White House Releases FY 22 Budget:
On May 28, the White House submitted its Fiscal Year 2022 (FY 22) budget request to Congress. Broadly, the budget request includes $133.7 billion for HHS which represents a 23.4 percent increase from the fiscal 2021 enacted level of $108.6 billion.

In particular, the State Offices of Rural Health grant program (SORH) was requested at the congressionally authorized level of $12,500,000 for FY 22, the same amount that Congress enacted for FY 21.  NOSORH has asked Congress to increase funding to $15 million for FY 22. The White House request for the Rural Hospital Flexibility grant program (Flex) was $57,509,000, an increase of $1.9 million over the FY 21 congressionally enacted level. In the HRSA budget justification, they wrote the increased funding for FLEX will expand activities for the state support of hospitals.

Attention now turns to Congress as they will begin to markup their FY 22 appropriations bills. The House Labor-HHS appropriations subcommittee will continue seeking input from members in June with an eye towards advancing a bill out of committee no later than the middle of July. The Senate appropriations process remains further behind.

Conrad 30 Bill Reintroduced in Congress:
Rep. Brad Schneider (D-IL) introduced H.R.3541 to provide incentives to physicians to practice in rural and medically underserved communities. The reintroduced bill would extend and expand the Conrad 30 Waiver program which allows foreign doctors studying in the U.S. to obtain a visa following medical residency if they practice in a rural or medically underserved area for at least three years. Under current law, foreign doctors on J-1 educational visas must return to their home country upon completing medical residency and wait two years before they can apply for a new visa or green card. A companion bill was introduced by Senators Amy Klobuchar (D-MN) and Susan Collins (R-ME). Here is the Klobuchar press release.

Rural Health-Related Bills Introduced in May
Senator Catherine Cortez Masto (D-NV) introduced S.1902 which seeks to establish a continuum of care for individuals experiencing mental or behavioral health crisis by increasing grant funding over five years to establish inter-professional health care teams at community health centers, rural health clinics, and behavioral health programs.

Senator Jon Tester (D-MT) introduced S.1893 a bill to amend title XVIII of the Social Security Act to support rural residency training funding that is equitable for all States.

Senator Tom Carper (D-DE) introduced S.1798 to provide for strategies to increase access to telehealth under the Medicaid program and Children’s Health Insurance Program.  Here is the Carper press release.  The bill would provide guidance to states on how to integrate telehealth into their Medicaid and CHIP programs and research how telehealth expansion can impact health care access, utilization, cost and outcomes.

Rep. Jason Smith (R-MO) introduced H.R. 3447 the Permanency for Audio-Only Telehealth Act, a bill that intends to ensure Medicare recipients who cannot access the video component during telehealth visits are able to access care through audio-only. The bill would also remove geographic and originating site restrictions to allow Medicare beneficiaries’ homes to be telehealth originating sites for audio-only telehealth services. Here is the press release from Smith’s office.

Rep. Mike Thompson (D-CA) re-introduced the CONNECT Act which is his comprehensive Telehealth bill. The bill would expand access to telehealth on a permanent basis.  Senator Brian Schatz (D-HI) introduced a strong bipartisan companion bill in the Senate, S. 1512. The bill includes 25 Senate Republicans as cosponsors.

Rep. Claudia Tenney (R-NY) introduced H.R.3069 which seeks to provide relief for small rural hospitals from inaccurate instructions provided by certain Medicare Administrative Contractors.

Senator Tina Smith (D-MN) introduced S.1491 which would amend the Public Health Service Act to improve obstetric care in rural areas.