1. Federal Office of Rural Health Policy Policy Research Team Overview

2. Tom Morris – Associate Administrator Sahira Rafiullah – Deputy Associate Administrator Aaron Fischbach – Policy Coordinator Alicia Swenson O’Brien, Sarah Young, Helen Newton, Suzanne Stack, Craig Caplan, Marty Rice, Natassja Manzanero, & Anthony Oliver – Policy Analysts Paul Moore & Dan Mareck – Clinical and Quality Advisors Steve Hirsch – Executive Secretary, National Advisory Committee Curt Mueller – Research and Evaluation Director Sarah Bryce – Research and Evaluation Associate Policy Research Team

3. Serve as HHS-wide resource on rural health services and data issues Review and comment on all HHS regulations Review legislation and reports to Congress Conduct rural health services research Staff the National Advisory Committee on Rural Health and Human Services Staff the White House Rural Council ORHP Policy Research Activities

4. PRT Grants and Cooperative Agreements Policy/Research: Rural Policy Analysis Rapid Response to Quick Data Turnaround Rural Health Research Centers Rural Training Track Technical Assistance Rural Health System Analysis and Technical Assistance Demonstrations with CMS: Frontier Extended Stay Clinic Frontier Community Health Integration

5. Rural Health Research Research from ORHP- funded rural health research centers past and present http://www.ruralhealthresearch.org

6. HOSPITAL Critical Access Hospital (CAH) Sole Community Hospital (SCH) Disproportionate Share Hospital (DSH) Rural Referral Center (RRC) Medicare Dependent Hospital (MDH) Rural Prospective Payment Hospital PHYSICAN Bonus Payments –Shortage Areas –Primary Care Graduate Medical Education (GME) AMBULATORY Rural Health Clinics (RHC) Federally Qualified Health Centers (FQHC) Community Health Centers (CHCs) POST-ACUTE Skilled Nursing Facility (SNF) Home Health Agency (HHA) Hospice Swing Beds Long Term Care Facilities Rural Provider Types

7. Inpatient Hospital Payment Outpatient Hospital Payment Physician Payment Inpatient Rehab Payment Inpatient Psych Hospital Payment Skilled Nursing Facility and Long Term Care Payments End Stage Renal Dialysis Payments Home Health Payments Hospice Payments Ambulance Fee Schedule Medicare Advantage Medicare Part D Rural Health Clinics Federally Qualified Health Centers Medicaid Waivers/SPAs Medicare GME EHR/Meaningful Use Telehealth ACA related insurance provisions Key Rural Regulatory Issues

8. RegulationProposedPub. DateEff. Date Inpatient Prospective Payment SystemAprilAugustOctober Outpatient Prospective Payment SystemJulyNovemberJanuary Skilled Nursing Facility Prospective Payment System AprilJulyOctober Home Health Prospective Payment System MaySeptemberOctober Inpatient Rehabilitation FacilitiesAprilAugustOctober Inpatient Psychiatric Facility Prospective Payment System JanuaryMarchJuly Physician Fee-ScheduleJulyNovemberJanuary RHCs & FQHCsN/A HospiceN/A Rural-Relevant Medicare Regulations This is not an official calendar endorsed by CMS.

9. ORHP Policy Focus for 2014-2015 Health Insurance Marketplaces and State Medicaid expansions ACA Outreach, Education, and Enrollment Quality  Rural hospitals – Partnership for Patients, VBP, etc.  CAHs - MBQIP  RHCs – quality measures cohort Outpatient Supervision at rural PPS and CAHs Stage 2 MU implementation and Stage 3 planning Primary care access Rural and Frontier Demonstrations RHSATA White House Rural Council activities

10. The White House Rural Council Created by Executive Order June 9, 2011 HHS Policy Ideas Expand NHSC to CAHs Expand Health IT Funding Reduce Regulatory Burden

11. National Advisory Committee on Rural Health and Human Services Advises the HHS Secretary on Rural Issues Policy Briefs on Current Issues Rural Site Visits http://www.hrsa.gov/advisorycommittees/rural/

12. Affordable Care Act Update

13. ACA Outreach and Enrollment CMS Outreach and Education Website http://www.cms.gov/Outreach-and-Education/Outreach-and-Education.html ORHP ACA Office Hours Wednesdays, 3-4 pm Eastern Call-in Number: (800) 857-3749Passcode: ORHPACA Adobe Connect Session: https://hrsa.connectsolutions.com/orh1/ E-mail name and organization to orhp-acaquestions@hrsa.gov to join the listserv Archive of prior calls: http://www.hrsa.gov/ruralhealth/affordablecareact/index.html ACA rural fact sheet: http://www.hhs.gov/healthcare/facts/factsheets/2013/09/rural09202013.html

14. 2014-2015 Enrollment Special enrollment opportunities:  https://www.healthcare.gov/how-can-i-get-coverage-outside-of-open- enrollment/special-enrollment-period/ 2015 Open Enrollment begins November 15  Shorter, 3-month period  CMS recently issued regulations about continuation coverage and eligibility redeterminations

15. ACA Coverage to Care If you’re a provider, staff, or someone helping people who are new to insurance, there are a few resources to address topics such as:  What it means to have health insurance  How to find a provider  When and where to seek health services  Why prevention is important  Resources: http://marketplace.cms.gov/help-us/c2c.html  A Roadmap to Better Care and Healthier You  http://marketplace.cms.gov/help-us/c2c-roadmap.pdf  Discussion Guides for Community Partners  Your Roadmap to Health (poster)  Provider Newsletter

16. Resources

17. Policy Resources Rural Assistance Center One stop shopping for all rural health and human services www.raconline.org Rural Health Research Gateway Access to all RHRC products on a range of rural health topics www.ruralhealthresearch.org Medicare www.cms.gov/Medicare/Medicare.html Rural Providers Resource Guide: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network- MLN/MLNProducts/Downloads/Rural-Health-Suite-ICN908465.pdf

18. Policy Resources Legislation and statutes http://thomas.loc.gov/ Social Security Act compilation (Medicare and Medicaid are Titles XVIII and XIX) http://www.ssa.gov/OP_Home/ssact/comp-ssa.htm Code of Federal Regulations -- Public Health (HHS) -- Title 42 http://ecfr.gpoaccess.gov/cgi/t/text/text- idx?sid=1ea2f8fcbc9a2ec1c2b44ef1c2374ab0&c=ecfr&tpl=/ecfrbrowse/Title42/42tab_ 02.tpl Federal Register https://www.federalregister.gov/ CMS interpretive guidelines (or state operations manuals) http://www.cms.gov/Regulations-and- Guidance/Guidance/Manuals/index.html?redirect=/Manuals/

19. CMS Rural Resources CMS Regional Office Rural Liaisons https://www.cms.gov/ProspMedicareFeeSvcPmtGen/downloads/RO -RH-Coordinators.pdf CMS Rural Open Door Forum- Sign up at: http://www.cms.hhs.gov/OpenDoorForums CMS National Provider Calls http://www.cms.gov/Outreach-and-Education/Outreach/NPC/National- Provider-Calls-and-Events.html CMS Rural Health Clinics Center http://www.cms.hhs.gov/center/rural.asp Key CMS Rural Resources

20. A Few Key Websites www.healthcare.gov www.cms.gov http://aspe.hhs.gov www.kff.org www.nashp.org www.commonwealthfund.org

21. Questions?