CMS Launches Rural Health Transformation Program

If you're reading this newsletter, you probably know that rural patients face higher chronic disease rates and longer travel times for care. As part of this year's working families tax cuts legislation that President Trump signed into law this summer, we also passed the single largest investment in rural healthcare with the Rural Health Transformation (RHT) Program.

This program empowers states to improve healthcare access and outcomes for rural communities. The program is structured with $50 billion in funding for approved states over five fiscal years, with $10 billion available each year starting in 2026. Half of the funding will be distributed equally to all approved states, and half will be allocated by the Centers for Medicare & Medicaid Services (CMS) based on rural needs and state-specific factors.

Information on how to apply for RHT Program funding will be released through a Notice of Funding Opportunity (NOFO) and available on grants.gov this month. In the meantime, you can find more information on RHT and register for applicant webinars on the CMS website.

Medicare Advantage Roundtable

I recently met with Seventh District constituents to discuss affordable healthcare options for seniors. As you may know, Medicare Advantage (MA) serves as a privately administered alternative to traditional Medicare. Under MA, the federal government pays private insurers a rate to provide Medicare Part A and Part B services, which are allowed to offer supplemental benefits not available under traditional Medicare like dental, vision, and wellness. I am proud to say that I am a cosponsor of the Improving Seniors' Timely Access to Care Act, which streamlines the prior authorization process for those enrolled in MA, allowing providers to spend more time on patient care.

Thank you to everyone who participated for sharing all the ways Medicare Advantage has helped you and your families.

Urging Implementation of the No Surprises Act

In 2020, the No Surprises Act (NSA) was signed into law to protect patients from surprise medical bills and increase transparency. Unfortunately, several key provisions are still unfulfilled. These delays and failures to implement the NSA hurt patients and providers in communities with limited hospital and physician options, like much of the Seventh District, more than other areas of the country. But now that we have an Administration that understands and wants to support our rural communities, I am hopeful we will see progress made.

I have joined my colleagues in sending a letter to the Departments of Health and Human Services, Treasury, and Labor, urging them to implement the NSA according to congressional intent, ensuring patient protections, timely payments, and healthcare price transparency.

Countering China's Fake Drug Supply

Patients and healthcare providers should be able to depend on a safe and secure drug supply without fear of exposure counterfeit medications. However, we have seen an influx in dangerous drugs impersonating weight-loss medication entering the U.S. supply from unregistered foreign sources, particularly from China. These drugs have been found to contain either unknown substances, impurities, or even completely different drugs. This obviously puts consumers at significant risk of adverse side effects.

I have joined my colleagues in calling on the Food and Drug Administration (FDA) to crack down on their enforcement against illicit imports. This includes, for example, coordinating with U.S. Customs and Border Patrol (CPB) to block unapproved drugs from unregistered sources.

Improving Portable Ultrasound Access for Seniors

Thanks to technological advancements, portable ultrasound equipment is more compact, lightweight, and able to deliver high-quality images. These improvements mean patients can get diagnosed for acute and chronic conditions like blood clots, heart failure, and abdominal issues faster than ever before. Unfortunately, despite these developments, Medicare's reimbursement structure has not kept face, which leaves providers of this equipment ineligible for reimbursement. 

I am proud to cosponsor the Portable Ultrasound Reimbursement Equity Act to update these policies and support broader access to efficient, on-site diagnostic care for Medicare beneficiaries. This will help seniors, living in rural areas or living with disabilities, like so many across the Seventh District, receive more timely and effective care.

Protecting American Innovation and Fair Prices for Consumers

Like many other industries, America has been taken advantage of by foreign countries in the pharmaceutical space. American patients currently fund about 75% of global profits, despite being less than 5% of the world's population. This imbalance is caused, in part, by foreign nations implementing price controls and reimbursement limits, shifting the burden to American consumers. This imbalance is especially clear when looking at the difference in contributions to research and development between the U.S. and other countries.

My colleagues and I have sent a letter to the U.S. Trade Representative Greer, urging him to aggressively hold foreign nations accountable for undervaluing American innovation. We recommended he establish a Chief Pharmaceutical Negotiator to make sure our trade deals with other countries prioritize fair reimbursement for medicines developed in America. This would ensure America maintains its global edge in biopharmaceutical innovation.

Thank you for reading!

fischbach.house.gov

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