2022 Legislative Summary

By Anthony Whisenant, policy intern –

The Mississippi Rural Health Association is pleased to report a successful legislative session this year. We have been supporting and tracking multiple bills throughout the year, working with lawmakers and supplying information to assist with successful passage. The following is a description of legislation that passed this year that the MRHA has been watching and supporting:

Mississippi House Bill 365 (top supported bill by the MRHA)

House bill 365 establishes the Mississippi Rural Hospital Loan Program in the state department of health to assist rural hospitals in providing needed direct healthcare services.  This increased funding will allow rural hospitals to offer additional services in their community that are not currently available there now, maintain or increase their staffing levels, and keep up with necessary facility maintenance.  For rural hospitals to be eligible for loans they must submit a financial audit proving they are in a good financial position.  The loan they receive may not be less than twenty-five thousand dollars or more than one-hundred thousand dollars.  The department will determine terms, conditions, and requirements for loans.  This loan program will be funded through a state appropriated $2.5 million in support. Note: the MRHA would love to have seen the loan amount increase to a cap of $1 million per facility, but this is a great start. A big thank you to Rep. Sam Mims for his sponsorship of this bill.

Mississippi House Bill 732

House bill 732 provides legislative intent to assure all Mississippians receive a consistent level of 9-8-8 and crisis behavioral service no matter where they live.  The purpose for the signing of this bill is to save lives of Mississippi residents by providing them better access to services pertaining to the behavioral health crisis.  This bill authorizes the state department of mental health to use technology that is interoperable across emergency response systems in Mississippi and to deploy crisis and outgoing services. 

Mississippi House Bill 1421

House bill 1421 establishes a grant program known as the Arpa Rural Water Infrastructure Grant Program in order to assist rural water associations in the construction of eligible drinking water infrastructure projects.  Upon approval, the department will enter into a project grant agreement with each guarantee to establish the terms of the grant for the project, including the amount of the grant.  In the first fiscal year after the effective date of this act, twenty percent of the funds appropriated to the department for the program will be obligated to projects that have completed plans and specifications, acquired all necessary land and/or easements, and are ready to proceed to construction. 

Mississippi House Bill 1538

House bill 1538 provides additional appropriation to the state department of health for the purpose of funding the Arpa Rural Water Associations Infrastructure Grant Program establishes under house bill 1421.  As a condition of receiving and expending the funds appropriated to the department under this act, the department shall certify to the Department of Finance and Administration that each expenditure of the funds appropriated to the department under this act complies with the guidelines, guidance, rules, regulations and/or other criteria.  It states that the money appropriated by the act will be paid by the State Treasurer out of any money in the Coronavirus State Fiscal Recovery Fund. 

Mississippi House Bill 1613

House bill 1613 makes appropriation to the Governor’s Office-Division of Medicaid for the purpose of providing medical assistance under the Mississippi Medicaid Law and defraying the expense of that law for the fiscal year 2023.  With this bill, the Governor’s Office – Division of Medicaid will provide statistical and financial reports monthly to the Legislative Budget Office and the PEER Committee.  These reports include an accounting of all funds spent in the medical program, the CHIP program, the Dialysis Transportation program, and each of the Home and Community Based Waiver programs.  The reports will also include an accounting of all funds spent in the administrative program, participant statistics, and any other information requested by the Legislative Budget Office and the PEER Committee. 

Mississippi Senate Bill 2738 (top supported bill by the MRHA)

The purpose of senate bill 2738 is to revise the definition of telemedicine as it is used in the statute requiring health insurance plans to provide coverage for telemedicine services.  It requires health insurance and employee benefit plans to reimburse providers for telemedicine services using the proper medical codes.  It provides that all health insurance and employee benefit plans in Mississippi must provide coverage for telemedicine services to the same extent that the services would be covered if they were provided through in-person consultation.  All health insurance and employee benefit plans in this state must reimburse providers who are out-of-network for telemedicine services under the same reimbursement policies applicable to other out-of-network providers of healthcare services.  A big thank you to Senators Boyd and Michel for their sponsorship of this bill.

Mississippi Senate Bill 2739

Senate bill 2739 requires nonemergency medical transportation (NEMT) providers to have a permit from the state department of health before they may provide NEMT transportation services in Mississippi.  It requires the department to adopt rules providing for applications of permits, issuance of permits, renewal of permits, and revocation of permits.  The bill authorizes the department to provide for the payment of fees for the issuance and renewal of permits.  It requires the department to adopt standards for the operation of vehicles used to provide NEMT transportation services.  The bill also authorizes the department to revoke the permit of or impose fines on any NEMT provider who is found to not follow the requirements and standards set by the department. 

Mississippi Senate Bill 2865           

Senate bill 2865 makes appropriation from the Coronavirus State Fiscal Recovery Fund to the Department of Mental Health for the purpose of assisting with behavioral and mental health needs.  The legislation intends that no funds under this act should be used to pay employee premium payments.  The bill states that as a condition of receiving the funds appropriated in this act, the Department of Mental Health shall obtain advice from the Office of the Coordinator of Mental Health Accessibility when determining the utilization of funds. 

Unfortunately one bill that did not pass this year was a bill sponsored by both the House and Senate to remove the Medicaid rate freeze, which was originally established in the Medicaid Technical Bill in 2021. This bill made it to conference, but unfortunately was not able to pass out of conference. We are hopeful that this rate freeze will be removed soon.

Note: The Mississippi Rural Health Association would like to thank its policy intern Anthony Whisenant for his work tracking this legislation and providing summaries to the MRHA membership.

Medical Robotics and Telemedicine

By: Andrea Casiano, Beverly Banez, Sunitha Dharman, & Trentan Pecorelli

University of St. Augustine for Health Sciences

Instructor: Dr. Ellen Jones

Although medical robots made their first appearance about 34 years ago to obtain a biopsy specimen, recent years of research using artificial intelligence and computer technology have led to diversified strategic uses of these robots in healthcare (Gyles, 2019). Today, medical robots are being deployed in surgical suites to assist with surgery, facilitate hospital logistical movements, and improve patient and provider experience. The CoVID experience has increased the burden to rural emergency departments, need for immediate triage, provide mental health services, and minimize the risk of contagion transmission in congested areas.  

Robotic telemedicine allows remote patient monitoring, improves access to care without exposure to contagions, and is smart enough to learn and be taught how to take vitals, deliver samples to the lab, and many other tasks (Zubrog, 2020). It can be leveraged to offload various exams and tasks, leading to more efficient and timely care.

Specialists are especially stretched in rural areas.  Presently, 39.5% of radiology consults, 27.8% of mental health consults, and 24.1% of cardiology consults take place via telehealth or telemedicine platforms.

Costs for robotic equipment include $50,000 for startup costs and $6,000 of maintenance costs.  This will result in an estimated reduction of operational costs of approximately $1,508 per patient served annually (Gkegkes et al., 2017; Jang, 2020).  

Medicaid has implemented the Quality Incentive Payment Program, whereby hospitals are compensated for improving quality benchmarks by reducing readmissions and improving population health, which can be achieved with the assistance of robotic telemedicine.The North American medical robot market is expected to see significant growth between 2022 and 2029, estimated to reach $5.67 billion (Data Bridge Market Research, 2022).

As part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Congress  approved 200 million dollars in funding for telehealth programs (Federal Communications Commission, 2021). The Connected Care Pilot Program, a $100 million dollar project, is another federal initiative that provides up to 85% funding for pilot programs to cover network and broadband connectivity costs intended to improve connected care services to patients requiring care (Federal Communications Commission, 2021).

The COVID-19 pandemic has changed healthcare utilization, and we must analyze and explore all available resources to implement robotic telemedicine to support current healthcare and improve future care and outreach.

References

Association of American Medical Colleges. (2021, June 11). AAMC Report Reinforces Mounting Physician Shortage. AAMC. Retrieved March 01, 2022, from https://www.aamc.org/news-insights/press-releases/aamc-report-reinforces-mounting-physician-shortage.

Centers for Disease Control. (n.d.). Health equity guiding principles for inclusive

communication. https://www.cdc.gov/healthcommunication/Health_Equity.html

Centers for Medicare and Medicaid Services. (2022). Historical. CMS. Retrieved March 2, 2022, from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical

Data Bridge Market Research. (2022). North America medical robots market report – Industry trends and forecast to 2029. https://www.databridgemarketresearch.com/reports/north-america-medical-robots-market

Data USA. (2019). Greenwood, MS. Data USA. Retrieved February 18, 2022, from https://datausa.io/profile/geo/greenwood-ms/#about 

Federal Communications Commission. (2021). Connected care pilot program. https://www.fcc.gov/wireline-competition/telecommunications-access-policy-division/connected-care-pilot-program

Federal Communications Commission. (2021). COVID-19 Telehealth program (Invoices & reimbursements). https://www.fcc.gov/covid-19-telehealth-program-invoices-reimbursements

Gyles C. (2019). Robots in medicine. The Canadian veterinary journal = La revue veterinaire canadienne, 60(8), 819–820. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625162/

Healthcare Financial Management Association. (2021). Revenue cycle innovation: How automation can mitigate the financial impact of COVID-19. https://www.hfma.org/topics/hfm/2021/november/revenue-cycle-innovation-how-automation-can-mitigate-the-financial-impact-of-covid-19.html

IFR. (2021). The role of robots in healthcare. IFR International Federation of Robotics. https://ifr.org/post/the-role-of-robots-in-healthcare-part2

Mississippi Division of Medicaid. (2021). Comprehensive quality strategyhttps://medicaid.ms.gov/wp-content/uploads/2021/09/MS-DOM-                                                   Comprehensive-Quality-Strategy-2021.pdf   

Rice, J. C. (2015). Healthcare information technology: A correlational study of governance maturity and patient costs. ResearchGate, 1–108. https://doi.org/10.13140 

Robnezieks, A. (2019, January 11). Which medical specialties use telemedicine the most? Retrieved March 6, 2022, from https://www.ama-assn.org/practice-management/digital/which-medical-specialties-use-telemedicine-most

SHRM. (2022). What is the difference between mission, vision, and values statements? SHRM. Retrieved February 17, 2022, from https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/isthereadifferencebetweenacompany%E2%80%99smission,visionandvaluestatements.aspx?_ga=2.1809329.1275640098.1627228177-151836398.1626106211

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal Of Medical Internet Research, 22(10), e17298. https://doi.org/10.2196/17298

Walston, S.L. (2018). Strategic healthcare management: Planning and execution, second edition (2nd Edition). Health Administration Press. https://bookshelf.vitalsource.com/books/9781567939606

World Health Day and COVID-19 Equity

As COVID-19 has shown, good health is not universal. Some communities face challenges that leave them more vulnerable to health risks than other groups. Each year on April 7, the World Health Organization, along with other related organizations, observes World Health Day to raise awareness of global health inequities, such as COVID-19’s disproportionate impact on minority communities.

According to data from the Centers for Disease Control and Prevention (CDC), people of color experience significantly higher rates of COVID-19 infection, hospitalization, and death, with Black and Hispanic people being hospitalized for COVID-19 at over double the rate of non-Hispanic white people. Various social, geographic, economic, and environmental factors – such as lack of health care access and increased exposure due to occupational settings –  have contributed to increased health risks in these communities.

Some of the same factors that are related to health disparities also affect COVID-19 vaccine equity. Across the U.S. vaccination rates are lower in the Black population when compared to rates in the white population. Many communities mistrust the health care system due to mistreatment by the medical community. Because they haven’t always been included in the research used to create treatment and prevention strategies, it can be difficult to trust those in the health care system even in moments when help is offered.

But the All of Us Research Program is looking to change that. If you are also looking for ways to help our community fight COVID-19, one way you can do your part is by participating in research. The All of Us Research Program is gathering health information from one million or more people across the U.S. from all different backgrounds to help build one of the most diverse health databases in history. Researchers can then use this information for important health studies.   COVID-19’s disproportionate impact on communities of color, those with disabilities, and others make the All of Us Research Program’s contributions especially important to efforts to learn more about the virus and related health disparities. While the health data contributed to the program may help with future treatment, All of Us implemented several initiatives to provide immediate insights into the impacts of the pandemic. The COVID-19 Participant Experience (COPE) Survey helps researchers understand how the pandemic has affected all aspects of people’s lives, like mental and physical health, housing, and job security. The Minute Survey can help researchers understand barriers to people receiving the COVID-19 vaccine by finding out who, when, and why people do or don’t get vaccinated. Sharing your story can help researchers learn more about COVID-19 and other diseases, which could lead to better treatment and disease prevention for all of us.

Make sure your community is included in health research and join All of Us at bit.ly/togetherAoU.

The Behind the Scenes Work Before Your Tax Election Goes Public

11 Steps that will Help You Sleep at Night!

As a firm who has a demonstrated record of success in hospital tax elections and won $180 million for clients, we have a unique perspective on how to begin the process. These steps are work that you do before you start the real work of public information and outreach. Hospitals who prepare well in the beginning are more successful.

First, research your messaging in the last election and see what promises you made and collect data on the promises you kept.

This step provides you with information that you can use to show that the hospital is trustworthy of another investment by the community. Use photos and descriptions of these completed projects. Get a testimonial from a popular physician on how this progress has helped deliver quality care in your hospital.  

Second, research how other public entities like school boards, city or county or fire departments have succeeded or failed in their recent tax elections. 

This information gives you an idea of the willingness of the voters to support public entities. Look for organized opposition in these past elections because those same folks may oppose your proposition. If this is your first election, this step is critical because you do not have a hospital track record to review. 

Third, determine the capital needs of the hospital that the funds will address. 

Perhaps, technology upgrades, lab expansion, a new clinic, new services like infusion or outpatient surgery are needed. Maybe you actually need a new hospital facility. Even if you are using other funding for your new facility, supplementing it with a community investment is important. Compile a list of your needs and most importantly prioritize them.  

If your funds will be to build a new hospital, you will need to demonstrate why this is necessary and how the community investment fits with the overall funding. 

Fourth, quantify the capital required to meet the needs that you have identified.

You need more than one global number. Today’s voters want to see an itemized list. Make sure that you know the schedule on which you will address the needs and account for any escalation in price. Currently construction costs are considerably higher than they were two years ago. 

Fifth, determine the amount and term of the property or sales tax that is realistic to attain the capital required.  

Get the input of the hospital’s bond counsel. The amount and term of the tax must meet bond obligations. 

Sixth, learn the required schedule of legal events that need to happen in relationship to the various election date options.  

Your bond counsel can provide the schedule. This action begins your decision sequence on which date would be best for your election. It also helps you to plan the public outreach information schedule.  

Seventh, determine what other items or candidates may be on the ballot on your most likely date of the election.  

Voters are influenced by other propositions and candidate elections.  For example – If the school system is unpopular and they have a proposition on the same ballot it may increase your unfavorable votes. 

Eighth, test the favorability of your proposed use of funds and other variables with the voters.   In the preparation phase, you can modify your proposal to ensure your success. Once decisions are made and there is information in the public domain, changes are impossible.  An accurate public opinion survey guides many key decisions in an election effort. 

Ninth, bring key physicians into the decision making process when you feel It’s appropriate.

You need “buy-in” from physicians to be successful. Having a discussion with physicians and getting their input is ensuring that your use of funds is aligned with the needs that they believe are important. It also makes them part of the team rather than part of the spectators to the process. 

Tenth, as you work through this preparatory process, look for allies. 

Some members of your leadership and hospital team have deep roots in the community.  Quietly make a list of those people. As you proceed through the entire community education and outreach process at a later time you will need these allies. 

Eleventh, develop a board strategy to persuade board members to approve your proposition.  

Board members are fearful of losing tax elections and raising taxes in general. If this is a renewal it is easier for board members to approve.  In all cases, board members need information and data to help them make ballot decisions. Survey results are very helpful. Major points must stand on as much data as possible. Preparing your messaging and timing your presentation to your board is extremely important. Questions must be anticipated and nothing must be left to chance.

After you have completed these 11 steps successfully, you are ready to prepare for the next phase, which is gaining the approval of your county board, state bond commission and educating the many stakeholders of the hospital and the public.   TCI can guide the leadership team through this preparation process and provide the research and messaging that you need. We want you to be successful in your next election!

We Help Our Clients Understand Their Environment and to Find Solutions.   Call Us 888-922-2824 or Email barbara@tciconsults.com


HRSA Looks to Reduce a Large Number of HPSAs

The US Health Resources and Services Administration (HRSA) has released a list of Health Professional Shortage Areas (HPSAs) slated for removal. Each year HRSA adds and reduces HPSAs based on the result of survey data from providers that determines how many are located in different counties compared to the population of those counties.

HPSAs are designated for shortages of primary care, dental or mental health professionals in certain geographic areas, population groups and/or facilities. The lists of designated HPSAs are reviewed, revised and published annually on the HRSA Data Warehouse shortage area topic web page.

The most recent pull of HPSAs “proposed for withdrawal” is staggering compered to previous years. And this is not just for Mississippi. More than 15% of primary care and 8% of mental health HPSAs nationwide are slated for withdrawal

Simply put, the removal of the HPSA designation and the loss of the federal funds that is allows in our state will have a large impact on providers. This will affect not only enhanced 10% bonus to physicians who provide Medicare service in these areas, but it will also affect National Health Service Corps, Nurse Corp program, and J-1 Visa Waiver programs.

Click here to view the full report of HPSAs slated proposed for withdrawal.

We are closely watching this situation and are working with the Mississippi State Department of Health to see what can be done about this situation.

COVID-19 isolation and quarantine period shortened 


The Centers for Disease Control and Prevention (CDC) has announced it has shortened the recommended isolation and quarantine period for people with COVID-19 to five days, if asymptomatic and if persons can wear a mask when around others. 
These updates are recommended as the Omicron variant continues to spread throughout the U.S. and reflect the current science on when and for how long a person is most infectious. Emerging information with the Omicron variant demonstrates that the majority of SARS-CoV-2 transmissions occur early in the course of illness, generally in the one to two days prior to the onset of COVID-19 symptoms and the two to three days afterward. The new CDC recommendations for the general population mean that asymptomatic people who test positive may leave isolation five days after testing if they can continue to consistently and correctly mask for five more days to minimize the risk of infecting others. Infected persons who cannot follow mask guidance after five days, for example, young children, need to remain in isolation for 10 days after testing positive. 
In addition, CDC is updating the recommended quarantine period for those exposed to COVID-19. For people who are unvaccinated or if they are more than six months past their second dose of mRNA vaccine (Pfizer or Moderna) or more than two months after their Johnson and Johnson vaccine and not yet boosted, CDC now recommends quarantine for five days followed by strict mask use for an additional five days. 
If a five-day quarantine for vaccinated, not yet boosted, persons is not feasible, it is imperative that an exposed person wear a well-fitting mask at all times when around others for 10 days after exposure. Individuals who have received their booster shot do not need to quarantine following an exposure, but they should wear a mask for 10 days after the exposure. 
For all those exposed, CDC states that best practice would also include a test for SARS-CoV-2 at the fifth day after exposure. If symptoms occur, individuals should immediately quarantine until a negative test confirms their symptoms are not attributable to COVID-19. 
Everyone is urged to continue to follow recommendations to be vaccinated and those 16 years of age and above to be boosted to reduce severe disease, hospitalization and death. According to CDC, data from South Africa and the United Kingdom demonstrate that vaccine effectiveness against infection for two doses of an mRNA vaccine is approximately 35 percent. A COVID-19 vaccine booster dose restores vaccine effectiveness against infection to 75 percent.
Vaccination remains the best way to protect yourself and others and to reduce the impact of COVID-19 on our communities in light of recent studies showing that the previously widely available monoclonal antibody treatments are not effective against the Omicron variant. 
Definitions of isolation and quarantine are as follows. Isolation relates to behavior after a confirmed infection. Isolation for five days followed by wearing a well-fitting mask will minimize the risk of spreading the virus to others. Quarantine refers to the time following exposure to the virus or close contact with someone known to have COVID-19. 
Visit https://msdh.ms.gov/msdhsite/_static/14,0,420.html for more information on COVID-19.
https://www.cdc.gov/media/releases/2021/s1227-isolation-quarantine-guidance.html

                                                                                                                   
12/28/21

Up to 12 Free Tuition Spots Now Available for the NARHC Certified RHC Professional Course in 2022

UPDATE 12/07/21 2:30PM – All available spots have now been filled. Thank you for your interest.

We are excited to announce a special opportunity for up to 12 rural health clinics in Mississippi to participate at no cost in the National Association of Rural Health Clinic (NARHC) Certified Rural Health Clinic Professional Course (CRHCP) this Spring. The CRHCP Course is designed to educate participants on the operations, rules and regulations to manage a successful rural health clinic. This highly sought after, full-spectrum course is offered to Directors, Consultants, Clinic Administrators & other RHC leaders. Upon course completion & attainment of an 80% or higher exam score, you will earn a CRHCP certification.This opportunity is presented with funding from the Mississippi Office of Rural Health & Primary Care, and will be awarded at a first-come-first-serve basis.  We have 12 scholarships for full tuition to this course. 

About the Course

The course is delivered in a self-paced, on-demand platform.  It is estimated to take approximately 15-20 hours to complete coursework., with most people requiring 4-6 weeks to complete.  There is a proctored exam that must be taken during the week of March 28 – April 4, 2022 for full course graduation.  
Click here to learn more about the course (but do not register through this site).

How to Apply

To apply, you may click here to view the Mississippi application.  Please submit the completed application to Ryan Kelly at ryan.kelly@mississippirural.org to mail to our office at 31 Woodgreen Place, Madison, MS 39110. 
The deadline to submit is December 31, 2021 or until all available spots are taken.

CMS Issues Emergency Regulation Requiring COVID-19 Vaccination for Health Care Workers

Yesterday, CMS released the interim final regulations requiring COVID-19 vaccination of eligible staff at health care facilities that participate in the Medicare and Medicaid programs. These requirements will apply to approximately 76,000 providers and cover over 17 million health care workers across the country.

Facilities covered by this regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by December 5, 2021All eligible staff must have received the necessary shots to be fully vaccinated – either two doses of Pfizer or Moderna or one dose of Johnson & Johnson – by January 4, 2022.  

At this time, CMS is not allowing for daily or weekly testing of unvaccinated individuals as an alternative to vaccination.  The regulation provides for exemptions based on recognized disability, medical conditions or religious beliefs, observances, or practices.  With regard to recognized clinical contraindications to receiving a COVID-19 vaccine, facilities should refer to the CDC informational document, Summary Document for Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States, accessed at www.cdc.gov/vaccines/covid-19/downloads/….  CMS directs providers and suppliers to the Equal Employment Opportunity Commission (EEOC) Compliance Manual on Religious Discrimination160 for information on evaluating and responding to requests related to religious beliefs, observances, or practices. While employers have the flexibility to establish their own processes and procedures, including forms, CMS points to The Safer Federal Workforce Task Force’s “request for a religious exception to the COVID-19 vaccination requirement” template as an example.

Facilities must develop a similar process or plan for permitting exemptions in alignment with federal law. CMS will ensure compliance with these requirements through established survey and enforcement processes.  If a provider or supplier does not meet the requirements, it will be cited by a surveyor as being non-compliant and have an opportunity to return to compliance before additional actions occur.

The requirements apply to: Ambulatory Surgical Centers, Hospices, Programs of All-Inclusive Care for the Elderly, Hospitals, Long Term Care facilities, Psychiatric Residential Treatment Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Home Health Agencies, Comprehensive Outpatient Rehabilitation Facilities, Critical Access Hospitals, Clinics (rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services), Community Mental Health Centers, Home Infusion Therapy suppliers, Rural Health Clinics/Federally Qualified Health Centers, and End-Stage Renal Disease Facilities.

NRHA will be reviewing the regulation and submitting comments on behalf of our members expressing concern about the workforce and access implications in rural areas.  Comments on the interim final regulation must be provided within 60 days of November 5th, 2021 to be considered. 

To view the interim final rule with comment period, visit: public-inspection.federalregister.gov/…

To view a list of frequently asked questions, visit: www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.docx

NRHA will be sharing a more detailed summary of the regulation shortly.  In meantime, feel free to contact our government affairs team at ccochran@ruralhealth.us. Thank you.

FY 2022 Appropriations Requests & Allocations

Hello NRHA members,

This week, the Senate Appropriations Committee (SAC) released the text of their nine remaining appropriations bills, including the Labor, Health and Human Services, Education, and Related Agencies (L-HHS) bill. Below is an update on NRHA’s fiscal year (FY) 2022 appropriations requests.

Both the House Appropriations Committee (HAC) and SAC recommended increasing funding for the U.S. Department of Health and Human Services (HHS) rural health programs, which are administered by the Federal Office of Rural Health Policy (FORHP). The HAC recommended increasing funding to $70.7 million above the FY 2021 enacted level, and the SAC recommended increasing funding to $73.2 million above the FY 2021 enacted level. NRHA is extremely pleased that both Congressional appropriations committees are seeking to provide more funding for rural health programs. However, we will continue to advocate that both committees match NRHA’s requested allocations for individual programs.

The HAC and SAC matched NRHA’s requested funding allocations for the Rural Maternal and Obstetric Management Strategies (RMOMS) program ($10 million) and Rural Residency Planning and Development (RRPD) program ($12.7 million). Additionally, the HAC and SAC included report language to encourage HRSA to expand the current program to include RTTs in obstetrics and gynecology and request a report in the fiscal year 2023 Congressional Budget Justification on the progress made to date and efforts to expand RTTs in obstetrics and gynecology. 

The HAC matched NRHA’s requested funding allocations for the Medicare Rural Hospital Flexibility (Flex) program ($61.2 million) and Rural Emergency Hospital (REH) Technical Assistance (TA) program ($10 million) but did not match NRHA’s requested funding allocations for the Rural Provider Modernization Technical Assistance program ($8 million) and Rural Provider Modernization Grants ($13 million). The SAC did not match NRHA’s funding allocation for any of these programs. Neither the HAC or SAC matched NRHA’s requested funding allocations for the United States Department of Agriculture (USDA) Rural Hospital Technical Assistance (TA) program ($5 million. 

Below is a chart of FY 2022 requests and allocations:  

Links:  

President Biden’s FY 2022 budget request

FY 2022 HAC L-HHS bill report

FY 2022 SAC L-HHS explanatory statement

FY 2022 HAC Ag bill report

FY 2022 SAC Ag bill report

$25.5 billion in Provider Relief Fund & American Rescue Plan rural funding is now available

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced a new application cycle for $25.5 billion in COVID-19 provider funding. Applicants will be able to apply for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments during the application process. PRF Phase 4 is open to a broad range of providers with changes in operating revenues and expenses. ARP Rural is open to providers who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). 

What Is the Provider Relief Fund?
Qualified providers of health care, services, and support may receive Provider Relief Fund payments for healthcare-related expenses or lost revenues due to coronavirus. These distributions do not need to be repaid to the US government, assuming providers comply with the terms and conditions.

What Is ARP Rural?
ARP Rural is intended to help address the disproportionate impact that COVID-19 has had on rural communities and rural health care providers; funding will be available to providers who serve patients in these communities. Eligible applicants can apply for the ARP Rural funds through the same Application and Attestation Portal that is available to apply for the Phase 4 General Distribution. Providers will apply for both programs in a single application.

In order to be considered for an ARP Rural payment, applicants must include any billing Tax Identification (TIN) owned by the applicant. ARP Rural payments will be determined based on the amount and type of Medicare, Medicaid, and CHIP services provided by billing TINs to rural beneficiaries. Applicants do not need to verify whether their beneficiaries live in an area that meets the definition of rural. HRSA will base payments on data already available to it using the Federal Office of Rural Health Policy definition of rural.

Please remember you have to APPLY for this funding. It will not be automatically allocated as with past phase funding.  In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application.

The application is open now and will close on October 26, 2021 at 11:59 p.m. ET. 

Providers who have previously created an account in the Provider Relief Fund Application and Attestation Portal and have not logged in for more than 90 days will need to first reset their password before starting a new application. 

Real time technical assistance is available by calling the Provider Support Line at (866) 569-3522, for TTY dial 711. Hours of operation are 8 a.m. to 10 p.m. CT, Monday through Friday.

Please go to the following HRSA web site to find out more information and access resources for your application: 
https://www.hrsa.gov/provider-relief/future-payments