On June 29, the Health and Human Services Department rescinded three controversial Bush Administration regulations governing Medicaid and said it would postpone and possibly change or rescind a fourth. These regulations are among seven that were proposed by the Bush Administration and rigorously opposed by NRHA. Congress placed a moratorium on the regulations last summer in the War Supplemental Bill, but it was set to expire on June 30, allowing the regulations to go into effect.

On May 1, the Centers for Medicare and Medicaid Services released the FY2010 inpatient prospective payment system (IPPS) proposed rule. This rule completes the agency's fiscal year proposal.

NHRA recently submitted comments to the CMS on the rule. The proposed changes, which are released every year for public comment, included strong fixes for rural Medicare disparities but also many changes that would directly impact many rural beneficiaries in a negative way. NRHA strongly urged CMS to ensure any changes to the way providers were reimbursed would not result in more limited access than the rural American health care infrastructure already faces. The proposed changes include: 

• Reconfiguring statistical geographic areas for wage index classification
• Changes requiring sole community hospitals (SCHs) and Medicare dependent hospitals (MDHs) to be subject to document and coding adjustments (DCA)
• Electronic health record (EHR) and health information technology (HIT) reimbursement compliance standards
• Changes affecting critical access hospitals

To view the letter to CMS with a complete list of NRHA's comments, please click here.

To read the proposed rule, click here.

On September 2, the NRHA submitted comments to CMS concerning the calendar year 2009 proposed rule for the Hospital Outpatient and Ambulatory Surgical Center Payment Systems. According to CMS, "the proposed rule builds on efforts across Medicare to transform the program into a prudent purchaser of health care services, paying based on quality of care, not just quantity of services." The final rule will be released by November 1.

Click here to read NRHA's comments.

Click here to read the proposed rule. 

On August 29, the NRHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) concerning the proposed Physician Fee Schedule for calendar year 2009.

Click here to read NRHA's comments.

Click here to read the proposed rule. 

On August 26 the NRHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) concerning a proposed rule that would change the conditions of participation for Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC). The proposed rule could have a major impact on the ability of rural safety net providers to continue to serve their communities. The NRHA shared serious concerns and reservations with CMS in regards to the impact of the proposed rule on RHCs and FQHCs.

The NRHA provides a regulatory guide to the NRHA membership on a CMS proposed rule to change the conditions of participation of Rural Health Clinics (RHC) and make payment changes for RHCs and Federally Qualified Health Centers (FQHCs) under Medicare. The proposed rule could have a radical impact on rural and frontier safety net providers. The guide explains the proposed rule and the proposed changes, shares NRHA's planned comments that will be offered to CMS regulators and gives details on how rural advocates can submit their own comments on the proposed rule.

The Centers for Medicare and Medicaid Services (CMS) released the fiscal year 2009 hospital inpatient prospective payment system (IPPS) final rule July 31. The rule is intended to focused on quality measures and hospital quality improvement programs. As part of these efforts, CMS added 13 quality measures and removed a single measure from the quality reporting measures that a hospital must report to receive the full market basket update of 3.6 percent. The NRHA had been strongly opposed to the list of 43 new measures in the proposed rule as being overly burdensome to rural hospitals. The association applauds the reduction in the final list, however, we must note that only four of the final measures were adopted by the Hospital Quality Alliance and that CMS expects to finalize two more measures in the hospital outpatient prospective payment system rule later in the fall. The final rule will take effect on Oct. 1, 2008.

Thanks to pressure of NRHA members and congressional supporters, the Health Resources and Services Administration (HRSA) has withdrawn a proposed rule on the designation of Medically Underserved Populations and Health Professional Shortage Areas (HPSA). After extending the public comment period on two different occasions, HRSA determined that due to receiving "many substantive comments on the proposed rule," the department "will issue a new notice of proposed rulemaking for further review and public comment prior to issuing a final rule."

The Centers for Medicare and Medicaid Services (CMS) has published a proposed rule impacting Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) operations. The proposed rule is now available here online.

Thanks to the pressure of NRHA members and congressional supporters, HRSA has extended the comment period for the proposed HPSA/MUP rule by 30 days, this time until June 30. The NRHA submitted comments last week, which are now available online. The delay should give you a chance to submit your own thoughts to HRSA.

On May 29, the NRHA submitted comments to the Health Resources and Services Administration (HRSA) concerning the proposed combined methodology for determining designation as a Health Professional Shortage Area and/or Medically Underserved Population. This change in methodology could have a radical impact on the ability of rural and frontier communities to recruit additional providers to their community.

The NRHA's draft comment letter to a new proposed rule on shortage areas (HPSA and MUP) is now available online for review and to use as a basis for your own comments. Comments are due Thursday, May 29th by 5 PM ET.

A new proposed combined methodology for determining designation as a Health Professional Shortage Area and/or Medically Underserved Population has been released. The NRHA provides this regulatory guide to explain the proposed methodology, to explain some how this could impact rural America, to share our initial intent on comments NRHA offers to HRSA regulators, and to give details on how rural advocates can submit their own comments on the proposed rule.