Rural Spotlight

December 4, 2023

Updates to Requirements for Buprenorphine Prescribing

As announced by the Substance Abuse and Mental Health Services Administration in January 2023, clinicians no longer need a federal waiver to prescribe buprenorphine for treatment of opioid use disorder. Clinicians are still required to register with the federal Drug Enforcement Agency to prescribe controlled medication.

On June 27, the DEA began to require that registration applicants – both new and renewing – affirm they have completed a new, one-time, eight hour training. Exceptions for the new training requirement are practitioners who are board certified in addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the U.S. within five years of June 27, 2023.

Watch this 11-minute video that explains the changes

Rural Health Clinics (RHCs) still have the opportunity to apply for a $3,000 payment on behalf of each provider who trained between January 1, 2019 and December 29, 2022 (when Congress eliminated the waiver requirement). Approximately $889,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis until funds are exhausted.

Please contact DATA2000WaiverPayments@hrsa.gov for additional information.

See Training Requirements

Apply for DATA 200 Waiver Training Payment

December 4, 2023

Trends in the Prevalence of Chronic Obstructive Pulmonary Disease

A review of data from the Behavioral Risk Factor Surveillance System showed the prevalence of COPD has remained stable overall, but with disparities based on rural residence. Specifically, between the years 2011 and 2021, prevalence increased for adults 75 years and older, for those living in rural areas, and for those who smoked.

Researchers suggest the COPD National Action Plan provides a comprehensive framework for COPD prevention, treatment, and management strategies. These can be tailored to address risk factors specific to various populations. In rural areas, for example, there are higher rates of smoking, history of asthma, and exposure to lung irritants, but limited access to pulmonologists.

The Rural Health Information hub (RHIhub) recently updated the Rural Chronic Obstructive Pulmonary Disease Toolkit, with models for effective COPD programs, issues to consider when implementing, and resources for funding and sustainability.

Overview of Chronic Obstructive Pulmonary Disease

Rural Chronic Obstructive Pulmonary Disease Toolkit

December 4, 2023

Upcoming Webinar – RHIhub – The Maternal, Infant, and Early Childhood Home Visiting Program in Rural Areas

Don’t miss this RHIhub webinar on Monday, December 11^th at 2:00 p.m. Central Time (CT).

The National Advisory Committee on Rural Health and Human Services (NACRHHS) and the Health Resources Services Administration’s (HRSA’s) Maternal and Child Health Bureau discuss findings and recommendations from the recent Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) policy brief.

This webinar is free. High-speed internet is required to participate. A recording will be available on the RHIhub website after the live event. Connection details will be emailed immediately upon registration.

When: Monday, December 11, 12:00 p.m. CT

December 1, 2023

OIG Issues Remote Patient Monitoring (RPM) Alert

The Office of Inspector General (OIG) is alerting the public about a fraud scheme involving monthly billing for remote patient monitoring. Please educate staff and patients with this important information.

Legitimate RPM involves using medical devices such as scales, glucose monitors, blood pressure cuffs, cardiac rhythm devices, and other equipment to remotely monitor for anomalies in patients with chronic medical conditions. This new treatment is beneficial for those whose condition might deteriorate quickly, where monitoring can reduce complications, hospitalizations or death.

However, the OIG has found unscrupulous companies are signing up Medicare enrollees for this service, regardless of medical necessity. Most often, the monthly monitoring never happens, but the enrollee is billed monthly anyway.

Scammers target Medicare enrollees through calls, texts, and Internet ads
Scammers steal Medicare numbers and other personal information
Scammers then bill Medicare for services that are unnecessary or never provided

Report Fraud

HHS.GOV
1-800-447-8477
TTY: 1-800-377-4950
Report Fraud to the FTC

Learn More

December 1, 2023

American Institute of Healthcare Compliance – Evaluation and Management (E/M) Visits

Beginning January 1, 2024, the Centers for Medicare and Medicaid (CMS) is finalizing implementation of a separate add-on payment for healthcare common procedure coding system (HCPCS) code G2211.

This add-on code will better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care.
Generally, it will be applicable for outpatient and office visits as an additional payment, recognizing the inherent costs involved when clinicians are the continuing focal point for all needed services, or are part of ongoing care related to a patient’s single, serious condition or a complex condition.

Split (or shared) Evaluation and Management (e/M) visits

Split (or shared) E/M visits refer to visits provided in part by physicians and in part by other nonphysician practitioners in hospitals and other institutional settings.

For CY 2024, CMS is finalizing a revision to the definition of “substantive portion” of a split (or shared) visit to include the revisions to the Current Procedural Terminology (CPT) guidelines, such that for Medicare billing purposes, the “substantive portion” means more than half of the total time spent by the physician or nonphysician practitioner performing the split (or shared) visit, or a substantive part of the medical decision making.
This responds to public comments asking that it be allowed that either time or medical decision making to serve as the substantive portion of a split (or shared) visit.

Click here for more PFS information from CMS

Click here for the November press release which provides a summary of changes

December 1, 2023

American Institute of Healthcare Compliance: Recognize Holiday Workplace Stress

With the holiday season here, it is important for leadership to recognize additional stresses on our workforce. The World Health Organization estimates that for every dollar U.S. employers spend treating common mental health issues, they receive a return of $4 in improved health and productivity. Employers can make a difference when it comes to helping their staff manage stress.

According to the National Institute of Mental Health, it is estimated that more than one in five U.S. adults live with a mental illness. Mental illnesses include many different conditions that vary in degree of severity, ranging from mild to moderate to severe.

The Occupational Safety and Health Administration (OSHA) states workplace stress has been reported to cause 120,000 deaths in the U.S. each year! OSHA also states that workplace stress and poor mental health can negatively affect workers through:

Job performance
Productivity
Work engagement and communication
Physical capability and daily functioning

Read through helpful information about SAD (Seasonal Affective Disorder) and download the PDF from the National Institute of Mental Health.

Access resources on OSHA’s website “Workplace Stress Make Work Better – Mental Health Matters.”

December 1, 2023

New Funding Opportunity – Geriatric Workforce Enhancement Program (GWEP) – HRSA-24-018

The Health Resources and Services Administration (HRSA) released a New Notice of Funding Opportunity (NOFO) to educate and train the health and supportive care workforces to care for older adults by collaborating with community partners.

The Geriatrics Workforce Enhancement Program (GWEP) – HRSA-24-018 aims to have applicants maximize patient and family engagement to address care gaps and improve health outcomes for older adults by integrating geriatrics with primary care and other appropriate specialties using the Age-Friendly Health Systems Framework.

Eligible Applicants

Schools of Allopathic Medicine, Osteopathic Medicine, Nursing, Allied Health, Pharmacy, Dentistry, Public Health, Optometry, Chiropractic, Veterinary Medicine, or Podiatric Medicine
Physician Assistant Education Programs
Graduate programs for Health Administration or Behavioral Health and Mental Health Practice, including:
- Clinical Psychology
- Clinical Social Work
- Professional Counseling
- Marriage and Family Therapy
Health care facilities
Programs leading to certification as a certified nurse assistant
Partnership of a school of nursing and health care facility
Partnership of a program leading to certification as a certified nurse assistant and a health care facility
Community-based organizations, if otherwise eligible
Tribes, and Tribal organizations, if otherwise eligible

HRSA anticipates awarding approximately $43 million to approximately 43 recipients through this funding opportunity

Contact Information for questions:

Jennifer Solomon, GWEP@hrsa.gov, (301) 443-0024

See Full Announcement

Apply Now

November 28, 2023

Licensure for Behavioral Health Providers

To increase access to care, states are creating new pathways for out-of-state providers to practice, including for behavioral health and prescribing of medication online.

Learn how states are increasing access to care by creating pathways for out-of-state providers to practice.

Learn More

November 27, 2023

November RQITA Monthly Newsletter

The Office of Rural Health and Primary Care (ORHPC) is happy to share the November RQITA Monthly Newsletter. Included in this edition:

Questions from the Field
- Discusses common questions or challenges seen in the MBQIP program
Resources and Tools
- What new resources are available to help navigate the MBQIP program
Upcoming Deadlines and Reporting Reminders
- Submission due January 3, 2024 – HCAHPS Q3 encounters (7/1/23 – 9/30/23)
- Submission due February 1, 2024 – OP-18 Q3 encounters (7/1/23 – 9/30/23)
- Reporting due February 24, 2024 – Safe Use of Opioids – Concurrent Prescribing measure for CY 2023 encounter (1/1/23 – 12/31/23)
Upcoming Events

November Monthly Newsletter

November 27, 2023

Updated RHIhub Topic Guide

The Rural Health Information Hub (RHIhub) recently updated their topic guide that shares resources and information to help rural communities address their emergency preparedness and response needs.

Included in the topic guides: