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EMS Balance Billing Quick Take—July 7, 2021

Webinar July 7, 2021 | 13:00–13:30 ET | Free to AAA Members
Speakers: Kathy Lester, Esq. & Asbel Montes

On July 1, CMS issued a proposed rule on Surprise Billing which applies to those providers and physicians identified in the No Surprises Act. This statute subjected ground ambulance suppliers to an HHS Advisory Committee process prior to any rulemaking addressing these services.

The consultants and staff of the American Ambulance Association are doing a deep dive into the 400+ page rule and evaluating its nuances. We continue to understand from our conversations that ground ambulances are not included and instead are subjected to the Advisory Committee.

The American Ambulance Association will soon provide a summary to members, and will address any confusion with the Administration. Join AAA for a quick take live webinar on July 7 at 13:00 ET to learn more!

Register Now

 

CMS | New Medicaid and CHIP Enrollment Snapshot

FOR IMMEDIATE RELEASE
June 21, 2021

Contact: CMS Media Relations
CMS Media Inquiries

New Medicaid and CHIP Enrollment Snapshot Shows Almost 10 million Americans Enrolled in Coverage During the COVID-19 Public Health Emergency

Report Shows Record Medicaid Enrollment and Highlights the Program’s Importance in Preserving Coverage for Millions of Children and Adults Throughout the United States

The Centers for Medicare & Medicaid Services (CMS) released a new Enrollment Trends Snapshot report today showing a record high, over 80 million individuals have health coverage through Medicaid and the Children’s Health Insurance Program (CHIP).  Nearly 9.9 million individuals, a 13.9% increase, enrolled in coverage between February 2020, the month before the public health emergency (PHE) was declared, and January 2021.

Among the 50 states and the District of Columbia, a total of 80,543,351 people were enrolled and receiving full benefits from the Medicaid and CHIP programs by the end of January 2021. In the 50 states that reported total Medicaid child and CHIP enrollment data for January 2021, over 38.3 million children were enrolled in Medicaid and CHIP combined, approximately 50% of the total Medicaid and CHIP enrollment. These numbers highlight the essential role the Medicaid and CHIP programs play in providing quality and needed coverage for millions of vulnerable children and adults. In fact, both programs serve as the largest single source of health coverage in the country.

“The Biden-Harris administration is using every lever to ensure any American needing access to quality health coverage receives it. Now more than ever, people need the peace of mind of knowing that they have health coverage,” said HHS Secretary Xavier Becerra. “This report reminds us what a critical program and rock Medicaid continues to be in giving tens of millions of children and adults access to care. This pandemic taught us that now more than ever, we must work to strengthen Medicaid and make it available whenever and wherever it’s needed using the unprecedented investments Congress provided.”

The increase in total Medicaid and CHIP enrollment is largely attributed to the impact of the COVID-19 PHE, in particular, enactment of section 6008 of the Families First Coronavirus Response Act (FFCRA). FFCRA provides states with a temporary 6.2% payment increase in Federal Medical Assistance Percentage (FMAP) funding.  States qualify for this enhanced funding by adhering to the Maintenance of Effort requirement, which ensures eligible people enrolled in Medicaid stay enrolled and covered during the PHE.

“Medicaid and CHIP serve as a much-needed lifeline for millions of people throughout this country. The increase we are seeing is exactly how Medicaid works: the program steps in to support people and their families when times are tough,” said CMS Administrator Chiquita Brooks-LaSure. “For the parents that may have lost a job or had another life change during the pandemic, having access to coverage for themselves and their kids is life-changing. CMS is committed to ensuring our nation’s marginalized communities and low-income families have the coverage they need.”

To assist states and territories in their response to the COVID-19 PHE, CMS developed numerous strategies to support Medicaid and CHIP programs in times of crisis, including granting states more flexibility in their Medicaid and CHIP operations. Today’s data release also reflects a range of indicators related to key application, eligibility, and enrollment processes from within state Medicaid and CHIP agencies.

The Snapshot is a product of the Centers for Medicare and Medicaid CHIP Services (CMCS) Medicaid and CHIP Coverage Learning Collaborative (MACLC), which monitors Medicaid and CHIP enrollment trends, primarily using the CMS Performance Indicator (PI) data reported to CMS by state Medicaid and CHIP agencies. PI data reflects key Medicaid and CHIP business processes- including applications, renewals, eligibility determinations, and enrollment.

The Enrollment Trends Snapshot, which is released monthly, is available here:  https://www.medicaid.gov/medicaid/program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot/index.html

The complete dataset, including data from January 2021, is available on data.Medicaid.gov.

HHS ASPR Project ECHO COVID-19 Clinical Rounds

HHS Office of the Assistant Secretary for Preparedness and Response

  • Peer to Peer Sharing : HHS ASPR, Project ECHO, and the National Emerging Special Pathogens Training and Education Centers (NETEC) together support the COVID-19 Clinical Rounds, peer to peer real-time knowledge sharing sessions among front line clinicians on challenges and successes encountered treating COVID-19.
  • Audience of Multidisciplinary Clinicians: Physicians, nurses, and EMS clinicians participate in the Rounds, which continue to focus on critical care, emergency departments, and EMS.
  • Format of Sessions: Each Clinical Rounds session includes brief presentations from experienced expert clinicians complemented by discussion among expert panelists in response to Q&A from participants.
  • Sharing of Experience, Not Official Guidance: Rounds are intended to be the sharing of clinical experience rather than formal recommendations or guidance.
  • Evolving Clinical Round Topics: Topics of Clinical Rounds evolve to address the dynamic COVID-19 medical response.
  • Continuing Medical Education (CME) Credit: Participants can fill out a short survey and receive 1 hour of Continuing Medical Education credit instantly for each session.

Medicare Ambulance Relief Bill introduced in Senate

Yesterday, Senators Catherine Cortez Masto (D-NV) and Susan Collins (R-ME) introduced the Protecting Access to Ground Ambulance Medical Services Act of 2021 (S. 2037). Senators Cortez Masto and Collins were joined by Senators Debbie Stabenow (D-MI), Bill Cassidy (R-LA), Patrick Leahy (D-VT) and Bernie Sanders (D-VT) as primary cosponsors and leads on the legislation.

S. 2037 is identical to H.R. 2454 by Representatives Terri Sewell (D-AL), Devin Nunes (R-CA), Peter Welch (D-VT) and Markwayne Mullin (R-OK) and would extend the temporary Medicare ground ambulance increases of 2% urban, 3% rural and the super rural bonus payment for five years. The increases are currently scheduled to expire on December 31, 2022. The five-year extension would allow for the increases to remain in place during the two-year delay on ambulance data collection due to the COVID-19 public health emergency, an analysis of the data by MedPAC and subsequent action by the Congress to reform the Medicare ambulance fee schedule.

The legislation would also help ensure that rural zip codes in large urban counties remain rural following geographical changes under the fee schedule as a result of the 2020 census data. The current definition using rural urban commuting areas (RUCA) in Goldsmith Modification areas would be modified for zip codes with 1,000 people or less per square mile would also be rural. Ground ambulance service providers and suppliers could also petition the Centers for Medicare and Medicaid Services (CMS) to make the argument that a specific zip code should be rural. It is vital that this provision be implemented before CMS makes changes from the 2020 census data which will likely occur in 2023.

The AAA has been leading the effort on the legislation with the support of the International Association of Fire Chiefs, International Association of Fire Fighters, National Association of EMTs, National Rural Health Association and the National Volunteer Fire Council.

The AAA will be launching a Call to Action shortly requesting AAA members to ask their Senators to cosponsor S. 2037, and reach out to their Representatives to cosponsor H.R. 2454 if they have not already done so.

We greatly appreciate the leadership of Senators Cortez Masto, Collins, Stabenow, Cassidy, Leahy, and Sanders on this vitally important legislation.

6/16 | Federal Interagency Committee on EMS Virtual Meeting

Federal Interagency Committee on EMS to Hold Virtual Meeting on June 16

FICEMS also recently approved a new strategic plan to guide Federal activities related to EMS through 2025

The Federal Interagency Committee on EMS, which coordinates EMS activities throughout the federal government, will hold its first virtual meeting of 2021 on June 16 at 1 pm ET. Members of the public are invited to watch the webcast. Visit the FICEMS meeting page to learn more and view the agenda, or click below to register now. Anyone wishing to provide public comment can email FICEMS@dot.gov with “FICEMS Feedback” in the subject line. There will also be opportunities to ask questions or submit comments via a chat function during the webcast.

Register Now

New FICEMS Strategic Plan

One of the items on the agenda for the next FICEMS meeting is the new FICEMS Strategic Plan, which is now available on EMS.gov. The plan will guide FICEMS and its efforts to support and advance EMS and 911 services in the Nation over the next five years. The plan outlines seven strategic goals, each with multiple objectives, that will serve as the foundation for the activities of FICEMS and its member agencies.

Read the FICEMS strategic plan and learn more about the committee’s vision for Federal support of state, local, tribal and territorial EMS.

Download

NEMSIS 2020 Public-Dataset Now Available

From NEMSIS on May 28, 2021

FOR IMMEDIATE RELEASE

NEMSIS 2020 Public-Dataset Now Available

Salt Lake City, Utah, May 11, 2021 – The National Emergency Medical Services Information System Technical
Assistance Center (NEMSIS TAC) today announced the availability of the 2020 Public-Release Research Dataset,
the largest publicly available dataset of emergency medical service activations in the United States. With this
release, NEMSIS aims to improve understanding of, confidence in, and support for EMS data collection and
analysis that will lead to data being utilized more effectively to improve patient care.

“The 2020 dataset is a powerful asset for researchers looking into all manner of conditions that affect different
aspects of EMS service.,” said Dr. N. Clay Mann, Professor in the Department of Pediatrics at the University of
Utah School of Medicine and Principal Investigator for the NEMSIS Technical Assistance Center. “Hopefully, the
information gathered during the COVID-19 pandemic will help give EMS agencies valuable insight on their work
improving EMS services under all sorts of conditions.”

The 2020 Public-Release Research Dataset is a subset of the National EMS Database that is the repository for
EMS data collected from U.S. States and Territories. NEMSIS maintains the national standard for how patient
care information resulting from an emergency 9-1-1 call for medical assistance is collected. The dataset includes
43,488,767 EMS activations submitted by 12,319 EMS agencies servicing 50 states and territories.

Those interested in requesting a copy of the 2020 Public-Release Research Dataset can contact the NEMSIS TAC
and fill out a request form at their website https://nemsis.org/using-ems-data/request-research-data. A
password-protected USB drive containing the dataset, the 2020 NEMSIS Data User Manual, NEMSIS Data
Dictionary v3.4.0, Extended Data Definitions v3.4.0, and sample SAS code file will be sent via postal service.

ABOUT NEMSIS

The National Emergency Medical Services Information System (NEMSIS) is the national health information
exchange and database used to collect and store EMS data from states and territories. NEMSIS is a universal
standard for how patient care information resulting from an emergency 9-1-1 call for medical assistance is
collected. It is a collaborative system to improve patient care through the standardization, aggregation, and
utilization of point-of-care EMS data at a local, state, and national level.
NEMSIS is a program of NHTSA’s Office of EMS and is hosted at the University of Utah.

CNN | Rural ambulance crews are running out of money and volunteers

From CNN on May 22, 2021

Rural ambulance crews are running out of money and volunteers. In some places, the fallout could be nobody responding to a 911 call

America’s rural ambulance services, often sustained by volunteers, are fighting for their survival — a crisis hastened by the impact of Covid-19.

More than one-third of all rural EMS are in danger of closing, according to Alan Morgan, CEO of the National Rural Health Association. “The pandemic has further stretched the resources of our nation’s rural EMS.”

Read Full Article

CMS | Medicare COVID-19 Data Snapshot

Today, the Centers for Medicare & Medicaid Services (CMS) released our monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 4.1 million COVID-19 cases among the Medicare population and over 1.1 million COVID-19 hospitalizations.

The updated snapshot covers the period from January 1, 2020 to March 20, 2021. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by April 16, 2021.

View the Updated Snapshot

NHTSA EMS.gov | EMS Week Video

From NHTSA’s Office of EMS on May 17, 2021

This week, May 16-22, 2021, we once again recognize the people of EMS by celebrating National EMS Week. We hope you’ll take a minute to watch this special message from the entire team here at the National Highway Traffic Safety Administration Office of EMS.


This year’s EMS Week theme, “This is EMS: Caring for our Communities,” couldn’t be more appropriate. The past year has been a challenge, but it has also reminded people across the nation just how valuable emergency medical services systems—and most important, clinicians—are to our communities. This nation is in debt to all of the EMS clinicians and the people behind the scenes who show up every day with true professionalism and dedication.

From all of us here at the Office of EMS, NHTSA, and the Department of Transportation: Thank you.

Presidential Proclamation for EMS Week 2021

From Whitehouse.gov’s Briefing Room on Presidential Actions

A Proclamation on Emergency Medical Services Week, 2021

Every day, in communities across the country, Emergency Medical Service (EMS) providers put themselves on the line to save lives, safeguard dangerous situations, and deliver hope to families and communities in crisis.  With selflessness, professionalism, and grace under fire, they provide essential care — never more so than during our battle with COVID-19 over the past year.  This year’s Emergency Medical Services Week theme, “THIS IS EMS:  Caring for Our Communities,” honors our heroic frontline workers who provide vital emergency medical care and ease the burden of crisis for Americans in need of help.

Through service, compassion, and dedication, EMS providers represent the very best of the American spirit.  In the face of unprecedented challenges, their expertise, endurance, and hard work have been a literal lifeline for families in every community.  Whether responding to the enormous suffering caused by COVID-19, the devastation of extreme climate events, or daily medical emergencies, EMS providers — many of whom are volunteers — prepare, sacrifice, and put others ahead of themselves.  Not only do they assume the heightened risks associated with emergency care during a pandemic, but they also spend countless hours away from families and friends in order to serve their communities.

In the face of these challenges, EMS providers have not hesitated to take on new roles, including supporting COVID-19 testing, therapeutics, and vaccination sites.  To help support the women and men who do this vital work, my American Rescue Plan included $100 million to support the mental well-being — including the mental health — of our health care professionals, paraprofessionals, public safety officers, and EMS providers.  My Administration has also made it a priority to ensure that our State, local, Tribal, and territorial partners have the resources they need so that EMS providers are trained and equipped to respond to public health emergencies safely and effectively, now and in the future.

During Emergency Medical Services Week, we extend our deepest gratitude to all EMS providers.  Their courage, selflessness, and commitment are extraordinary examples of what it means to serve this great country.  We also extend our sincere condolences to the loved ones of EMS providers who have given their lives in the line of duty.  This week and every week, I urge all Americans to express their appreciation for our Nation’s EMS providers — and to bring greater safety to their lives, and to all of our lives, by getting vaccinated to help bring an end to the COVID-19 pandemic.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 16 through May 22, 2021, as Emergency Medical Services Week.  I call upon public officials, doctors, nurses, paramedics, Emergency Medical Service providers, and all the people of the United States to observe this week with appropriate programs, ceremonies, and activities.

IN WITNESS WHEREOF, I have hereunto set my hand this fourteenth day of May, in the year of our Lord two thousand twenty-one, and of the Independence of the United States of America the two hundred and forty-fifth.

 JOSEPH R. BIDEN JR.

 

 

HRSA | Federal Office of Rural Health Policy Update

HRSA | Federal Office of Rural Health Policy Update | May 13, 2021

What’s New

CDC and USDA Team Up for Vaccine Education Effort.  The Centers for Disease Control and Prevention (CDC) is providing $9.95 million in funding to the U.S. Department of Agriculture’s USDA) National Institute of Food and Agriculture (NIFA) to improve vaccine confidence in rural areas.  NIFA will work with local partners through the Land Grant University System and its Cooperative Extension System, a nationwide educational network that provides non-formal higher education and learning to farming communities.

HRSA COVID-19 Coverage Assistance Fund.  The Health Resources and Services Administration (HRSA) will provide claims reimbursement at the national Medicare rate for eligible health care providers administering vaccines to underinsured individuals. This may be particularly helpful in rural communities given higher rates of uninsured and underinsured.

HHS/DoD National Emergency Tele-Critical Care Network.  A joint program of the U.S. Department of Health & Human Services (HHS) and the U.S. Department of Defense (DoD) is available at no cost to hospitals caring for COVID-19 patients and struggling with access to enough critical care physicians, nurses, respiratory therapists and other specialized clinical experts. Teams of critical care clinicians are available to deliver virtual care through lightweight telemedicine platforms, such as an app on a mobile device. Hear from participating clinicians and email to learn more and sign up.

HHS Coordinates New Effort to Vaccinate Migratory/Seasonal Workers in Agriculture.  The U.S. Department of Health & Human Services (HHS) is working with several divisions, including the Food and Drug Administration and the Health Resources and Services Administration to boost vaccination rates in a workforce often at heightened risk of COVID-19 infection.

RAND/RWJF Report:  COVID-19 and the Experiences of Populations at Greater Risk.  The RAND Corporation joined with the Robert Wood Johnson Foundation (RWJF) to examine the way people view health issues. Researchers asked people in the United States about their experiences related to the pandemic, and their views on issues such as freedom, racism, and the role of government.


COVID-19 Resources

New: FCC Emergency Broadband Benefit ProgramThe Federal Communications Commission (FCC) created this temporary program to help eligible individuals and households afford internet service during the pandemic. Eligible households can enroll through an approved broadband service provider or by visiting GetEmergencyBroadband.org.  The program will end when the fund runs out of money, or six months after the U.S. Department of Health and Human Services declares an end to the COVID-19 health emergency, whichever is sooner.

We Can Do This: COVID-19 Public Education Campaign.  The U.S. Department of Health & Human Services announced a national effort to help community partners promote COVID-19 vaccine confidence.  The campaign includes educational materials targeted to specific audiences and seeks volunteers for the COVID-19 Community CorpsNew: The Rural Communities Toolkit provides resources for building vaccine confidence.  

Volunteer to Administer COVID-19 Vaccines.  The U.S. Department of Health & Human Services has expanded its definition of persons authorized to give the vaccine.  These include, among others, current and retired traditional and non-traditional health care professionals, and students in health care programs.

HHS Facts About COVID Care for the Uninsured. The U.S. Department of Health & Human Services (HHS) helps uninsured individuals find no-cost COVID-19 testing, treatment and vaccines.  The HRSA Uninsured Program provides claims reimbursement to health care providers generally at Medicare rates for testing, treating, and administering vaccines to uninsured individuals, including undocumented immigrants.  There are at-a-glance fact sheets for providers and for patients in English and Spanish.

Federal Office of Rural Health Policy FAQs for COVID-19.  A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders.  NewResources for Rural Health Clinics.

COVID-19 FAQs and Funding for HRSA Programs. Find COVID-19-related funding and frequently asked questions for programs administered by the Health Resources and Services Administration (HRSA).

CARES Act Provider Relief Fund Frequently Asked Questions.  Includes information on terms and conditions, attestation, reporting and auditing requirements, general and targeted distributions, and how to report capital equipment purchases.

CDC COVID-19 Updates.  The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, including a section specific to rural health care, a vaccine locator by state, and COVID-19 Vaccination Trainings for new and experienced providers.  NewUpdated Frequently Asked Questions about COVID-19 vaccination, including new guidance for use in adolescents 12 and older.

CMS Coronavirus Partner Resources.  The Centers for Medicare & Medicaid Services (CMS) provides information for providers, health plans, state Medicaid programs, and Children’s Health Insurance Programs and holds regular stakeholder calls to provide updates.

HHS Coronavirus Data Hub.  The U.S. Department of Health & Human Services (HHS) website includes estimated and reported hospital capacity by state, with numbers updated daily.

NIH Community Engagement Alliance Against  COVID-19 Disparities.  The National Institutes of Health (NIH) created a collection of online resources with information for communities hit hardest by the pandemic, such as African Americans, Hispanics/Latinos, and American Indian/Alaska Natives.

COVID-19 Data from the U.S. Census Bureau. The site provides access to demographic and economic data, including state and local data on at-risk populations, poverty, health insurance coverage, and employment.

ATTC Network COVID-19 Resources for Addictions Treatment. The Addiction Technology Transfer Center (ATTC) Network was established in 1993 by the Substance Abuse and Mental Health Services Administration.  The online catalog of COVID-related resources includes regularly-updated guidance and trainings for professionals in the field.

GHPC’s Collection of Rural Health Strategies for COVID-19.  The FORHP-supported Georgia Health Policy Center (GHPC) provides reports, guidance, and innovative strategies gleaned from their technical assistance and peer learning sessions with FORHP grantees.  New: The Impact of Rural Residence on COVID-19 Disparities.

Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties.  The RUPRI Center for Rural Health Policy Analysis provides up-to-date data on rural and urban confirmed cases throughout the United States.  An animated map shows the progression of cases beginning March 26, 2020 to the present.

Rural Response to Coronavirus Disease 2019.  The Rural Health Information Hub has a compendium of rural-specific activities and guidelines, including Rural Healthcare Surge Readiness, a tool with resources for responding to a local surge in cases.

SAMHSA Training and Technical Assistance Related to COVID-19.  The Substance Abuse and Mental Health Services Administration (SAMHSA) created this list of resources, tools, and trainings for behavioral health and recovery providers.

Mobilizing Health Care Workforce via Telehealth.  ProviderBridge.org was created by the Federation of State Medical Boards through the CARES Act and the FORHP-supported Licensure Portability Program. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.

Online Resource for Licensure of Health Professionals.  Created by the Association of State and Provincial Psychology Boards, the site provides up-to-date information on emergency regulation and licensing in each state for psychologists, occupational therapists, physical therapists assistants, and social workers. 


Funding and Opportunities

Nurse Corps Scholarship Program – extended to May 26. The Nurse Corps Scholarship Program provides financial support to students enrolled in nursing degree programs in exchange for a commitment to serve in high-need areas across the country. This year, Nurse Corps has additional funding for qualified nursing students that includes tuition, fees, other reasonable educational costs, and a monthly living stipend.

DOJ National Tribal Clearinghouse on Sexual Assault – June 3. The U.S. Department of Justice (DOJ) will make one award for $980,000 to an organization that can provide nationwide training and technical assistance for response to sexual assault crimes and services for victims in American Indian/Alaska Native communities.

DOJ Comprehensive Opioid, Stimulant, and Substance Abuse Site-Based Program – June 7. The U.S. Department of Justice (DOJ) will make 110 awards with total funding of $163 million to support state, local, tribal, and territorial response to use of illicit substances.  A subcategory of the program will award up to $600,000 each for projects in rural areas, small counties, and tribal areas with a population of fewer than 100,000 for a federally recognized tribe.

HRSA Rural Northern Border Region Planning Program – June 14. The Health Resources and Services Administration’s (HRSA) will make approximately four awards of up to $190,000 each to support health care needs in underserved rural communities of the Northern Border Regional Commission (NBRC) service area.

DOJ Second Chance Act Youth Offender Reentry Program – June 15.  The U.S. Department of Justice (DOJ) will make 13 awards of up to $750,000 each to support youth returning to their communities from correctional facilities.  The program encourages collaboration between state agencies, local government, and community- and faith-based organizations.  Separately, the DOJ will make approximately 15 awards of up to $750,000 each for the Juvenile Drug Treatment Court Program – June 15.

USDA Local Food Promotion Program – June 21.  The U.S. Department of Agriculture (USDA) will make grants of up to $200,000 each for planning grants, and up to $750,000 for implementation grants.  Grant recipients will create or expand projects that increase the availability of locally produced food.

DOJ Strategies to Support Children Exposed to Violence – June 22.  The U.S. Department of Justice (DOJ) estimates eight awards with total investment of $7 million to support community-level strategies for children exposed to violence.  Priority consideration will be given to applications promoting civil rights, building trust between law enforcement and the community, and that are intended to benefit high poverty areas.

HUD Housing Opportunities for Persons with AIDS – July 6.  The U.S. Department of Housing and Urban Development (HUD) will make 18 awards of up to $2.25 million each for community projects that provide housing for people with HIV/AIDS in underserved areas. Rural populations are among those of interest for ensuring health equity. Also known as Housing as an Intervention to Fight AIDS, the program aims to create housing and service models that can be replicated in other similar localities.


Rural Health Research

Research in this section is provided by the HRSA/FORHP-supported Rural Health Research Gateway.  Sign up to receive alerts when new publications become available. 

Medicare-Paid Naloxone: Trends in Nonmetropolitan and Metropolitan Areas.  Previous research has found that Medicare paid for an increasing share of naloxone prescriptions from 2016 to 2018 and pays for 1/3 of all naloxone dispensed from retail pharmacies as of 2018.  This brief from the Rural and Underserved Health Research Center examines trends in Medicare-paid naloxone dispensing rates in nonmetropolitan versus metropolitan areas from 2014 to 2018.


Policy Updates

Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov.

Request for Information on Advancing Equity and Support for Underserved Communities – Comments due July 6.  The Office of Management and Budget (OMB) seeks input from a broad array of stakeholders in the public, private, advocacy, not-for-profit, and philanthropic sectors, including State, local, Tribal, and territorial areas, on available methods, approaches, and tools that the Government can use to promote equity and support underserved communities.

Increased Medicare payment for COVID-19 monoclonal antibody infusions.  The Centers and Medicare & Medicaid Service (CMS) announced last week an increase in the national average payment rate for administering monoclonal antibody treatments for COVID-19 from $310 to $450 for most health care settings.  Additionally, they have established a higher national payment rate of $750 for monoclonal antibody treatments administered in a beneficiary’s home, including the beneficiary’s permanent residence or temporary lodging.  CMS is updating its COVID-19 toolkits for providers, states, and insurers to reflect this change.

Medicare Guidance on Interoperability Rule Requirements for Hospitals.   This interpretive guidance from the Centers for Medicare & Medicaid Services (CMS) outlines the Conditions of Participation (CoPs) requiring hospitals, psychiatric hospitals, and Critical Access Hospitals (CAHs) to send electronic patient event notifications of a patient’s admission, discharge, and/or transfer to another healthcare facility or to another community provider or practitioner, which are effective as of May 1, 2021.  These CoPs were finalized in the May 2020 Interoperability and Patient Access Final Rule and are addressed in the recently released Interoperability Final Rule FAQs.

Medicare Waiver for Ambulance Treatment in Place.  This Fact Sheet describes the circumstances in which ground ambulance services may be reimbursed by Medicare for treatment provided in place because a patient was not able to be transported to a destination permitted under Medicare regulations due to community-wide emergency medical service (EMS) protocols due to the COVID-19 PHE.  This waiver is retroactively effective to March 1, 2020.


Learning Events and Technical Assistance

ONDCP Workshop for SUD: Rural Faith-Based Leaders – Thursday, May 13 at 1:00 pm ET.  The Office of National Drug Control Policy (ONDCP) will hold a second session (90 minutes) in its series for faith leaders in rural areas.  The workshops are meant to increase understanding of substance use disorder (SUD) and provide guidance on connecting faith to prevention, treatment, and recovery.  If you would like to attend, please RSVP to Betty-Ann Bryce, Special Advisor for Rural Affairs at MBX.ONDCP.RuralAffairs@ondcp.eop.gov with your name, title, organization, state/county, and contact information/email address. The Rural Health Information Hub has a recording of the first workshop for faith leaders in its Community Toolbox for SUD.

MATRC: Answering Questions About Telehealth and Telemental Health – Friday, May 14 at 12:00 pm ET.  The Mid-Atlantic Telehealth Resource Center (MATRC) holds a live, two-hour event to answer questions about the basics.  The MATRC is one of 14 FORHP-Supported Telehealth Resource Centers.  This is a recurring session taking place every other Friday from 12:00 to 2:00 pm ET.

HRSA Telehealth Series: Learn About Licensure Compacts – Monday, May 17 at 12:30 pm ET.  Experts from the National Center for Interstate Compacts will discuss agreements for doctors, nurses, psychologists and other clinicians to see patients across state lines via telehealth.

SBIRT for SUD Native American Communities – Tuesday, May 18 at 11:00 am ET.  Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a process to quickly assess substance use disorder (SUD) in a person and move them toward more extensive treatment.  This hour-long session is hosted by the National American Indian & Alaska Native Prevention Technology Transfer Center.

AgriSafe: Zoonotic Disease and Pregnancy – Wednesday, May 19 at 1:00 pm ET.  The AgriSafe Network will hold a one-hour session to explain the risk that diseases transmitted between farm animals and humans pose to pregnant women.

Overcoming Mental Health Stigma in Rural Communities – Wednesday, May 19 at 2:00 pm ET.  The Mental Health Technology Transfer Center Network will host a one-hour workshop to discuss what influences negative attitudes toward mental health and techniques to overcome various forms of stigma.

Assessment of Opioid Misuse Risk Among Farmers in the Clinical Setting – Friday, May 21 at 1:00 pm ET. The AgriSafe Network will host an hour-long webinar to provide insight on misuse risk factors and warning signs among farmers.

SAMHSA Connecting Prevention Specialists to Native Communities – Friday, May 21 at 1:00 pm ET.  The Tribal Training and Technical Assistance Center at the Substance Abuse and Mental Health Services Administration (SAMHSA) holds virtual trainings to cover topics such as crisis response, youth engagement, and sexual assault awareness.  Trainings will take place on the third Friday of each month.


Resource of the Week

Successful COVID-19 Messaging in Rural CommunitiesIn this 30-minute video, the state leadership in West Virginia present insight from their research and vaccine outreach campaign.


Approaching Deadlines

CDC Childhood Lead Poisoning Prevention and Surveillance – extended to May 14 (from April 25)

Park and Recreation Mentorship Grants for Rural Youth Impacted by Opioids – May 15

ARC Investments Supporting Partnerships/Recovery Ecosystems – Letters of Intent May 17

CDC Drug Free Communities – extended to May 17 (from May 10)

Cross-Jurisdictional Sharing in Public Health: Small Grants Program – May 17

EPA Technical Assistance for Wastewater Treatment – May 17

SAMHSA Overdose Treatment for Use by First Responders – May 17

HRSA Expanding Community-Based Workforce for COVID-19 Vaccine Outreach – May 18

Comments Requested:  Proposed Changes to the Census Bureau Definition of Urban – May 20

CMS Primary Care First Model Cohort 2 – extended to May 21 (from April 30)

CDC Community Health Workers for COVID Response – May 24

New Sites for National Health Service Corps (NHSC) – May 25

Native American Agriculture Fund Grants for Youth – May 25

Nurse Corps Scholarship Program – extended to May 26

US Treasury | Coronavirus State and Local Fiscal Recovery Funds to Deliver $350 Billion

From the US Treasury on May 10, 2021

Aid to state, local, territorial, and Tribal governments will help bring back jobs, address pandemic’s economic fallout, and lay the foundation for a strong, equitable recovery 

 

WASHINGTON — Today, the U.S. Department of the Treasury announced the launch of the Coronavirus State and Local Fiscal Recovery Funds, established by the American Rescue Plan Act of 2021, to provide $350 billion in emergency funding for state, local, territorial, and Tribal governments.  Treasury also released details on the ways funds can be used to respond to acute pandemic-response needs, fill revenue shortfalls among state and local governments, and support the communities and populations hardest-hit by the COVID-19 crisis. Eligible state, territorial, metropolitan city, county, and Tribal governments will be able to access funding directly from the Treasury Department in the coming days to assist communities as they recover from the pandemic.

“Today is a milestone in our country’s recovery from the pandemic and its adjacent economic crisis. With this funding, communities hit hard by COVID-19 will able to return to a semblance of normalcy; they’ll be able to rehire teachers, firefighters and other essential workers – and to help small businesses reopen safely,” said Secretary Janet L. Yellen.  “There are no benefits to enduring two historic economic crises in a 13-year span, except for one: We can improve our policymaking. During the Great Recession, when cities and states were facing similar revenue shortfalls, the federal government didn’t provide enough aid to close the gap. That was an error. Insufficient relief meant that cities had to slash spending, and that austerity undermined the broader recovery. With today’s announcement, we are charting a very different – and much faster – course back to prosperity.”

While the need for services provided by state, local, territorial, and Tribal governments has increased —including setting up emergency medical facilities, standing up vaccination sites, and supporting struggling small businesses—these governments have faced significant revenue shortfalls as a result of the economic fallout from the crisis. As a result, these governments have endured unprecedented strains, forcing many to make untenable choices between laying off educators, firefighters, and other frontline workers or failing to provide services that communities rely on. Since the beginning of this crisis, state and local governments have cut over 1 million jobs.

The Coronavirus State and Local Fiscal Recovery Funds provide substantial flexibility for each jurisdiction to meet local needs—including support for households, small businesses, impacted industries, essential workers, and the communities hardest-hit by the crisis. Within the categories of eligible uses listed, recipients have broad flexibility to decide how best to use this funding to meet the needs of their communities. In addition to allowing for flexible spending up to the level of their revenue loss, recipients can use funds to:

  • Support public health expenditures, by – among other uses – funding COVID-19 mitigation efforts, medical expenses, behavioral healthcare, mental health and substance misuse treatment and certain public health and safety personnel responding to the crisis;
  • Address negative economic impacts caused by the public health emergency, including by rehiring public sector workers, providing aid to households facing food, housing or other financial insecurity, offering small business assistance, and extending support for industries hardest hit by the crisis
  • Aid the communities and populations hardest hit by the crisis, supporting an equitable recovery by addressing not only the immediate harms of the pandemic, but its exacerbation of longstanding public health, economic and educational disparities
  • Provide premium pay for essential workers, offering additional support to those who have borne and will bear the greatest health risks because of their service during the pandemic; and,
  • Invest in water, sewer, and broadband infrastructure, improving access to clean drinking water, supporting vital wastewater and stormwater infrastructure, and expanding access to broadband internet.

Insufficient federal aid and state and local austerity under similar fiscal pressures during the Great Recession and its aftermath undermined and slowed the nation’s broader recovery. The steps the Biden Administration has taken to aid state, local, territorial, and Tribal governments will create jobs and help fuel a strong recovery. And support for communities hardest-hit by this crisis can help undo racial inequities and other disparities that have held too many places back for too long.

For an overview of the Coronavirus State and Local Fiscal Recovery Funds program including an expanded use of eligible uses, see the fact sheet released today. Find additional details on the state, local, territorial, and Tribal government allocations on the Coronavirus State and Local Fiscal Recovery Funds Webpage.

 

CMS | Sequestration | Claims Hold Lifted

CMS Confirms Suspension of Medicare Sequester Through End of 2021; Announces Lifting of Claims Hold

On April 16, 2021, CMS published a notice on the MLNConnects webpage announcing the passage of the Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes. The law, enacted on April 14, 2021 extends the suspension of the Medicare “sequester” through December 31, 2021.

In anticipation of the legislation’s passage, CMS announced on March 30, 2021 that it had instructed its Medicare Administrative Contractors (MACs) to hold Medicare Fee-For-Service claims with dates of service on or after April 1, 2021. With the passage of the bill, CMS further indicated that it has instructed its MACs to release any claims currently being held, and to reprocess any claims paid with the sequester applied. CMS indicated that no action is required on the part of health care providers and suppliers.

Medicare 2% Cut Freeze Extended

Yesterday, Presiden Biden signed into law legislation (H.R. 1868) to extend the current temporary freeze on the 2% Medicare sequestration cut. H.R. 1868 extends the deadline of the freeze from today until December 31. Contractors had been holding Medicare claims to avoid any issues but will again start processing claims. The AAA as well as other national EMS and fire organizations had pushed for the extension of the freeze.

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