Knowledge of the health care industry as a whole is not sufficient to meet the needs of health care providers in rural areas. Polsinelli’s health care team understands the unique business, clinical, regulatory and community issues that rural health care providers face.

We have extensive experience representing a variety of rural health care providers including Critical Access Hospitals (CAHs), Rural Health Centers (RHCs), Federally Qualified Health Centers (FQHC) and Rural Community Hospitals.

These providers, and their patients, face vastly different obstacles than their urban counter parts. Economic, cultural, educational and health disparities add a level of complexity to the provision of quality care that do not affect urban hospitals in the same way. Despite extremely limited resources, rural providers creatively tackle these hurdles by innovating strategies like telehealth, physical and mental health integration and aligning with other rural health providers or urban hospitals to ensure their patients have sustained access to the highest level of care possible within their own communities. Polsinelli helps rural health care providers across the country solve a variety of issues, including:

  • Government and commercial reimbursement, including Medicaid expansion, Medicaid waiver programs, unique Medicare rules for rural providers and Medicare cost-based and prospective payment systems
  • Facility, licensure, enrollment, survey and certification
  • Provider-based and space sharing rules applicable to CAH’s, and related RHCs or outpatient departments
  • Compliance with HRSA and other third-party grant rules
  • Alignment models with other rural providers or urban systems
  • State licensure and coordination with state rural health offices
  • Compliance with state and federal fraud and abuse laws
  • Governance requirements and issues
  • Telehealth opportunities
  • Physician contracting, engagement, and employment
  • Audits and investigations
  • Behavioral Health Care and Substance Abuse models in rural areas
  • Medical staff and peer review
  • EMTALA compliance
  • Star rating/hospital compare issues
  • School-based health care
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$50 Billion Rural Health Fund: State Applications Now Open, Provider Input Urged
The Centers for Medicare and Medicaid Services (CMS) announced this week that state applications for the new $50 billion Rural Health Transformation Fund are now open and due no later than Nov. 5, 2025.i For health care providers, this is a one-time opportunity to influence how billions in federal funds will be directed across provider payments, workforce stabilization, chronic disease care, digital infrastructure and more. The tight deadline means health care providers should move quickly to engage with state government to help shape how these dollars are prioritized.  About the Rural Health Fund The Rural Health Transformation fund was a last-minute addition to the “One Big Beautiful Bill Act” in response to bipartisan concerns over the Act’s Medicaid policy changes and their potential
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Medicare Continues its Updates to Provider Enrollment Policies as Part of Efforts to Enhance Program Integrity and Transparency
The Centers for Medicare & Medicaid Services (“CMS”) continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment regulations and policies through recent regulatory and sub-regulatory actions. These efforts, which are described in detail below, include updates to Medicare’s provider and supplier enrollment regulations at 42 C.F.R. §424, Subpart P and changes to the Form CMS-855A for the first time in twelve years. These changes are another indicator of Medicare’s trend towards enhanced oversight and enforcement of program integrity standards as health care providers and suppliers have exited the COVID 19 Public Health Emergency. Notably, CMS has consistently trended towards enhanced disclosure and publication of ownership and control interests for certain providers, including a recent
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