NOSORH welcomes new Policy Committee Co-Chair Scott Daniels (HI), stepping in for Mark Schoenbaum who retired earlier this month. Watch for the article in the Roots newsletter next week for a tribute to Mark’s great work for NOSORH over the years. Lisa Davis (PA) will continue to serve on the Board as the Policy Ex-Officio. In addition, Matt Strycker, NOSORH Project Manager, will be adding support to the important work of the the Policy Committee.

NOSORH has resources to help you and your state partners prepare for the National Rural Health Association Policy Institute being held Feburary 6-8 in Washington, DC. One-page state profiles are available to help SORH document rural health and the impact of their work. For help in completing your state’s profile, contact Donna Pfaendtner. A NOSORH request factsheet will be prepared for your use at the Policy Institute and Hall Render staff are available to join you on hill visits if you’re interested. Please plan to join the member and State Office Council meeting February 5 at 6 pm. In addition, NOSORH will host a webinar on January 18 at 2:00 pm ET to help SORH and their partners prepare for the Institute.

The following update was provided for our members by Hall Render, NOSORH Legislative Liaison:

SORH Reauthorization Bill Introduced in the Senate
On January 4, a bipartisan group of Senators introduced the State Offices of Rural Health (SORH) Reauthorization Act of 2017. Co-Chairs of the Senate Rural Health Caucus, Senators Pat Roberts (R-KS) and Heidi Heitkamp (D-ND), introduced the stand-alone bill which NOSORH has endorsed.

The legislation seeks to reauthorize the State Offices of Rural Health grant program for the first time, maintains the three-to-one federal to state match, and ensures greater accountability to HHS from state grantees. Other Senators who have endorsed the legislation as original co-sponsors are John Barrasso (R-WY), Bob Casey (D-PA), Charles Grassley (R-IA) and Tammy Baldwin (D-WI). All SORH and partners are asked to reach out to their Senators to inquire about their interest in sponsoring the bill.

With the stand-alone Senate bill now introduced, NOSORH will focus on getting a companion measure introduced in the House of Representatives.

Rural Broadband Program Expanded by FCC
In December, the Federal Communications Commission (FCC) voted to put additional funds into its rural health broadband subsidy program. The funds will be redistributed to ensure all eligible applicants in 2017 receive money. The Rural Health Care Program distributes $400 million annually for rural doctors, hospitals and nursing homes to adopt and pay for broadband internet access. The additional funds were necessary since the program reached its funding cap the last two years due to the increase in telemedicine use, as well as nursing homes being eligible for subsidies.

On January 2, the FCC issued a notice of proposed rulemaking seeking suggestions on how to expand its Rural Health Care Program. The notice mulls several possible changes to the program beyond merely raising the cap, including changing the definition of “rural health care” and cracking down on perceived waste, fraud and abuse. The NOSORH Policy and Program Monitoring Team will be crafting comments and response to the notice. Comments are due Friday, February 2.

Congress Passes Stopgap Spending Bill to Avoid Government Shutdown
After passing the most significant tax reform legislation in decades, Republicans avoided a government shutdown on December 22 by passing legislation that temporarily funds the government through January 19, 2018. The House voted 231-88 to approve the short-term spending bill, and the Senate quickly followed, passing the bill on a 66-32 vote.

The spending package maintains FY 2017 spending levels and waives the Pay-As-You-Go rules that would have resulted in billions of dollars in cuts to programs like Medicare. It also funds the Children’s Health Insurance Program (“CHIP”) through March 31, 2018 with $2.85 billion in allocated funds. Congress is likely to come to terms on a FY 2018 spending package by mid-January.  Congress will then shift its focus to the FY 2019 appropriations process.

Congress Shifts Focus to 340B Drug Discount Program
Starting January 1, 2018, hospitals will receive the average sales price minus 22.5 percent, a change that will result in payment cuts of $1.6 billion. In the House, almost 100 lawmakers from both sides of the aisle have cosponsored a measure (H.R. 4392) that would reverse the action taken by CMS.

In early December, a bipartisan group of six senators submitted a letter to Senate leadership calling for the passage of legislation to prevent a dramatic reduction in payments for hospitals participating in the 340B drug discount program.

In late December, Rep. Larry Bucshon (R-IN) introduced the 340B Protecting Access for the Underserved and Safety-Net Entities Act, or 340B PAUSE Act (H.R. 4710), to amend the Public Health Service Act to establish a moratorium on the registration of certain new 340B hospitals and associated sites. The legislation was introduced to address concerns of lack of transparency or oversight in the program. The 340B PAUSE Act temporarily pauses new enrollment of Disproportionate Share Hospitals into the 340B discount drug program and requires basic data reporting. Critical access hospitals, sole community hospitals and rural referral centers would not be affected by this legislation.


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