Webinar: HPSA 101 for Rural Health Clinics

Date: December 2, 2020

Time: 1:00 PM CT


A HPSA (Health Professional Shortage Area) designation allowed you to initially setup your Rural Health Clinic (RHC), but what are the other major RHC benefits tied to this Federal designation? Join HPSA Acumen, Inc. and the National Association of Rural Health Clinics on December 2, 2020, at 2pm Eastern for a webinar with experts from HPSA Acumen, Inc. who will discuss the benefits currently available to RHCs, how to apply for them, and what the next steps are to securing those incentives. Some of those benefits include education loan forgiveness, J-1 visa waivers, state and federal grants, and expedited physician licensing to help increase access to care. 

This webinar is being provided free of charge. However, you must register in advance.  

When the webinar begins you will be connected to audio using your computer’s speakers.

If you have issues registering and are using Internet Explorer, try using another browser. If you continue to have issues, please contact 866.306.1961 for assistance.

A copy of the slides and a recording will be available within a few days after the webinar is complete at: https://www.narhc.org/narhc/TA_Webinars1.asp.

If you have any questions about registering please email asst@narhc.org.

CMS Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge

November 25, 2020

The Centers for Medicare & Medicaid Services (CMS) outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus disease 2019 (COVID-19) hospitalizations across the country. These flexibilities include allowances for safe hospital care for eligible patients in their homes and updated staffing flexibility designed to allow ambulatory surgical centers (ASCs) to provide greater inpatient care when needed. Building on CMS’s previous actions to expand the availability of telehealth across the nation, these actions are aimed at allowing health care services to be provided outside a hospital setting while maintaining capacity to continue critical non-COVID-19 care, allowing hospitals to focus on the increased need for care stemming from public health emergency (PHE).

“We’re at a new level of crisis response with COVID-19 and CMS is leveraging the latest innovations and technology to help health care systems that are facing significant challenges to increase their capacity to make sure patients get the care they need,” said CMS Administrator Seema Verma. “With new areas across the country experiencing significant challenges to the capacity of their health care systems, our job is to make sure that CMS regulations are not standing in the way of patient care for COVID-19 and beyond.”

Acute Hospital Care at Home

In March 2020, CMS announced the Hospitals Without Walls program, which provides broad regulatory flexibility that allowed hospitals to provide services in locations beyond their existing walls. CMS is expanding on this effort by executing an innovative Acute Hospital Care At Home program, providing eligible hospitals with unprecedented regulatory flexibilities to treat eligible patients in their homes. This program was developed to support models of at-home hospital care throughout the country that have seen prior success in several leading hospital institutions and networks, and reported in academic journals, including a major study funded by a Healthcare Innovation Award from the Center for Medicare and Medicaid Innovation (CMMI).

The program clearly differentiates the delivery of acute hospital care at home from more traditional home health services. While home health care provides important skilled nursing and other skilled care services, Acute Hospital Care at Home is for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis.

To support these efforts, CMS has launched an online portal https://qualitynet.cms.gov/acute-hospital-care-at-home to streamline the waiver request process and allow hospitals and healthcare systems to submit the necessary information to ensure they meet the program’s criteria to participate. CMS will also closely monitor the program to safeguard beneficiaries by requiring hospitals to report quality and safety data to CMS on a frequency that is based on their prior experience with the Hospital At Home model.

Ambulatory Surgical Center (ASC) Flexibility

As part of Hospital Without Walls, CMS also previously announced regulatory flexibility that allowed ASCs – facilities that normally provide same-day surgical care – the ability to be temporarily certified as hospitals and provide inpatient care for longer periods than normally allowed, with the appropriate staffing in place. ASCs are normally subject to a requirement that patients only remain in their care for less than 24 hours or require admission to a regular hospital.

CMS is announcing an update to that regulatory flexibility, clarifying that participating ASCs need only provide 24-hour nursing services when there is actually one or more patient receiving care onsite. The program change provides ASCs enrolled as hospitals the ability to flex up their staffing when needed and provide an important relief valve in communities experiencing hospital capacity constraints, while not mandating nurses be present when no patients are in the ASC. The flexibility is available to any of the 5,732 ASCs throughout the country seeking to participate and will be immediately effective for the 85 ASCs currently participating in the Hospital Without Walls initiative. CMS expects this flexibility will allow these and additional ASCs enrolled as hospitals to serve as an added access point that will allow communities to maintain surgical capacity and other life-saving non-COVID-19, like cancer surgeries. Allowing these types of treatments to occur in designated ASCs enrolled as hospitals while hospitals are managing any surges of COVID-19 would allow vulnerable patients to receive this needed care in settings without known COVID-19 cases.

The announcement builds upon the critical work by CMS to expand telehealth coverage to keep beneficiaries safe and prevent the spread of COVID-19. CMS has expanded the scope of Medicare telehealth to allow Medicare beneficiaries across the country to receive telehealth services from any location, including their homes. CMS also added over 135 services such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, that could be paid when delivered by telehealth. The flexibilities announced today, and the aggressive action taken by CMS to remove barriers to telehealth, ensure patients and providers have options when receiving and providing care given the challenges and additional stress placed on hospitals and the health care system during the COVID-19 PHE.

To view the Acute Hospital Care At Home initiative and application, please visit: CMS’: https://qualitynet.cms.gov/acute-hospital-care-at-home  

For more on the ambulatory surgical center flexibilities, please see: https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/guidance-processing-attestation-statements-ambulatory-surgical-centers-ascs-temporarily-enrolling

To view comments from health systems participating in the Acute Hospital Care at Home, please visit: https://www.cms.gov/files/document/what-are-they-saying-hospital-capacity.pdf

Link to FAQs:


COVID-19 Cases and Deaths, Metropolitan and Nonmetropolitan Counties Over Time

A new rural policy data brief is available from the RUPRI Center for Rural Health Policy Analysis.

Fall 2020 has seen a dramatic increase in COVID-19 case and mortality rates in the United States. This data brief compares 7-day moving average COVID-19 incidence and mortality rates between metropolitan, micropolitan, and noncore counties in the United States.

Please click here to read the brief.  

Funding: Advanced Nursing Education – Sexual Assault Nurse Examiners (ANE-SANE) Program

Funding Opportunity Number: HRSA-21-016

Apply for this grant on grants.gov through February 17, 2021.

The Health Resources and Services Administration (HRSA) is accepting applications for fiscal year (FY) 2021 for the Advanced Nursing Education – Sexual Assault Nurse Examiners (ANE-SANE) Program. This program will increase access to physical and mental health care treatment for survivors of sexual assault and domestic violence. Grantees will train Sexual Assault Nurse Examiners (SANEs) to practice in rural and underserved health settings.

Eligible applicants are accredited:

  • Schools of nursing
  • Nursing centers
  • Nurse-managed health clinics
  • Academic health centers
  • State or local health departments
  • HRSA-supported health centers
  • Rural health clinics
  • Public or non-profit hospitals

Refer to page 8 of the funding opportunity to view all eligible applicants.

HRSA expects approximately $8 million to be available in FY 2021 to fund 16 grantees.

For a complete list of funding opportunities, visit the HRSA website.

Technical Assistance

The following technical assistance webinar has been scheduled to help applicants understand, prepare, and submit an application for this notice of funding opportunity (NOFO).

Date: Monday, December 7, 2020
Time: 1:00 – 2:30 p.m. ET

Link: https://hrsa.connectsolutions.com/ane-sane-2021-nofo/
Call-In: 888-989-6513
Participant Code: 3913569


CMS Announces Historic Changes to Physician Self-Referral Regulations

November 22, 2020

The Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based reimbursement. The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from sending a patient for many types of services to a provider that the physician owns, is employed by, or otherwise receives payment from—regardless of what that payment is for.  The old federal regulations that interpret and implement this law were designed for a health care system that reimburses providers on a fee-for-service basis, where the financial incentives are to deliver more services. However, the 21st century American health care system is increasingly moving toward financial arrangements that reward providers who are successful at keeping patients healthy and out of the hospital, where payment is tied to value rather than volume.

Full press release

Primary Care First Participants Announced

The Center for Medicaid and Medicaid Innovation is excited to announce details on the first cohort of Primary Care First participants, including the 916 primary care practices and 37 regional partnerships with commercial, State, and Medicare Advantage plans partnering across the selected Primary Care First regions.

Primary Care First is a voluntary, five-year alternative payment model that will reward value and quality by offering innovative payment model structures to support delivery of advanced primary care. The Primary Care First Payment Model Option will begin on January 1, 2021.

Monitor the Primary Care First webpage for future model updates. Please contact PrimaryCareApply@telligen.com with any questions or comments.

Community Health Access and Rural Transformation (CHART) Model Community Transformation Track Factsheet

The Centers for Medicare and Medicaid Services (CMS) released a factsheet providing information on the State Medicaid Agency’s role in the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track. CMS announced the Notice of Funding Opportunity (NOFO) for the Community Transformation Track in September. Applications are due by February 16, 2021.