| View this online. July 13, 2023 What's New CMS Proposes Remedy for 340B Medicare Drug Payment Policy – Comment by September 5. This proposed rule describes the actions that the Centers for Medicare & Medicaid Services (CMS) proposes to take to comply with the United States Supreme Court's decision about the adjustment of Medicare payment rates for drugs acquired under the 340B Program from calendar year (CY) 2018 through September 27th of CY 2022. As background, in 2018, CMS decreased the Medicare payment rate for 340B drugs from average sales price (ASP) plus 6 percent to ASP minus 22.5 percent. They also made a corresponding increase to payments to all hospitals (340B hospitals and non-340B hospitals) for outpatient non-drug items and services, so the policy change was budget neutral. The Supreme Court unanimously ruled that the differential payment rates for 340B-acquired drugs were unlawful because, prior to implementing the rates, HHS failed to conduct a survey of hospitals' acquisition costs under the relevant statute. To comply with the ruling, CMS proposes to pay affected 340B providers an estimated $7.8 billion in lump sum payments and to reduce future outpatient non-drug item and service payments to all hospitals starting in CY 2025. CMS would continue to adjust the OPPS payments until the full $7.8 billion is offset, estimated to be 16 years. The proposed actions in this rule would affect all hospitals. CDC Awards for High Obesity Program. This week, the Centers for Disease Control and Prevention (CDC) announced awards totaling more than $11 million for its program specifically designed to reach U.S. counties with high rates of obesity. Most awards for the five-year program are in rural areas, cited by the CDC as having a higher obesity prevalence. Sixteen land grant universities will work with local cooperative extension services to increase the availability of affordable, healthy foods and safe, convenient places for physical activity. HHS Seeks Input on Smoking Cessation Framework Draft – Comment by July 30. Last week, the U.S. Department of Health & Human Services (HHS) released a draft framework for an initiative that aims to ensure every person in America has access to comprehensive, evidence-based treatment. The framework is organized around six goals that range from increasing awareness of the benefits of smoking cessation to finding the best measures for success of the effort. Research released last year showed that, in 2020, smoking prevalence was higher in rural (19.2 percent) than urban areas (14.4 percent). From 2010 to 2020, odds of quitting were lower in rural versus urban areas. HHS invites all potentially interested parties—individuals, associations, governmental and non-governmental organizations, academic institutions, and private sector entities—to respond by July 30. Application Assistance for the Rural Healthcare Provider Transition Project – Wednesday, July 19 at 1:00 pm ET. Applications are being accepted to receive one year of technical assistance through this ongoing program administered by the FORHP-supported National Rural Health Resource Center. Beginning in January 2024, experts will help small rural hospitals and CMS-certified rural health clinics strengthen their foundation in key elements of value-based care including, but not limited to, efficiency, quality, patient experience, and safety of care. The July 19 information session will provide further details about the program and application process. Improving Behavioral Health Services in Rural Communities through Medicaid – Wednesday, July 26 at 3:00 pm ET. The National Academy for State Health Policy hosts a one-hour session to explore effective use of Medicaid funding for rural residents. Partnership for Quality Management (PQM) Seeks Rural Health Experts for Committees – Submit Nominations by July 30. As mentioned in the Policy Updates section of last week's Announcements, new committees are being formed by Battelle, as contracted by CMS, to make recommendations on health care quality measurement. Rural health experts are sought for all PQM committees (on the nomination form, one can check a box as a "rural health expert"). More information on PQM can be found here: Get Involved | Partnership for Quality Measurement (p4qm.org). Nominations for all committees have a deadline of July 30. Ongoing: Updates to Requirements for Buprenorphine Prescribing. As announced by the Substance Abuse and Mental Health Services Administration in January 2023, clinicians no longer need a federal waiver to prescribe buprenorphine for treatment of opioid use disorder. Clinicians will still be required to register with the federal Drug Enforcement Agency (DEA) to prescribe controlled medications. Beginning on June 27, the DEA registration will require applicants – both new and renewing – to affirm they have completed a new, one-time, eight-hour training. Exceptions for the new training requirement are practitioners who are board certified in addiction medicine or addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the U.S. within five years of June 27, 2023. Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained between January 1, 2019 and January 25, 2023 (when Congress eliminated the waiver requirement). Approximately $900,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted. Send questions to DATA2000WaiverPayments@hrsa.gov. COVID-19 Resources Provider Relief Fund Reporting Period 5. The Provider Relief Fund (PRF) Reporting Portal is open from July 1 to September 30, 2023 at 11:59 p.m. ET. Providers who received one or more PRF (General or Targeted) and/or American Rescue Plan Rural payments exceeding $10,000, in the aggregate, from January 1, 2022 to June 30, 2022 must report on their use of funds during Reporting Period 5 to comply with PRF Reporting Requirements. More information and resources can be found on the PRF Reporting webpage. 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. Teams of critical care clinicians - critical care physicians, nurses, respiratory therapists, and other specialized clinical experts – are available to deliver virtual care through telemedicine platforms, such as an app on a mobile device. Hear from participating clinicians, and email to learn more and sign up. Mobilizing Health Care Workforce via Telehealth. ProviderBridge.org was created through the CARES Act by the Federation of State Medical Boards and HRSA's Office for the Advancement of Telehealth. 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 Occupational Therapists, Physical Therapists, Psychologists, and Social Workers. The site provides up-to-date information on emergency regulation and licensing in each state. Funding and Opportunities VA Grants for Transportation of Veterans in Highly Rural Areas – July 31. Grants from the U.S. Department of Veterans Affairs (VA) will go to new organizations providing transportation to VA medical centers. Eligible applicants are VA-recognized veteran service organizations and state veteran entities that do not currently have a grant under this program. The original deadline of July 30 for this program has been moved back by one day to July 31. DOJ Grants to Tribal Domestic Violence and Sexual Assault Coalitions – August 4. The U.S. Department of Justice (DOJ) will make 20 awards for the development and operation of nonprofit, non-governmental coalitions that provide essential services for domestic violence and sexual assault in Tribal communities. DOT Nationally Significant Freight and Highway Programs – INFRA Grants – August 21. The U.S. Department of Transportation (DOT) will invest $3.1 billion in this program also known as INFRA – Infrastructure for Rebuilding America. Project goals include safety/repair of existing highway infrastructure, but also expanding transportation in rural areas, access to broadband, and other projects that affect public health. 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. Accommodation and Acceptability of Health Care by Non-Metropolitan/Metropolitan and Race/Ethnicity Status. Among the findings from the RUPRI Center for Rural Health Policy Analysis: - Non-metropolitan respondents more frequently reported lack of transportation, whereas metropolitan respondents were more likely to report not getting appointments scheduled soon enough (both examples of accommodation barriers).
- Among the non-metropolitan respondents, lack of transportation was most common among Hispanic, non-Hispanic Black, and American Indian/Alaska Native respondents compared to non-Hispanic White counterparts.
- Among non-metropolitan respondents, a higher percentage of American Indian/Alaska Native respondents reported not being at all satisfied with their care.
Policy Updates Send questions to ruralpolicy@hrsa.gov. New Report to Congress on Medicaid Non-Emergency Medical Transportation (NEMT). In this report, the Centers for Medicare & Medicaid Services (CMS) provide an extensive analysis of Medicaid coverage of NEMT, including the types of medical services accessed, monthly trends in the use of NEMT versus telehealth services, and a comparison of the volume of NEMT services used by states and geographic area. For example, in 2021, about 7 percent of beneficiaries living in frontier or remote areas used NEMT compared to less than 4 percent of all Medicaid beneficiaries. New Report to Congress on Baseline Trends and Framework for Evaluating the No Surprises Act. This report from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) details key trends in factors that will be important to evaluate the No Surprises Act (NSA) and describes the framework for future evaluations. The NSA, enacted on December 27, 2020, addresses certain instances of surprise billing where individuals with private health coverage receive unexpectedly high medical bills when they are unknowingly or unavoidably treated by an out-of-network provider, facility, or provider of air ambulance services. ASPE found that overall, between 2012 and 2020, out-of-network claims decreased similarly in rural and urban areas. Learning Events and Technical Assistance Analyzing State Laws Regulating Incentives for Health Behavior – Wednesday, July 26 at 12:00 pm ET. This presentation will describe the results of a qualitative study examining state laws regulating incentives for health behavior. Such laws may have important implications for provision of contingency management for substance use disorder, including in rural areas. The session is hosted by the FORHP-supported Center on Rural Addiction at the University of Vermont. HRSA's Maternal Health Webinar Series – Wednesday, July 26 at 4:00 pm ET. Regions 5 and 7 of HRSA's Office of Intergovernmental and External Affairs will host two local grantees of the Rural Maternity and Obstetrics Management Strategies program. Resource of the Week Leveraging Career Pathway Programs: State Strategies to Combat Health Care Workforce Shortages. The National Conference of State Legislatures provides an overview of programs states have implemented to address or mitigate workforce shortages. The report describes programs across various stages of education, including K-12, community college, and undergraduate programs. Approaching Deadlines HRSA Faculty Loan Repayment Program – July 13 HRSA Substance Use Disorder Treatment and Recovery Loan Repayment Program – July 13 HRSA Sites for Substance Use Disorder Treatment and Recovery Loan Repayment Program – July 13 HRSA Behavioral Health Workforce Education and Training – Children, Adolescents, and Young Adults Program for Professionals – July 14 HRSA Maternity Care Nursing Workforce Expansion Program – July 14 HRSA Medical Student Education Program for Underserved States – July 14 ACL Tribal Long Term Services and Support Resource Center – July 17 DOL Critical Sector Job Quality Grants – July 17 HRSA Enhanced Healthy Start Initiative – July 17 National Environmental Public Health Internship Program – July 17 Region IV Public Health and Primary Care Leadership Institute – July 17 USDA Native Community Development Financial Institution Relending Demonstration Program – July 17 HHS Healthy Families Community-Based Perinatal Health Initiative – July 18 HRSA Pediatric Specialty Loan Repayment Program – July 20 Comments Requested: New Partnership for Quality Measurement – July 21 DRA Delta Leadership Institute Executive Academy – July 26 DHS Rural Emergency Medical Communications Demonstration Project – July 28 Partnership for Quality Management (PQM) Seeks Rural Health Experts – July 30 ACF Alaska Native Tribal Resource Center on Domestic Violence – July 31 GAO Calls for HIT Advisory Nominations – July 31 Hardship Exceptions for Medicare Promoting Interoperability Program – July 31 Nominations for GAO Health Information Technology Advisory Committee – July 31 VA Grants for Transportation of Veterans in Highly Rural Areas – July 31 HHS Center for Indigenous Innovation and Health Equity – August 1 EPA Brownfields Job Training Grants – August 2 CDC Foundation Seeking Community Data for Overdose Prevention – August 4 DOJ Grants to Tribal Domestic Violence and Sexual Assault Coalitions – August 4 ACL Alzheimer's Disease Programs Initiative – States and Community Grants – August 7 Department of Education Full-Service Community Schools Program – August 8 ACF Culturally Specific Family Violence Prevention – August 11 National Medical Fellowships Health Equity Leaders – August 11 Berkley Rural Public Health Master's Program – August 13 Dept of Transportation Rural and Tribal Assistance Pilot Program – August 14 CMS Seeking Researchers for Health Data Access Program – August 15 Comments Requested: ACL Updates Older Americans Act – August 15 Rural Healthcare Provider Transition Project – August 15 DOT Nationally Significant Freight and Highway Programs – INFRA Grants – August 21 Comments Requested: CMS Updates Policy for End Stage Renal Disease – August 25 USDA Grants for Education and Research at 1890 Land-Grant Institutions – August 30 EPA Community-Based Research to Mitigate Environmental Health Disparities – August 31 Comments Requested: Remedy for 340B Medicare Drug Payment Policy – September 5 NIH Research to Improve Native American Health (AIDS Related) – September 7 NIH Tobacco Control Policies to Promote Health Equity – September 8 NRHA Rural Health Fellows Program – September 14 EPA Solar for All Competition – September 26 NIH Assessing Real-World Effectiveness of Telehealth Guided Provider-to-Provider Communication in Rural Communities – October 5 UMMC Caregiver University for Alzheimer's Support – Quarterly deadlines until October 10 American Psychological Foundation Grant for Rural First Responders Mental Health Interventions – October 15 NIH Pilot Interventions to Integrate Social Care and Medical Care for Diabetes, Digestive, and Kidney Diseases – October 19 NIH Researching Social Networks to Promote Behavior Change – November 3 Ongoing Opportunities HRSA Needs Rural Reviewers for Grant Applications Economic Development Administration Public Works/Economic Assistance Program (CARES Act Funding) Extended Public Comment Period for FCC's COVID-19 Telehealth Program FCC Affordable Connectivity Program for Broadband Service SAMHSA 988 Suicide and Crisis Lifeline Volunteer and Job Opportunities USDA Emergency Rural Health Care Grants (Track One only) – September 2023 or until funds run out ACF Low Income Home Energy Assistance Program ACF Rural Community Development Program for Rural Water Systems Addiction Policy Forum: Sites for Anti-Stigma Pilot AgriSafe Mental Health Training for Agricultural Producers & Families AHRQ Health Services Research Demonstration and Dissemination Grants – October 2023 American Association of Birth Centers (AABC) Foundation - Accreditation Grants American Heart Association Rural Health Care Outcomes Accelerator American Indian Public Health Resource Center Technical Assistance AmeriCorps American Connection Corps for Broadband in Rural Areas Appalachian Regional Commission J-1 Visa Waivers for Doctors ASA Rural Access to Anesthesia Care Scholarship Burroughs Wellcome Fund Seed Grants for Climate Change and Health – Quarterly through August 2023 CDC Direct Assistance to State, Tribal, Local, and Territorial Health Agencies CDC Training Pediatric Medical Providers to Recognize ACEs CORH Targeted Technical Assistance for Rural Hospitals Program Delta Region Community Health Systems Development Program Delta Regional Authority Community Infrastructure Fund Delta Doctors J-1 Visa Waiver Program Department of Commerce: Economic Development Assistance Programs DRA Technical Assistance for Delta Region Community Health Systems Development EPA Drinking Water State Revolving Fund EPA Water Infrastructure and Innovation Program FEMA/SAMHSA Post-Disaster Crisis Counseling Assistance and Training Program GPHC & RWJF: Rapid Cycle Research and Evaluation Grants for Cross-Sector Alignment HRSA Seeking Nominations for Migrant Health Advisory HRSA Technical Assistance for Look-Alike Initial Designation for the Health Center Program Housing Assistance Council: Housing Loans for Low-Income Rural Communities HUD Distressed Cities and Persistent Poverty Technical Assistance Program HUD Hospital Mortgage Insurance Program IHS Tribal Forensic Healthcare Training IHS/DOD Medical Supplies and Equipment for Tribes (Project TRANSAM) NARHC Certified Rural Health Clinic Professional Course National Health Resource Center on Domestic Violence Technical Assistance Native Americans into Medicine Host Sites for National Environmental Public Health Internship NIH Addressing the Impact of Structural Racism and Discrimination – Various dates until October 2025 NIH Native American Research Centers for Health – Various dates until July 2026 NIH Project Talk Initiative Host Site Applications NIH Researching Mental Health Practices in Low-Resource Settings – September 2024 NIH Researching Social, Behavioral, and Economic Impact of COVID-19 in Underserved/Vulnerable Populations – September 2024 NIH Researching the Role of Work in Health Disparities – Various dates until September 2024 NIH Special Interest Research – Pandemic Impact on Vulnerable Children and Youth – May 2024 NIH Researching Barriers to Care for HIV-Associated Comorbidities – May 2025 NIH Research to Address Vaccine Hesitancy in Health Disparity Populations – June 2026 Nominations for Federal Advisory Commission on HIV, Viral Hepatitis, and Sexually Transmitted Diseases NRHA Chief Nursing Officer Certification Program for Rural Hospitals Oweesta Native CDFI Loan Funds and Technical Assistance Primary Care Development Corporation Community Investment Loans Rural Community Assistance Corporation Community Facility Loans for Western States and Pacific Islands Rural Community Assistance Corporation Environmental Infrastructure Loans for Western States Rural Graduate Medical Education Planning and Development RTT Collaborative: Rural Training Track Directors University RWJF Investigator-Initiated Research to Build a Culture of Health RWJF Pioneering Ideas Brief Proposals SAMHSA Crisis Counseling Assistance and Training Program for Communities Post-Disaster SAMHSA Training to Provide Medication Assisted Treatment SBA Guaranteed Loans for Small Business Southeast Rural Community Assistance Loans Tribal Grant Writing Training Treasury Department Opportunity Zone Economic Development Program United South and Eastern Tribes, Inc Tribal Health Program Support USDA Community Facilities Program USDA Community Food Projects Technical Assistance USDA Drinking Water and Waste Disposal for Rural and Native Alaskan Villages USDA Economic Impact Initiative Grants USDA Emergency Community Water Assistance Grants USDA Healthy Food Financing Initiative Technical Assistance USDA Multifamily Housing Loan Guarantees USDA Intermediary Relending Program USDA Rural Business Development Grants USDA Rural Business Investment Program USDA Rural Energy Savings Program USDA SEARCH – Special Evaluation Assistance for Rural Communities and Households (for Water/Waste Projects) USDA Summer Food Program USDA Technical Assistance for Healthy Food Financing Initiative USDA Telecommunications Infrastructure Loans and Loan Guarantees USDA Funding for Rural Water and Waste Disposal Projects USDA Water and Waste Disposal Grants to Alleviate Health Risks on Tribal Lands and Colonias USDOT Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S) Veterans Affairs Health Professional Scholarship Program Veterans Affairs Virtual Living Room - Using Technology to Address the Critical Healthcare Needs of Veterans in Rural Areas WWAMI Area Health Education Center Scholars Program | 
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