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Announcements from the Federal Office of Rural Health Policy

February 18, 2015

Hot off the Presses

1. As we head into the final stretch of this Marketplace Open Enrollment period, the staff of the Federal Office of Rural Health Policy wants to thank you for all the work you have been doing to enroll rural Americans. As of January 16, over 1.3 million rural Americans have enrolled in 2015 Marketplace plans, 18 percent of those individuals enrolling in coverage in the 37 states using the Federally Facilitated Marketplace.  Please continue to encourage your patients and community to visit gov or contact the Marketplace call center to learn about their options and the financial help that is available. If you need ideas for ways to reach individuals and families in your community, our office has compiled a guide of Best Practices in Rural Outreach and Enrollment based on feedback from grantees during the last Outreach and Enrollment period. Again, February 15th is the final deadline to enroll before Open Enrollment ends. This is an opportunity for all of us to help as many rural Americans as possible secure affordable, quality health insurance and access health care services.  From all of us here in the Federal Office of Rural Health Policy, thank you for your contribution to improving the health of individuals and families across the country.

2. HHS recently announced a major new initiative focused on health care delivery system reform.  This initiative, which was launched by HHS Secretary Sylvia M. Burwell on January 26th, included measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they give patients. To support these activities, HHS is creating a Health Care Payment Learning and Action Network that will involve both public and private sector stakeholders. You can read more about the initiative in this link: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html. We want to hear from rural providers about the implications of this work by sending us feedback at: RuralDSR@hrsa.gov.

3. FORHP is pleased to announce the release of the Rural Health Care Coordination Network Partnership Program, a new one-time funding opportunity.  The purpose of the three-year pilot program is to support the development of formal, mature rural health networks that focus on care coordination activities for the following chronic conditions:  type 2 diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD).  FORHP plans to award up to 8 new awards for $200,000 per award each year.  The deadline to apply is April 6th.  For further information, please contact: Sara Afayee at safayee@hrsa.gov or (301) 945-4169.

Events and Webinars

4. The National Advisory Committee on Rural Health and Human Services invites you to two webinars on topics the Committee has addressed in recent years. In the first webinar on February 18th at 2 PM Eastern, the Committee will discuss two briefs that cover topics related to the Affordable Care Act. The first brief details best practices for Affordable Care Act Outreach, Education, and Enrollment in rural communities. The second brief discusses pricing of insurance plans and premiums for rural populations on the 2014 Health Insurance Marketplaces. A brief on the provision of hospice benefits to the rural population will also be discussed. Click here for more information and to register for the February 18th

The second webinar, on February 26th at 2 PM Eastern, will cover two recent briefs from the Committee on rural human services topics. The first brief focuses on the intersection of federal human services programs and rural poverty, including case studies on two different types of anchor organizations to coordinate human services in rural communities. The second brief addresses the unique needs and characteristics of individuals and families experiencing homelessness in rural America. Click here for more information and to register for the Feb 26th webinar.

5. The Federal Office of Rural Health Policy will be hosting a final “ORHP, ACA, and You” Office Hours webinar on February 18.  This webinar will focus on drawing lessons from the 2015 Open Enrollment period and informing assisters about policy concerns for the 2015 Marketplace. Specifically, the presentation will focus on addressing network adequacy. Rural health researcher Tim Size from the Rural Health Wisconsin Cooperative will be presenting his findings on this subject. Please find call details below:

Wednesday February 18
Dial-in: 800-779-8692
Participant Passcode: 5192826
Adobe Connect Session: https://hrsa.connectsolutions.com/orhp_officehours_0218/

6. The SAMHSA-HRSA Center for Integrated Health Solutions invites you to a webinar on Thursday, February 26th from 2-3:30 PM Eastern get an overview of integration models used in rural settings, planning best practices, financing considerations, and implementation strategies for primary care and behavioral health providers to collaborate and better meet the behavioral health needs of their communities. Learn how one rural primary care provider successfully collaborated with a behavioral health organization and the local Medicaid plan to improve the health status of the community, including reducing depression and substance abuse. For more information and to register, click here.

7. The Mid-Atlantic Telehealth Resource Center (MATRC), a Federal Office of Rural Health Policy (FORHP) grantee, is holding its annual Telehealth Summit March 29th – 31st at the Greenbrier in White Sulphur Springs, WV. The theme of the Summit is “Next Generation Telehealth in a World of Accountable Care.” In addition, there will be three special Pre-Summit workshops on Sunday, March 29 on the topics of Telehealth 101; Critical Access Hospitals; and Telemental Health for Counselors, Psychologists, and Other Behavioral Health and Substance Abuse Providers. For more information and/or to register, please visit:  http://matrc.org/summit/index.html

8. Save the Date – The FORHP will be hosting a webinar on the Veterans Choice Program on Tuesday, March 3, 2015 from 3pm – 4pm.  The Veterans Choice Program is a new program from the Department of Veterans Affairs (VA) that expands access to health care to thousands of veterans by allowing them to receive care from non-VA health care providers. More details on the webinar will be forthcoming.

9. The American Public Health Association’s Rural and Frontier Health Committee will be holding a webinar titled: “Using the Chartbook Data to Make a Difference in Rural Health Outcomes”, on Monday, February 23rd at 2 PM Eastern.This webinar will discuss approaches for effectively using data from the recently published rural health chartbook to advance and enhance rural population health.  Alana Knudson and Michael Meit from the National Opinion Research Center (NORC) will present and facilitate discussion of paths forward.

To register for the webinar, go to http://mcdph.org/regdetail.asp?L=417.

Funding Opportunity Announcements

10. The Federal Office of Rural Health Policy (FORHP) is pleased to announce the release of the Rural Outreach Benefits Counseling Program (Benefits Counseling), a new one-time funding opportunity. The purpose of the three-year pilot program is to expand health insurance outreach, education, and enrollment efforts to eligible uninsured and newly insured individuals and families in rural communities. FORHP plans to award up to 10 new awards for $75,000 per award each year. The deadline to apply is March 30th.  For further information, please contact: Linda Kwon at lkwon@hrsa.gov or (301) 594-4205.

11. In response to the White House Job-Driven Training initiative, the FORHP is pleased to announce the release of the Rural Network Allied Health Training Program (Allied Health Training), a new one-time funding opportunity. The Allied Health Training Program supports the President’s Rural Health Care Initiative by focusing on rural recruitment and retention activities and builds upon the accomplishments of the Rural Health Workforce Development (RHWD) pilot program, which ended in 2013. The deadline to apply is March 31st.  For further information, please contact: Marcia Colburn at mgreen@hrsa.gov or (301) 443-3261.

Other Useful Information and Resources

12. HRSA’s Black Lung/Coal Miner Clinics Program (BLCP) in collaboration with The Division of Coal Mine Workers’ Compensation, better known as the Federal Black Lung Program (FBLP) in the U.S. Department of Labor (DOL), is in need of additional physicians to perform disability evaluations. The FBLP processes claims for benefits by miners to determine if they are totally disabled by pneumoconiosis, and must provide miners with a complete pulmonary evaluation performed by a highly-qualified physician, particularly physicians who are certified in internal medicine, pulmonary disease, or other appropriate specialties.

Please contact Tracey Teague, DCMWC Training and Outreach Coordinator, at 202-343-5905 or Teague.tracey@dol.gov if you or a provider you know are interested in performing disability testing for miners, or if you have any questions about our program. DCMWC will work with providers to make sure any special needs–such as secondary billing for lab testing, tests performed at another location, etc.—are accommodated.  DCMWC will also work with providers to make sure that miners will be afforded a complete pulmonary examination that complies with the law and regulations.

13. ADDITIONAL UPDATED INFO:   Please submit automatic HPSA attestation forms to HRSA, not to CMS.  HRSA/FORHP will provide an updated list of RHCs with automatic HPSA designations to CMS.

For the 2016 Marketplace insurance plan year, CMS has released a draft list of Essential Community Providers (ECPs). For the first time, the list includes many Rural Health Clinics (RHCs). ECPs are providers who care for predominantly low-income, medically underserved individuals. Under the Affordable Care Act, insurers (called Qualified Health Plan issuers) must include a minimum number of ECPs within their provider networks for plans sold on the insurance Marketplaces.  Insurers can use the list to select ECPs to include in their provider networks. The draft list of ECPs and a description of the list are available here.  Scroll down to the section titled “Other QHP Application Resources.”

An RHC is included on the list if it meets the following requirements.

  • Based on attestation, it accepts patients regardless of ability to pay and offers a sliding fee schedule, or it is located in a primary care Health Professional Shortage Area (geographic, population, or automatic); and
  • It accepts patients regardless of coverage source (i.e., Medicare, Medicaid, CHIP, Marketplace plan, etc.).

More than 3,300 RHCs currently meet these requirements and are included on the 2016 list.  Any RHC not on the list is eligible to be added to a future version of the list by completing a form (the one used for automatic HPSA designation) available here and faxing it to HRSA, along with a copy of the clinic’s sliding fee schedule.  Please note that the fax number provided on the form is incorrect; use 301-443-2111 or 301-443-0463 instead.  More info about the RHC auto HPSA designation process is available here.

14. CMS recently announced that it plans to shorten the 2015 Medicare Meaningful Use reporting period to 90 days through rulemaking this Spring. This is the result of concerns raised by providers about their ability to deploy 2014 Edition Certified EHR Technology. CMS is also planning to realign hospital reporting periods to the calendar year, and to modify other aspects of Meaningful Use to match long-term goals, reduce complexity, and lessen providers’ reporting burden. These changes are being proposed separately from the Meaningful Use stage 3 proposed rule, which is also being developed and will address the program framework in 2017 and beyond.For more information about the CMS EHR Incentive Program, please visit: http://www.cms.gov/EHRIncentivePrograms.

15. On December 31st, the IRS published Final Rule, “Additional Requirements for Charitable Hospitals: Community Health Needs Assessments for Charitable Hospitals.” Finalizing regulations published in the proposed rule of April 2013, this final rule authorizes not-for-profit hospitals to include outreach and education about health insurance options such as Medicaid, CHIP, and the Marketplace in their implementation strategy if their community health needs assessment indicates high levels of low-income and uninsured patients in the hospital’s service area. As implementation strategies are included as a part of a hospital’s community benefit reporting, this rule permits most rural hospitals to include outreach and enrollment activities in their community benefit reporting. Find more information about strategies rural hospitals have employed in outreach and enrollment activities on the Rural Health Research Gateway.

This rule also provides guidance and implementation instructions for hospital Financial Assistance Policies, limits on charges to patients eligible under those policies, and related reporting requirements created by the Affordable Care Act (P.L. 111-148). The final regulations apply to a hospital facility’s taxable years beginning after December 29, 2015, although large sections have been in effect as similar interim regulations for some time. Hospital and community partners should know that these final regulations have been published. People responsible for reporting and compliance at tax-exempt hospitals (including Form 990 and Schedule H) should be familiar with all of these requirements.

16. Click here for the latest issue of MLN Connects, a weekly newsletter that gives provider news and updates that may affect how rural providers are impacted by CMS rollouts. Previous issues and a link to subscribe to MLN Connects are available in the archive.

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