HUD Commits $54.5 Million to Rural Housing and Social Supports 

Date: June 27, 2022

HUD Commits $54.5 Million to Rural Housing and Social Supports  

The U.S. Department of Housing and Urban Development (HUD) announced a broad, new initiative to connect individuals and families to housing, health care, and supportive services. Total funding of $322 million is a supplement to HUD’s Continuum of Care (CoC) Program, with $43 million for incremental housing vouchers for at-risk households, and $54 million set aside for projects in rural areas. The Supplemental to Address Unsheltered and Rural Homelessness requires collaboration among housing authorities, health care organizations, and those that provide support for individuals and families facing issues that often lead to homelessness – such as domestic violence, youth trauma, and substance use disorder. HUD will hold a 90-minute Kick Off Webinar on Tuesday, June 28 at 2:30 PM ET.  The Federal Office of Rural Health Policy will provide further details for rural health providers in a webinar on Thursday, June 30 at 2:00 PM ET. 

Rheumatology Symposium

Date: June 22, 2022

Registration is open!

10th Annual James and Nancy Cassidy Rheumatology Symposium to be held virtually October 21, 2022

The purpose of this symposium is to provide a forum for updating health professionals interested in the treatment of rheumatologic diseases, increase awareness of rheumatologic diseases and provide continuous medical education to the health care community.

Virtual Event information and registration is available on the website. Register today!

2022 Rheumatology Brochure

Accreditation Information

Activity approved for AMA PRA Category 1 Credits

American Board of Pediatrics (ABP) MOC Part 2 Points

Presented By:

MU School of Medicine: Department of Child Health, Division of Pediatric Rheumatology
James T. and Nancy D. Cassidy Endowed Lectureship Fund | MU Extension
Continuing Education for Health Professions

Social and Emotional Support during the COVID-19 Pandemic by Sexual Orientation and Rurality

Date: June 22, 2022

Social and Emotional Support during the COVID-19 Pandemic by Sexual Orientation and Rurality

Rural residents face distinct risks for social isolation and loneliness, as do lesbian, gay, and bisexual (LGB) adults. This policy brief examines nationally representative data on social and emotional supports during the COVID-19 pandemic by rurality and sexual orientation.

Key Findings

  • Rural LGB adults reported the lowest levels of having their social and emotional needs met.
  • Approximately 32.7% of rural LGB adults said those needs were always met (versus 55.7% of rural heterosexual adults).
  • Rural LGB adults also reported the greatest decrease in social and emotional support during the COVID-19 pandemic, with 23.5% saying they had less support than they had a year ago.

Contact Information:

Mariana Story Tuttle, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401

Additional Resources of Interest:

COVID-19 Therapeutics Webinar with the U.S. Surgeon General

Date: June 22, 2022

The U.S. Department of Health and Human Services (HHS) remains committed to distributing vaccines and therapeutics for free to communities across the country. While vaccines still remain the best way out of the pandemic, there are therapeutics, both pre-treatment and treatments, available that can help those at highest risk. It’s not only critical that health care providers are aware of and understand the eligibility criteria for prescribing these medications, but it’s also imperative that potential patients are armed with the right information that can help quickly connect them with these critical drugs.

Join the U.S. Surgeon general along with subject matter experts from the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) for a webinar and interactive discussion on the current COVID-19 therapeutics landscape and opportunities for increased outreach and education across providers and consumers. HHS encourages members from patient advocacy groups as well as clinicians to join this important call.
What: Discussion with the U.S. Surgeon General on COVID-19 Therapeutics
Date: Thursday, June 23, 2022
Time: 2:00 PM – 3:00 PM ET

Register Here

Dr. Vivek Murthy, U.S. Surgeon General
Dr. Meg Sullivan, ASPR Chief Medical Officer
Dr. Meghan Pennini, ASPR Therapeutics Director
Dr. Michael Anderson, ASPR Senior Advisor
Dr. Derek Eisnor, ASPR/BARDA Medical

CY 2023 Proposed Payment Updates and Policy Changes Updates for Home Health Agencies and Home Infusion Therapy Suppliers

Date: June 22, 2022

Proposals and Updates to the HH PPS for CY 2023

This rule proposes routine, statutorily required updates to the home health payment rates for CY 2023. The Centers for Medicare and Medicaid Services (CMS) estimates that Medicare payments to Home Health Agencies (HHAs) in CY 2023 would decrease in the aggregate by -4.2%, or -$810 million compared to CY 2022, based on the proposed policies. This decrease reflects the effects of the proposed 2.9% home health payment update percentage ($560 million increase), an estimated 6.9% decrease that reflects the effects of the proposed prospective, permanent behavioral assumption adjustment of -7.69% ($1.33 billion decrease), and an estimated 0.2% decrease that reflects the effects of a proposed update to the fixed-dollar loss ratio (FDL) used in determining outlier payments ($40 million decrease).

Proposed Permanent Cap on Wage Index Decreases

To achieve the policy goal of increased predictability in home health payments, while aligning with proposals in the FY 2023 Inpatient Prospective Payment System proposed rule and other proposed rules, this rule proposes a permanent, budget neutral approach to smooth year-to-year changes in the pre-floor/pre-reclassified hospital wage index. Specifically, this rule proposes a permanent 5% cap on negative wage index changes (regardless of the underlying reason for the decrease) for home health agencies.

Recalibration of Patient-Driven Groupings Model (PDGM) Case-Mix Weights

Each of the 432 payment groups under the PDGM has an associated case-mix weight and Low Utilization Payment Adjustment (LUPA) threshold. CMS’ policy is to annually recalibrate the case-mix weights and LUPA thresholds using the most complete utilization data available at the time of rulemaking. In this proposed rule, CMS is proposing to recalibrate the case-mix weights (including the functional levels and comorbidity adjustment subgroups) and LUPA thresholds using CY 2021 data to more accurately pay for the types of patients HHAs are serving.

PDGM and Behavioral Assumptions

On January 1, 2020, CMS implemented the home health PDGM and a 30-day unit of payment, as required by the Bipartisan Budget Act of 2018. The PDGM, which Congress required, better aligns payments with patient care needs, especially for clinically complex beneficiaries that require more skilled nursing care rather than therapy. The law required CMS to make assumptions about behavior changes that could occur because of the implementation of the 30-day unit of payment and the PDGM. In the CY 2019 HH PPS final rule with comment period, CMS finalized three behavioral assumptions (clinical group coding, comorbidity coding, and LUPA threshold). The law also requires CMS to annually determine the impact of differences between assumed behavior changes and actual behavior changes on estimated aggregate expenditures, beginning with 2020 and ending with 2026, and to make temporary and permanent increases or decreases, as needed, to the 30-day payment amount to offset such increases or decreases. Additionally, in the CY 2019 HH PPS final rule (83 FR 56455), it was stated that CMS interpret actual behavior change to encompass both behavior changes that were previously outlined, as assumed by CMS when determining the budget-neutral 30-day payment amount for CY 2020, and other behavior changes not identified at the time the 30-day payment amount for CY 2020 is determined. In the CY 2022 home health proposed rule, CMS solicited comments on a repricing methodology to determine the impact of behavior changes on estimated aggregate expenditures. This CY 2023 proposed rule proposes the repricing method, which calculates what the Medicare program would have spent had the PDGM not been implemented in CYs 2020 and 2021, assuming that HHAs would have provided home health services in the same way they do under the PDGM, compared to what actual home health expenditures were under the PDGM in CY 2020 and CY 2021.

Using this method, CMS is proposing a -7.69% permanent adjustment to the 30-day payment rate in CY 2023 to ensure that aggregate expenditures under the new payment system (PDGM) would be equal to what they would have been under the old payment system. While the law also requires CMS to implement one or more temporary adjustments to retrospectively offset for such increases or decreases in estimated aggregate expenditures, CMS also has the discretion to implement these adjustments in a time and manner deemed appropriate, therefore, CMS is not proposing a temporary payment adjustment in CY 2023. However, CMS is soliciting comments on how best to implement a temporary payment adjustment, estimated to be $2.0 billion for excess estimates in CYs 2020 and 2021.

Comment Solicitation on the Collection of Data on the Use of Telecommunications Technology under the Medicare Home Health Benefit

CMS finalized policy changes regarding the use of services furnished via telecommunications systems in the CY 2021 HH PPS final rule. However, the collection of data on the use of telecommunications technology under the home health benefit is limited to a broad category of telecommunications technology costs under administrative costs on the HHA cost reports (reported at the agency level). This proposed rule solicits comments on the collection of data on the use of such services furnished using telecommunications technology on the home health claims (at the individual beneficiary level). Collecting data on the use of telecommunications technology on home health claims would allow CMS to analyze the characteristics of the beneficiaries utilizing services furnished remotely, and could give us a broader understanding of the social determinants that affect who benefits most from these services, including what barriers may potentially exist for certain subsets of beneficiaries.

For additional information about the Home Health Prospective Payment System.


For additional information about the Home Health Patient-Driven Groupings Model.


For additional information about the Home Infusion Therapy Services benefit. 


The proposed rule can be downloaded from the Federal Register.

CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Requirements Proposed Rule (CMS-1766-P)

Date: June 22, 2022

CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Requirements Proposed Rule (CMS-1766-P)


On June 17, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2023 Home Health Prospective Payment System (HH PPS) Rate Update proposed rule, which would update Medicare payment policies and rates for home health agencies (HHAs). This rule includes proposals and routine updates to the Medicare Home Health PPS and the home infusion therapy services’ payment rates for CY 2023, in accordance with existing statutory and regulatory requirements. In addition, CMS is proposing to apply a permanent prospective payment adjustment to the home health 30-day period payment rate to account for any increases or decreases in aggregate expenditures, as a result of the difference between assumed behavior changes and actual behavior changes, due to the implementation of the Patient-Driven Groupings Model (PDGM) and 30-day unit of payment. CMS is soliciting comments on how best to implement a temporary payment adjustment for CYs 2020 and 2021. CMS is also soliciting comments on the collection of telehealth data on home health claims to allow CMS to analyze the characteristics of the beneficiaries utilizing services furnished remotely. The actions CMS is taking in this proposed rule would help improve patient care and also protect the Medicare program’s sustainability for future generations by serving as a responsible steward of public funds.


For additional information about the Home Health Prospective Payment System.


For additional information about the Home Health Patient-Driven Groupings Model.


For additional information about the Home Infusion Therapy Services benefit. 


The proposed rule can be downloaded from the Federal Register.

Children age 6 months and up now eligible for COVID-19 vaccination in Missouri

Date: June 21, 2022

The Missouri Department of Health and Senior Services (DHSS) has adopted the Centers for Disease Control and Prevention’s (CDC) recommendation for children down to 6 months of age to receive the Pfizer-BioNTech or Moderna COVID-19 vaccines. The CDC’s recommendation was made after analyzing substantial data from clinical trials involving thousands of children, confirming the vaccine’s safety and effectiveness for children in this age group. The U.S. Food and Drug Administration’s (FDA) authorized Pfizer-BioNTech and Moderna vaccines for children down to 6 months of age on June 17.

  • Pfizer-BioNTech vaccine: Now authorized to be given to children ages 6 months-4 years in three doses, with a 3-week interval between the first two doses, followed by a third dose at least 8 weeks after the second dose.
  • Moderna vaccine: Now authorized to be given to children 6 months-5 years in two doses with 28 days between the two doses.

Previously, the Pfizer-BioNTech vaccine was authorized for use in individuals ages 5 and older, and the Moderna vaccine was authorized for those 18 and older. The Moderna vaccine for those ages 6-17 is scheduled for discussion among members of the Advisory Committee on Immunization Practices on June 23.

There have been over 2 million confirmed cases of COVID among children 6 months through 4 years of age, according to CDC data. Of those cases, over 200 children have died after contracting the virus. COVID-19 is the fifth most common cause of death in children under age 5.

Missourians are encouraged to stay up-to-date on COVID-19 vaccines to ensure maximum protection. Sufficient supplies of vaccines are available throughout the state.

Missouri providers who pre-ordered vaccines for children down to 6 months of age are listed at, and will soon list locations on an interactive map where vaccines are available. Those who ordered Pfizer-BioNTech are experiencing manufacturer delivery delays. Contact the provider before arriving. You can also text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.

Parents & Kids COVID-19 FAQs

COVID-19 Vaccination Schedules

Continuing Nursing Education Scholarship Opportunity for Missouri Nurses

Date: June 21, 2022

AgriSafe Network currently has a scholarship opportunity that allows nurses providing care for individuals in rural Missouri to complete the AgriSafe Nurse Scholar continuing nursing education program free of cost (a $500 value). These scholarships are made possible by FCS Financial and Farm Credit Services of Southeast Missouri.

The Nurse Scholar program provides learners with 20 hours of continuing nursing education and is accredited by the American Nurses Credentialing Center (ANCC). The AgriSafe Nurse Scholar program is completed when convenient for the learner, online in a self-paced format. It is taught by expert agricultural health & safety educators, and helps nurses increase their competence in prevention, identification, and assessment of diseases and conditions commonly experienced by people working in agriculture. Topics covered include mental health needs, heat related illnesses, sleep deprivation, chemical/pesticide safety, respiratory health and much more. Additional information about the program is available on the AgriSafe Nurse Scholar Program website.

The program can be completed anytime between now and March 15, 2023. The deadline to apply for this scholarship is July 30, 2022. Interested candidates can apply for the scholarship here. If you know anyone that might be interested in this scholarship opportunity, please share this information with them.

Questions may be sent to