Rural Health Policy

Regulatory Review

The Federal Office of Rural Health Policy is charged in Section 1102(b) of the Social Security Act with advising the Secretary of the U.S. Department of Health and Human Services on the effect that federal health care policies and regulations may have on rural communities. Monitoring current and proposed changes, including programs established under titles XVIII and XIX (Medicare and Medicaid), FORHP analyzes their impact on the financial viability of small rural hospitals and clinics, on the ability of rural areas to attract health professionals, and on rural areas’ access to high quality care.

Data collection and analysis is essential to understanding the challenges in rural communities, how those communities are impacted by policy, and setting policy for the future. For this reason, the work of the Rural Health Research Centers informs that of FORHP’s policy team and vice versa.

Policy Announcements

January 11-15

Request for Comments: Improvements to Quality Reporting. On December 31st, CMS and the Office of the National Coordinator for Health Information Technology (ONC) issued a Request for Information to inform future rulemaking on health information technology (IT) certification.  Specifically, they are requesting feedback on how often to require recertification, the number of clinical quality measures to which a certified Health IT Module should be certified, and ways to improve testing of certified Health IT Module(s). This is a chance to inform policy for health IT and quality reporting requirements from the unique perspective of rural providers. Comments must be submitted by 5 p.m. ET on Monday, February 1.  

December 7-11

Cut to Inpatient Prospective Payment. On December 1, the Centers for Medicare & Medicaid Services (CMS) published a notice with comment period explaining its rationale and methodology for a 0.2% cut to inpatient hospital payments based on an increase in inpatient encounters due to the two-midnight policy. CMS is requesting public comment on its methodology for calculating the cut and the appropriateness of alternative methods. Comments are due February 2, 2016.

October 26-30

On October 29, the Centers for Medicare & Medicaid Services (CMS) announced its final rule updating Medicare payment rates for home health agencies (HHAs) for 2016. As authorized by the Affordable Care Act, the rule launches a new Home Health Value-Based Purchasing model to begin January 1, 2016 for all Medicare-certified HHAs in nine states: Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee. Of note for rural HHAs, the rule implements the extension of the 3% rural add-on payment through January 1, 2018 as authorized by the Medicare Access and CHIP Reauthorization Act of 2015.

On October 29, The Centers for Medicaid & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced rules for the third and final stage of Meaningful Use, the set of standards for using Electronic Health Records (EHRs). The new regulations aim to “ease the reporting burden for providers, support interoperability, and improve patient outcomes.” CMS provides a fact sheet on EHR Incentive Programs going forward and seeks public comment, particularly from rural providers, about quality measurements aligning with the Medicare Access and CHIP Reauthorization Act (MACRA).

On October 30, CMS released a final rule updating Medicare payment rates for calendar year 2016 under the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment System. The rule finalizes several policy changes, including a payment transition for former Medicare Dependent, Small Rural Hospitals (MDH), and changes to the Two-Midnight rule for short inpatient stays. 

Last Reviewed: November 2015