With the growing COVID-19 concern brewing around us, here are some rural-relevant resources that might be helpful.Additional updates, resources and information will be added to this page as they become available…
Visit the CMS Current Emergencies landing page for Medicare and Medicaid related COVID-19 information. CMS has issued several guidance announcements and “special” announcements in the last few weeks dealing with this and many other potential challenges our providers may face.
Several additional resources – from assistance with supply chain to potential payroll tax reductions – are being introduced every day. Sometimes more than once a day. Keep an eye out to pertinent information that might be relevant to providers and stakeholders in your state.
CMS – Lessons from the Front Lines: COVID-19 every Friday, 12:30 – 2:00 PM Eastern This call series is an opportunity for CMS officials to hear directly from physicians and other clinical leaders as they share their experiences, best practices, strategies, and insights related to COVID-19. These calls are held weekly on Fridays at 12:30 PM Eastern and specific topics vary. To join the calls: Participant Dial-In: (877) 251-0301 Access Code: 8672948 Webcast Streaming
We are about preparation not panic. Please reach out to Tammy Norville (email@example.com), NOSORH Technical Assistance Director, with questions, for discussion or for additional assistance.
Congress Picks up Pace as June turns to July
The House is back in session for the final week of June and is expected to meet throughout July. During the week of June 29, the House will vote on H.R. 1425, the Patient Protection and Affordable Care Enhancement Act. The bill will most likely pass on party lines and is not going to be taken up by the Senate. The legislation would expand the ACA’s tax credits, pressure states to expand Medicaid programs with the promise of more federal funding, and cap individual premiums at 8.5% of their income. The bill also allows immigrants living in the US under DACA to get access to subsidized insurance plans.
Beginning the week of July 6, the House will begin marking up Fiscal Year 2021 appropriation bills. The Labor-HHS bill, which sets the funding level for the SORH, FLEX and other rural health programs, is included in the HHS funding bill and is scheduled for markup July 7. The full House is expected to consider the bills on the floor the weeks of July 20 and July 27. The Senate will most likely not begin the markup process until September. Expect Congress to pass a continuing resolution through the November election.
Also beginning the week of July 6, the Senate is expected to begin negotiations with the White House on the next COVID-legislative package. During June, the Senate HELP Committee held a telehealth hearing that looked into which of the 30-plus temporary telehealth changes should be made permanent post-COVID-19 emergency. HELP Chairman Alexander (R-TN) called for Medicare to permanently lift restrictions on telehealth coverage for rural areas. Look for the next Senate COVID legislative package to include language making some of the temporary rural provisions permanent.
Rural Health-Related Bills Introduced in June
Rep. Sherrill (D-NJ) and Hern (R-OK) introduced the “protect Telehealth Access Act.” H.R. 7391 seeks to eliminate a requirement that someone receiving telehealth services must be located in a rural area or health professional shortage area, and that the person may only get telehealth services at home and in limited circumstances. Here is the press release.
Rep. Liz Cheney (R-WY) and Rep. Jason Smith (R-MO) introduced H.R.7338, the bill would amend title XVIII of the Social Security Act to allow HHS to waive requirements of telehealth services under Medicare. The bill would allow seniors to utilize CARES-related telehealth provisions after the national emergency period expires.
Senator Cindy Hyde-Smith (R-MS) introduced S.3998 to amend title XVIII of the Social Security Act to simplify payments for telehealth services furnished by Federally Qualified Health Centers or Rural Health Clinics under Medicare.
Rep. Guest (R-MS) introduced H.R.7208 to amend the Small Business Act to include hospitals serving rural areas or areas of persistent poverty in the Paycheck Protection Program.
Senator Mike Rounds (R-SD) introduced S.3917 to establish a home-based telemental health care demonstration program for purposes of increasing mental health services in rural medically underserved populations.
Rep. Norma Torres (D-NM) introduced H.R.7190 to amend the Public Health Service Act to provide for the establishment of a virtual health pilot program to facilitate utilization of remote patient monitoring technology to maintain or expand access to health care services for individuals in rural areas during the COVID-19 emergency period. Senator Martha McSally (R-AZ) introduced companion legislation in the Senate, S. 3951.
The NOSORH Grant Writing Institute features a series of nine online learning sessions covering every aspect of grant writing with a unique rural health focus. The series is intended for beginners seeking to gain the skills to research and draft winning proposals from various agencies.
Class size is limited to the first 50 registrants. Group discounts are available.
Favorite thing about working at a SORH: Opportunities abound. Being a member of a SORH is all about making connections and reducing duplication of efforts. I love being able to connect people with resources and other groups that will further their work. I also love being able to really listen to people’s needs and show them that they are being heard with results from those conversations.
What I’m working on right now: Financial indicator data visualizations over time and a claims denials analytics project final analysis.
People would be surprised if they knew: I’ve had three careers before coming to work for a SORH (personal trainer, nutrition and physical activity research, and teaching middle school health). Each have contributed some significant learnings that help me in my current role.
If you could learn to do anything, what would it be? At the moment, learn to sew. I’m realizing as I watch communities come together to protect themselves and others against COVID that some basic sewing skills would be really helpful.
What’s your hidden talent? I can sing with my mouth closed.
Where is your favorite place in the world? The woods or the beach. The quiet and stillness provides amazing rejuvenation.
My Top 3 Goals for 2020:
1. Adjust to the new normal
2. See #1
3. Excel in the new normal
On May 15, the House passed H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions Act. The massive $3 trillion Coronavirus Relief bill is not going to be considered by the Senate, but does represent a starting point in the next virus-relief package. A few of the bill highlights include: an additional $100 billion to the Public Health and Social Services Emergency Fund; reduce the interest rate in Medicare Advanced Payment loans for all hospitals; include hazard pay for frontline healthcare workers; and a requirement for the promulgation of emergency OSHA standards for healthcare workers. Notably absent from the bill was a liability protection measure which Senate Republicans have said is a “red-line” for their support. The Senate will begin putting together their own COVID-relief package this month. The bill is expected to be much smaller in scope.
Appropriations: Along with consideration of an additional COVID-relief bill, Congress will use June and July to attempt to advance the Fiscal Year 2021 appropriations bills, which are one of the few “must-pass” legislative items this year. House leadership has indicated they will not begin the markup process until Congress has reached an agreement on the next Coronavirus relief bill. The Senate has hinted they may hold markups before the July 4 recess, although a markup of the Labor-HHS package has traditionally been one of the later bills to move.
NOSORH will meet with lawmakers and their staff throughout the process and urge them to increase funding for the State Offices of Rural Health Program to $15 million annually. NOSORH has been in discussions and will continue to advocate for increased funding and reauthorization for the Medicare Rural Hospital Flexibility grant program.
Bills Introduced: A bipartisan group of senators introduced the Save our Rural Health Providers Act. Sens Lisa Murkowski (R-AK), Joe Manchin (D-WV), and Cindy Hyde Smith (R-MS) introduced the bill which seeks to create a new formula to ensure the provider relief fund has a dedicated set-aside amount directed towards rural areas of the U.S. The bill would create a 20 percent benchmark in the Provider Relief Fund which according to a press release would allocate more than $10 billion to rural states. The bill also grants priority for facilities that provide care for populations with limited access to health infrastructure. A companion bill was introduced in the House by Rep Small (D-MN) and Hagedorn (R-MN).
Also this month, Senators Schatz (D-Hawaii), Murkowski (R-AK), Boozman (R-AR) and Peters (D-MI) introduced the Health Care Broadband Expansion During COVID-19 Act. The bill directs $2 billion to help health care providers increase broadband capacity and expand telehealth services during the current public health crisis.
Listening Session Resources:
Favorite thing about working at a SORH: Working with farmers
What I’m working on right now: Writing up Worker Protection Standard trainings for our Amish and Old Order Mennonite farmers
Last place I traveled to: The Crystal Coast of North Carolina
What I’m currently reading: Cave of Bones, by Anne Hillerman (a Navajo police mystery)
What was your first job? Hospital security
Where is your favorite place in the world? The Sangre de Cristo Mountains of New Mexico
What led you to a career in rural health? I was a Penn State farm safety extension educator prior to this position.
The SORH work that I am most proud of: Our compliance assistance