NRHA's Rural Health Voices blog offers informed commentary on the latest news in rural health care from NRHA staff and editorials from selected contributors.

CMS Issues Delay in Physician Supervision Rule

This notice was just issued by Amy Hall, Director, Office of Legislation, CMS:The Centers for Medicare & Medicaid Services (CMS) will instruct all of its Medicare contractors not to evaluate or enforce the supervision requirements for therapeutic services provided to outpatients in Critical Access Hospitals (CAHs) for the duration of calendar year (CY) 2010.  The final 2010 hospital outpatient prospective payment system rule had specified that a “direct supervision” standard is required...

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CMS Meaningful Use Comment Letter

NRHA has submitted its comments to CMS regarding the proposed regulations to implement portions of the HITECH section of ARRA. NRHA's letter outlines our support for the widespread adoption of HIT in rural areas but we are very concerned that many rural providers will not be able to access any of the incentive money. For this reason, we lay out suggestions that would make HITECH program more "rural friendly." The comments are due today at 5:00 pm ET. Please submit a comment and feel free to...

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Congressional Health Reform – an NRHA Government Affairs Update

The Senate Health, Education, Labor and Pensions (HELP) Committee last week finished its fourteen day hearing to markup its health reform legislation, the Affordable Health Choices Act. With a final party line vote of 13 Democrats to 10 Republicans, the bill passed through Committee and health reform is one step closer to becoming a reality. That was one step, however, out of many… The Senate Finance Committee, also with health reform jurisdiction, has yet to release even a draft of its...

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Proposed Health IT Certification Programs

Today the Department of Health and Human Services released a Notice of Proposed Rulemaking for the Establishment of Certification Programs for Health Information Technology (Health IT). The rule first proposes the creation of a temporary certification program for Electronic Health Records (EHRs) and EHR modules. This serves as a bridge to the second, permanent certification proposal, which establishes detailed guidelines to support an ongoing program of testing and certification of health...

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One in Three Small Town Residents Without Health Coverage by 2019

According to a recently released Center for Rural Affairs' report, approximately one in three rural Americans living in communities with fewer than 2,500 residents will be uninsured by 2019. Throughout the remainder of rural America, approximately one in four residents will likely go without health care coverage and the annual cost of health care for all rural households will rise from $2,705 to nearly $4,700 on average.

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HIPAA version 5010 fact sheets and checklists Released by CMS

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HIT Policy Committee Recommendation One Small (CPOE) Step From Flexibility

by Louis Wenzlow, Rural Wisconsin Health Cooperative What is the 3-1-1-1-0 Recommendation? The HIT Policy Committee today created a framework for much needed flexibility within the EHR incentive program. Rather than requiring providers to meet all of the 20-plus meaningful use objectives (as is currently required in the CMS proposed rule), the Policy Committee recommended that providers be able to defer a certain portion of meaningful use objectives without jeopardizing their incentive...

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CMS Proposed Rule: How to Stretch Without Breaking

By: Louis Wenzlow, Rural Wisconsin Health Cooperative Figure 1: Hospitals (I Believe) Likely to be Excluded from IncentivesLet's Get Meaningful One thing we can all agree on: for the EHR incentive program to be meaningful, it needs to be designed to support our national goals of reducing healthcare costs and increasing healthcare quality. We're moving to electronic health records not for the technology's sake, but because we believe the technology is a means to actually help people and...

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How the CMS Proposed Rule Will Raise the Cost of Rural Healthcare

by Louis Wenzlow, Rural Wisconsin Health Cooperative Summary CMS' claims regarding the financial benefits of electronic health records (EHRs) for providers are not supported by their source reference material; and the benefits CMS predicts are not likely to materialize, especially for small rural providers. Due to their low volumes, small rural providers are much more likely to see a negative financial ROI on their EHR investments. So EHRs will in all likelihood increase the cost of...

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