Announcements from the Federal Office of Rural Health Policy

January 25, 2018

What’s New

DEA Broadens Access to Drug Treatment.  On Tuesday, the Drug Enforcement Agency (DEA) announced a change in regulation designed to increase access to Medication Assisted Treatment (MAT) for opioid addiction in rural areas.  Under the Comprehensive Addiction and Recovery Act (CARA), prescribing authority for long-term use of buprenorphine, the drug used in outpatient addiction treatment, was expanded in 2016 to include qualified nurse practitioners and physician assistants.  In the same year, CARA also gave authority to the Department of Health and Human Services (HHS) to increase the maximum number of patients that a qualified practitioner may treat from 100 to 275.  This week’s action by the DEA incorporates those changes into its regulations for the Controlled Substances Act and is intended to increase access to treatment in rural areas.  Research has shown that more than half of rural counties had no DEA waivered physicians in 2016.  Rural physicians, nurse practitioners and physician assistants can get no-cost MAT waiver training online from the Providers’ Clinical Support System.

Rural Health  Research

Rural Health Research 2017 Year in Review.  As noted above, the HRSA/FORHP-funded Rural Health Research Gateway published a report last year on the number of rural physicians prescribing buprenorphine.  The report was one of 16 peer-reviewed articles from 2017 on subjects ranging from the decline of obstetric services in rural counties to predicting financial distress and closure in rural hospitals .  Sign up for email alerts on the Gateway website to see research as soon as it’s released in 2018.

Policy Updates

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New Medicare Episode Payment Model – March 12.  The CMS Innovation Center is launching a new voluntary payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced).  This model includes financial risks as well as incentives, so it will qualify as an Advanced Alternative Payment Model (APM) under the Quality Payment Program.  According to the BPCI Advanced Model Fact Sheet, certain Medicare beneficiaries will be excluded from the model, but many of the clinical episodes that will be tested are frequently encountered by rural providers, including COPD, sepsis, stroke, and fractures of the femur, hip or pelvis.   The CMS Innovation Center will hold a Q&A Open Forum on the BPCI Advanced model on Tuesday, January 30, 2018 from 12 pm – 1 pm EDT.

Resources, Learning Events and Technical Assistance

Tackling Opioids in the Chickasaw Nation – Thursday, January 25 at 3:00 pm ET.  With funding from the Substance Abuse and Mental Health Services Administration, the Chickasaw Nation created a movement for prevention of opioid misuse aimed at creating awareness and reducing access to drugs and alcohol.  In this one-hour webinar, experts will explain various components, challenges and successes of the program.

FDA Opioid Policy Steering Committee Meeting – Tuesday, January 30 at 8:30 am ET.  The Food and Drug Administration (FDA) established the Opioid Policy Steering Committee (OPSC) to explore and develop strategies to combat the opioid crisis.  OPSC will hold a public meeting to collect stakeholder input on new approaches FDA might adopt to promote the safe use of opioid painkillers and reduce overprescribing that may contribute to new addiction.  New ideas may benefit rural communities where CDC research shows rates of prescription opioid misuse and overdose death are highest.  Comments on the proposed strategy for prescribing will be accepted through March 16.  

Cardiovascular Disease in Women and Minorities – Thursday, February 1 at 12:30 pm ET. As a kick-off for American Heart Month, HRSA’s Office of Regional Operations will host this one-hour webinar to distinguish care patterns and patient outcomes across various populations.  Cardiovascular disease is one of several chronic conditions impacting quality of life, mortality and healthcare costs in rural areas.

Approaching Deadlines

Preventive Medicine Residency Program – January 26
Comments Requested: Rules for School Lunches – January 29
Training Nurses for Primary Care – January 29
Grants to Address Local Drug Crises – January 29
Comments Requested: DOL Updates Senior Employment Program – January 30
Training and Enhancement – Primary Care Physicians and PAs – January 30
ASTHO Community Health Worker Learning Community – January 31
ASTHO Telehealth Learning Community – January 31
Addressing Violence Against Women in Rural Areas – January 31
PCORI  Engagement Awards – February 1
Comments Requested: FCC Rural Health Care Funding – February 2
Medicaid and CHIP Payment and Access Commission (MACPAC) Nominations – February 5
Comments Requested: Revised Head Start Quality Measures – February 6
Comments Requested: Quality Measures Under Consideration – February 9
Comments Requested: USDA Child Nutrition Programs – February 12
Understanding Vaccination Coverage in Rural Areas – February 13
Environmental Problem-Solving for Underserved Communities – February 16
Tribal Practices for Wellness in Indian Country – February 20
Comments Requested: Addressing Needs in Rural Schools – February 20
Campus Suicide Prevention – February 20
SAMSHA Treatment Drug Courts – February 21
Rural Health Network Development Planning Program – February 23
Medicare Rural Hospital Flexibility Program EvaluationFebruary 23
Nurse Anesthetist Traineeship Program – February 28
Rural PREP Microresearch – March 1 (depending on funds)
Comments Requested:  Labor Redefines Employer Health Plans – March 6
New Medicare Episode Payment Model – March 12
Rural Health Clinic Policy and Assessment Program – March 16
Comments Requested: FDA Opioid Prescribing Guidelines – March 16
Guaranteed Loans for Rural Rental Housing – Ongoing through 2021
Drinking Water and Waste Disposal for Rural and Native Alaskan Villages – Ongoing
HIT Strategies for Patient-Reported Outcome Measures – Ongoing
HIT to Improve Health Care Quality and Outcomes – Ongoing
Community Facilities Program –  Ongoing
Summer Food Service Program – Ongoing