Congressional Research Service
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