May 2019

May 2019

Greetings Flex Coordinators,

Thank you to everyone who worked with your critical access hospitals (CAH) to prepare Fiscal year (FY) 2019 waiver requests for the Medicare Beneficiary Quality Improvement Project (MBQIP) participation requirements. These CAHs clearly struggle with quality data reporting, but your waiver requests also document a lot of progress that they have made and the work your Flex programs are putting in to help them. As you saw from the MBQIP mailing list, we recently posted the FY 2020 MBQIP participation requirements. For the FY 2020 award year, CAHs will be required to report data in three of the four MBQIP quality domains for at least two quarters.

Spring is also the season of proposed regulations from the Centers for Medicare and Medicaid Services (CMS) and there were several proposals of interest to rural stakeholders in the Inpatient Prospective Payment System proposed rule including a change to distance criteria for CAH-owned ambulances and a change to the wage index calculations for PPS hospitals. As with any proposed rules, stakeholders who support or oppose these proposed changes should submit comments to let the agency know what you think—it’s your opportunity to influence the final policy. If you aren’t already on the mailing list, I encourage you to sign up for the weekly Announcements from the Federal Office of Rural Health Policy which are the best way to stay up-to-date on the latest policy proposals from CMS.

On the subject of new models, the CMS Innovation Center recently released frequently asked questions and a preview of the request for applications for the new Emergency Triage, Treat, and Transport (ET3) Model which may interest rural EMS stakeholders. 

The Federal Register has a second request for comments on the extension of the Flex Program Performance Improvement and Measurement System (PIMS) measures. This is a follow-up to the first notice published in February 2019. We must publish the two separate notices as part of the standard process for getting approval to collect Flex PIMS data for another three years.

Looking ahead, the 2019 Flex Reverse Site Visit will kick off July 10 (with an optional EMS small group meeting the day before on July 9). This annual program meeting is our chance to get together and share successes and lessons learned. We will have a rural health policy expert panel as part of the meeting—post any topics you’d like to hear about in the Flex Program Forum so we can be sure to have the panel cover them. If you haven’t yet registered for the RSV, please do so right away. As you make your travel plans, please make sure that you allow time to stay at the hotel until at least 2:30 pm on Thursday so you don’t miss our closing conversation.

Finally, I am compiling resources for you on the grant closeout and no-cost extension (if applicable) processes for the end of the current budget year. I’ll be sharing more information on these processes via the Flex mailing list.

I’m looking forward to seeing you all in July

Sarah Young

Flex Program Coordinator

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,205,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.