As midterm elections loom, Congress sent to the president the federal government's first comprehensive policy response to the nation's opioid crisis; a bipartisan House letter questions outpatient payment cuts; and New Hampshire senators introduced surprise billing legislation.

Modeled on a program developed at essential hospital St. Joseph's Regional Medical Center, in Paterson, N.J., the Alternatives to Opioids bill is one of 25 opioid-related bills the House passed last week.

The interagency effort targets obstacles to health care, including a fragmented delivery system and lack of specialty service access, faced by many rural communities.

This year's report includes the commission’s statutorily required annual analysis of Medicaid disproportionate share hospital payments, as well as chapters on Medicaid managed care and telehealth.

In response to the request for information, the association encouraged flexibility and a focus on hospitals treating high numbers of complex patients.

The rule includes additional cuts to new off-campus, provider-based departments (PBDs), as well as physician payment and quality program changes.

The committees were convened at the direction of the Department of Health and Human Services and include representatives from members of America’s Essential Hospitals.