Healthcare Regulatory Alerts

In a letter to State enforcement agencies (SA’) dated 3/31/23, CMS issued a categorical waiver for Health Care Microgrid Systems (HCMS’). HCMS’ are small-scale electrical grids where the sources of electricity can be provided by clean energy technologies (e.g., fuel cells, solar, wind, energy storage, etc.).

The waiver permits new and existing health care facilities subject to CMS requirements to utilize alternate sources of power other than a generator set or battery system only if in accordance with the 2021 edition of the NFPA 99, 2023 edition of the National Electric Code (NFPA 70), and associated references.

The categorical waiver excludes long-term care (LTC) facilities that provide life support as the LTC requirements at 42 CFR 483.90(c)(2) requires these facilities to have an emergency generator without exception.

In a letter to State enforcement agencies (SA’) dated 3/31/23, CMS announced that until further notice, the Centers for Medicare and Medicaid Services (CMS) will use the 2010 and 2020 Census urban criteria when making rural location determinations.

On March 24, 2022, the Census Bureau (CB) published final regulations establishing its new criteria for defining urban areas based on the results of the 2020 Decennial Census. The final rule modified some, and retired other, terminology currently used in statute and regulations for CMS’s oversight of the Medicare Rural Health Clinic (RHC) program.

Specifically, the CB is retiring the terms “urbanized” and “urban clusters” and defining urban areas using modified population and geographic definitions. Section 1861(aa)(2) of the Social Security Act (the Act) requires an RHC, among other things, to be located in an area that is not urbanized, as defined by the CB. Currently, CMS approves RHC applicants if their physical address is considered “non-urbanized” or in an “urban cluster.” Given the CB change, CMS policy no longer aligns with the Act.