| Read this in your browser July 25, 2025 What's New Rural Hospital Stabilization Program (RHSP) Fall 2025 Cohort – August 20. The FORHP-funded National Rural Health Resource Center (the Center) provides tailored assistance to help hospitals improve financial stability, expand needed community services, and keep care close to home. Eligible facilities include Critical Access Hospitals, Prospective Payment System hospitals, Rural Emergency Hospitals, and Indian Health Service hospitals. Last month, the Center announced eight hospitals that were selected for the first cohort. Space is limited, so register now for a webinar for applicants on Wednesday, August 5. 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. Interstate Occupational Licensure Arrangements to Expand Access to Behavioral Health Services. This policy brief from the WWAMI Rural Health Research Center describes state-based provisions to expand behavioral health services through interstate licensure arrangements for psychologists, social workers, licensed professional counselors, marriage and family therapists, and school psychologists, including licensure compact agreements and licensure portability models. Policy Updates Send questions to ruralpolicy@hrsa.gov. Revised Interpretation of "Federal Public Benefit." The U.S. Department of Health and Human Services (HHS) issued a Federal Register Notice that revises the 1998 interpretation of the term "Federal public benefit" as used in Title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). Read the Federal Register Notice. The notice establishing this revised policy interpretation takes effect immediately upon publication in the Federal Register and has a 30-day comment period that ends at 11:59 p.m. ET on Wednesday, August 13, 2025. See the HHS press release. CMS Limits Certain Medicaid Demonstration Authorities. Last week, the Centers for Medicare & Medicaid Services (CMS) informed states that it does not anticipate approving new or existing Section 1115 Demonstrations that expand continuous eligibility or test workforce initiatives. Under federal regulations, states generally must redetermine a beneficiary's eligibility once every 12 months. Using Section 1115 waivers, states were allowed to expand continuous eligibility - increasing the length of time that individuals could stay enrolled in Medicaid or CHIP, instead of proving their eligibility annually. States also used these waivers to test initiatives to expand the health workforce, such as student loan repayment and workforce training programs to recruit and retain providers, through the Medicaid program. States with currently approved Section 1115 waivers for expanded continuous eligibility must notify beneficiaries about any changes to their current period of continuous eligibility and when the beneficiary will need to undergo their next redetermination. CMS will allow currently approved workforce initiatives in California, Massachusetts, New York, North Carolina, and Vermont to run their course. CMS Proposes to Decrease Hospital Outpatient Payments for Non-Drug Items and Services to Offset Higher Payments Made as a Result of 340B Payment Policy – Comment by September 15. Between 2018 and 2022, the Centers for Medicare & Medicaid Services (CMS) decreased Medicare reimbursements to hospitals paid under the outpatient prospective payment system (OPPS) for drugs acquired through the 340B Drug Pricing Program ("340B Program"), a Health Resources and Services Administration (HRSA) program that allows covered entities to purchase certain outpatient drugs at discounted prices from drug manufacturers. To maintain budget neutrality, CMS redistributed the savings to all hospitals paid under the OPPS by increasing their payment rates for non-drug items and services. In 2022, the Supreme Court held that because CMS did not conduct a survey of hospitals' acquisition costs, they could not vary the payment rates for outpatient prescription drugs by hospital group. In response, CMS finalized in the Final Remedy rule that 340B hospitals would receive a one-time lump sum payment reimbursing them for the decreased drug payments, and CMS would reduce payments for non-drug items and services to all OPPS providers by 0.5 percent starting in 2026 until the total offset was reached (estimated to be about 16 years). In the Medicare OPPS proposed rule released last week, Approaching Deadlines CMS Wasteful and Inappropriate Service Reduction (WISeR) Model – July 25 HHS Revised the Interpretation of "Federal Public Benefit" – Comment by August 13 CMS Seeks Input on the Estimated Burden to Meet Emergency Preparedness Requirements – Comment by August 19 Rural Hospital Stabilization Program – Fall 2025 Cohort – August 20 CMS Proposed Rule for CY 2026 End Stage Renal Disease Prospective Payment System – Comment by August 29 CMS Rate Update for CY 2026 Home Health Prospective Payment System – Comment by August 29 CMS Proposes Updates to Medicare Physician Fee Schedule Payments – Comment by September 12 CMS Proposes Updates to Medicare Hospital Outpatient Prospective Payment System – Comment by September 15 Ongoing Opportunities Bold indicates HRSA- and/or FORHP-funded opportunities. Administration for Children & Families: Low Income Home Energy Assistance Program Cybersecurity & Infrastructure Security Agency – Technical Assistance for Rural EMS Communications Delta Regional Authority: Community Infrastructure Fund Delta Region Community Health Systems Development Program General Services Administration: Federal Surplus Property Available for Public Use HRSA Needs Rural Reviewers for Grant Applications HRSA National Health Service Corps/SAMHSA: Medications for Opioid Use Disorder Training HRSA Technical Assistance for Look-Alike Initial Designation for the Health Center Program Indian Health Service/Department of Defense: Medical Supplies and Equipment for Tribes (Project TRANSAM) Licensure Portability: The Multi-Discipline Licensure Resource Project National Rural Health Resource Center: Rural Hospital Stabilization Program ProviderBridge: Mobilizing Health Care Workforce via Telehealth Rural Graduate Medical Education Planning and Development Small Business Administration Guaranteed Loans for Small Business Small Business Administration Rural Initiative Pilot Program Substance Abuse and Mental Health Services Administration/Federal Emergency Management Agency/: Post-Disaster Crisis Counseling Assistance and Training Program Targeted Technical Assistance for Rural Hospitals Program USDA: National School Lunch Afterschool Snack Program USDA: Summer Food Service Program USDA/National Rural Health Association: Rural Hospital Technical Assistance USDA Rural Development: America's Healthy Food Financing Initiative USDA Rural Development: Circuit Rider Program – Technical Assistance for Rural Water Systems USDA Rural Development: Community Facilities Program USDA Rural Development: Economic Development Loans & Grants – Ongoing with deadlines every quarter USDA Rural Development: Emergency Community Water Assistance Grants USDA Rural Development: Grants for Rural and Native Alaskan Villages USDA Rural Development: Intermediary Relending Program – Ongoing with deadlines every quarter USDA Rural Development: Multifamily Housing Loan Guarantees USDA Rural Development: Rural Business Investment Program USDA Rural Development: Rural Energy Savings Program USDA Rural Development: SEARCH – Special Evaluation Assistance for Rural Communities and Households (for Water/Waste Projects) USDA Rural Development: Telecommunications Infrastructure Loans and Loan Guarantees U.S. Department of Transportation: Rural Opportunities to Use Transportation for Economic Success (R.O.U.T.E.S) U.S. Environmental Protection Agency: Drinking Water State Revolving Fund U.S. Department of Veterans Affairs: Physical Therapy Telehealth Research Study for Older Veterans – Ongoing until October 2026 | 
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