Rural Spotlight

CMS Details About 1135 Waiver

The Secretary of Health and Human Services has invoked her waiver authority under Section 1135 of the Social Security Act.  This allows for the waiver or modification of certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements to ensure that sufficient health care items and services are available to meet the needs of individuals enrolled in Social Security Act programs in the emergency area and for the time periods covered by the 1135 authority. 

Requests by providers to operate under the flexibilities afforded by the waiver should be sent to the state survey agency or CMS regional office.  Please visit this website for a detailed paper outlining the 1135 waiver process.

Further information on the 1135 Waiver process can be found by clicking here. 

Success Stories and New Funding Opportunities

The Rural Assistance Center has released the latest information on success stories and funding opportunities for rural entities and individuals. Click here to see that list.

Rural Health Providers Also Treat the Economy

It has been shown time and time again that health care providers in rural communities help those communities thrive. The economies of those communities are boosted both directly and indirectly with millions of dollars. The Iowa Independent has chronicled one recent study that supports that idea even more. Read the article here.

Emergency Declaration Could Lead to CAH Bed Waivers

From: HRSA

The “National Emergency” declared by Pres. Obama isn’t enough to allow CAHs to exceed the bed limit. 

The Secretary would have to issue a Sec. 1135 waiver and, as of yet, hasn’t done so.  However, because the President has declared a National Emergency the Secretary can issue the waiver. 

Section  1135  of  the  Act  authorizes  the  Secretary  of  the  Department  of  Health  and  Human  Services  to  waive  or  modify  certain  Meicare,  Medicaid,  CHIP,  and  HIPAA  requirements.   However,  two  prerequisites  must  be  met  before  the  Secretary  may  invoke  the  §  1135  waiver  authority.   First,  the  President  must  have  declared  an  emergency  or  disaster  under  either  the  Stafford  Act  or  the  National  Emergencies  Act.   Second,  the  Secretary  must  have  declared  a  Public  Health  Emergency  under  Section  319  of  the  Public  Health  Service  Act.   Then,  with  respect  to  the  geographic  area(s)  and  time  periods  provided  for  in  those  declarations,  the  Secretary  may  elect  to  authorize  waivers/modifications  of  one  or  more  of  the  requirements  described  in  Section  1135(b).

From the Office of Rural Health Policy:

There are three steps to this process, two of which are already complete:  The President declares a National Emergency , The Secretary declaring a Public Health Emergency, and the Secretary’s waiver authority which allows for waivers to the requirement in certain cases only to the extent necessary as determined by CMS.  In order for a CAH to request a waiver to the bed limit requirement, they need to request a wavier through their CMS Regional Office.    CMS is not approving pre-emptive waivers, meaning that the CAH needs to be able to document their specific need for increasing the bed limit.  CMS is working to develop an expedited waiver review process and identifying point people for these waivers in each of the regional offices.  To find out more information on requesting waivers visit http://www.cms.hhs.gov/H1N1/.  The CMS Regional Office Rural Health Coordinators http://www.cms.hhs.gov/ProspMedicareFeeSvcPmtGen/downloads/RO-RH-Coordinators.pdf  may also be a resource.   

Read more here.

The Uneven Cost of Rural Health Care

From: The Daily Yonder

The nation is spending vastly more on health care in some rural areas than in others without any indication that the increased spending results in better health.

In Whitefish, Montana, the average yearly cost of taking care of a Medicare patient over a three-year period ending in 2006 was $3,950.

Across the country in the Florida Panhandle town of Graceville, the cost of tending a Medicare patient during the same time was nearly $15,500.

People in Graceville are poorer than people in Whitefish, it’s true. But the difference in cost of caring for a Medicare patient in these two towns is astounding — more than four times more expensive in one rural Florida hospital than in one town in rural Montana.

Continue reading this article...

Barriers Between Health and Technology

Social media has exploded in recent years and just about every business has a Twitter account or Facebook page. That leaves some wondering why hospitals seem to be one of the last to jump on this technology bandwagon. Read this article from Suburban Journals.

Announcement of Medicare Provider Feedback Group Town Hall Meeting

The annual Medicare Provider Feedback Group (MPFG) Town Hall meeting is scheduled for October 29th. This meeting is open to all Medicare Fee-for-Service (FFS) providers and suppliers that participate in the Medicare program, including physicians, hospitals, home health agencies, third-party billers, and interested parties, to present their individual views and opinions on selected FFS Medicare topics. In addition, we will be soliciting input on how we can improve communications to better serve the Medicare providers and suppliers. Read the public meeting notice here.

Rural Hospitals Seek Rx for Survival

By: John Stucke

POMEROY, Wash. – It is autumn in this small town along Pataha Creek, tucked into the rolling hills south of the Snake River. The downtown is populated with a handful of shoppers, pickups and minivans. It boasts nine churches and two bars. This wheat farming town also has the distinction of being the seat of Garfield County – with 2,400 people, the state’s least populous. These aren’t heady times for Pomeroy. The price of wheat is down, big-box stores in larger towns lure away local dollars, and the recession has delivered a wallop. Yet there’s a bit of rejoicing about the arrival of the town’s newest resident. After two years of searching, Pomeroy has a local doctor again.

Embraced by residents

Although people in Pomeroy like to brag that the town is “about 30 miles from anywhere,” it sits squarely at the crossroads of what works and what doesn’t in the realm of rural health care.
On the plus side, “If something is wrong I can walk right in here and see my doctor,” said Harold Waldher, who moved back to his hometown after retiring in the Seattle area. “That’s not something a lot of people in cities can say.”

Rural Residents Lag in Preventive Services Use; Lag Increases with Service Complexity

This research brief describes the receipt of preventive services among rural adults and explores the factors that are related to disparities in utilization. Click here to read it.

A Rare Case of Homegrown Medicine

The rule of thumb in small-town America is that doctors go away. End of story. Rural spots like Panguitch — population 1,500, 90 minutes to the nearest city of any size — are increasingly pressed to have doctors at all. Rarer still are physicians like Dr. Miller, 32, who grew up here, went away to study and hone his craft, then came back to practice. He and his wife, Ashlee, and their three children, ages 1, 2 and 5, returned last summer.

Perhaps it is something in the water. Dr. Miller is one of three physicians at Garfield Memorial Hospital — 41 beds and two trauma rooms adjacent to a meetinghouse for the Church of Jesus Christ of Latter-day Saints — and none of them have ever worked anywhere else since their residency training. First jobs became careers. One of Dr. Miller’s colleagues has been here 10 years, the other 15.
Read more about Dr. Miller here.