Rural Health Information Hub Latest News

Dear Clinician: CMS Adds New COVID-19 Clinical Trials Improvement Activity to the Quality Payment Program

CMS issued a letter thanking clinicians for their ongoing efforts to treat patients and combat COVID-19 and shared additional details on the new Merit-Based Incentive Payment System (MIPS) improvement activity. As announced earlier this month, clinicians who participate in a COVID-19 clinical trial and report their findings to a clinical data repository or registry many now earn credit in MIPS under the Improvement Activities performance category for the 2020 performance period by attesting to this new activity.

Dear Clinician Letter

CMS Gives States Additional Flexibility to Address Coronavirus Pandemic

CMS has approved 140 requests for state relief in response to the COVID-19 pandemic, including recent approvals for Arkansas, Hawaii, Kentucky, Massachusetts, Minnesota, Montana, Oklahoma, Oregon, South Dakota, Tennessee, Virginia, and Wyoming. These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of waivers, amendments, and Medicaid state plan flexibilities, including for programs that care for the elderly and people with disabilities. CMS developed a toolkit to expedite the application and review of each request and has approved these requests in record time. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

 Section 1135 Waivers

Section 1115(a) Waivers 

1915(c) Waiver Appendix K Amendments

Medicaid State Plan Amendments

CHIP State Plan Amendments

Farmers Markets in Pennsylvania

Ths pandemic has spotlighted the need for fresh fruits and vegetables. Pennsylvania’s hardworking farmers, farm workers, farmers market operators, and others in the agricultural industry have shown their commitment to ensuring residents across the commonwealth have access to these products.

Here is a list of all the operating farmers markets across Pennsylvania.

Pennsylvania Governor Announces Reopening of 24 Counties Beginning May 8

Balancing economic benefits and public health risks, Governor Tom Wolf today announced the reopening of 24 counties in the northwest and north-central regions of the state, moving them from red to yellow beginning at 12:01 a.m., Friday, May 8.

Counties Moving to Yellow Reopening:

The 24 counties that will move from red to yellow on May 8 are: Bradford, Cameron, Centre, Clarion, Clearfield, Clinton, Crawford, Elk, Erie, Forest, Jefferson, Lawrence, Lycoming, McKean, Mercer, Montour, Northumberland, Potter, Snyder, Sullivan, Tioga, Union, Venango, and Warren.

These counties were deemed ready to move to a reopening – or yellow phase – because of low per-capita case counts, the ability to conduct contact tracing and testing, and appropriate population density to contain community spread.

All reopening decisions follow the six standards outlined in the governor’s plan to reopen Pennsylvania. These include adhering to:

  • Data-driven and quantifiable criteria to drive a targeted, evidence-based, regional approach to reopening.
  • Clear guidance and recommendations for employers, individuals, and health care facilities and providers for assured accountability.
  • Adequate and available personal protective equipment and diagnostic testing.
  • A monitoring and surveillance program that allows the commonwealth to deploy swift actions for containment or mitigation.
  • Protections for vulnerable populations such as limitations on visitors to congregate care facilities and prisons.
  • Limitations on large gatherings unrelated to occupations.

Please find the full plan here.

Resources for Helping Consumers Who are Experiencing Life Changes

The HHS Health Insurance Marketplace provides a list of resources for Federally-facilitated Marketplace assisters to help consumers are experiencing life changes, like loss of job-based coverage and shifts in income.

For information on reporting changes to the Marketplace, see these resources:

For information on Special Enrollment Periods, see these resources:

For information about transitioning from job based coverage to other forms of coverage (including Medicaid and COBRA), see these resources:

For guidance related to Coronavirus Disease 2019 (COVID-19), qualified health plans (QHPs) and other private market coverage, see: Coronavirus Disease 2019 (COVID-19) Guidance.

Need additional help? Refer to the Assister Technical Assistance Resource Page for more information about Marketplace eligibility and enrollment. If you need additional assistance, Navigators can reach out to their Project Officers with questions and CACs can contact the CAC inbox at

HHS Begins Distribution of Payments to Hospitals with High COVID-19 Admissions, Rural Providers

On May 1, 2020, the Department of Health and Human Services (HHS) began processing payments from the Provider Relief Fund to hospitals with large numbers of COVID-19 inpatient admissions through April 10, 2020, and to rural providers in support of the national response to COVID-19.

“These new payments are being distributed to healthcare providers who have been hardest hit by the virus: $12 billion to facilities admitting large numbers of COVID-19 patients and $10 billion to providers in rural areas, who are already working on narrow margins,” said HHS Secretary Alex Azar. “HHS has put these funds out as quickly as possible, after gathering data to ensure that they are going to the providers who need them the most. With another $75 billion recently appropriated by Congress, the Trump Administration will continue doing everything we can to support America’s heroic healthcare providers on the frontlines of this war on the virus.”

COVID-19 High-Impact Distribution:

Recognizing the particular impact the COVID-19 pandemic has had on hospitals in certain parts of the nation, and that inpatient admissions are a primary driver of costs to hospitals related to COVID-19, HHS is distributing $12 billion to 395 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020, $2 billion of which will be distributed to these hospitals based on their Medicare and Medicaid disproportionate share and uncompensated care payments.

These 395 hospitals accounted for 71 percent of COVID-19 inpatient admissions reported to HHS from nearly 6,000 hospitals around the country. The distribution uses a simple formula to determine what each hospital receives: hospitals are paid a fixed amount per COVID-19 inpatient admission, with an additional amount taking into account their Medicare and Medicaid disproportionate share and uncompensated care payments.

These hospitals will begin receiving funds via direct deposit in the coming days.

View the state and county breakdown – PDF.

Rural Distribution:

Rural hospitals, many of whom were operating on thin margins prior to COVID-19, have also been particularly devastated by this pandemic. As healthy patients delay care and cancel elective services, rural hospitals are struggling to keep their doors open.

Recipients of the $10 billion rural distribution will include, rural acute care general hospitals and Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs), and Community Health Centers located in rural areas.

Hospitals and RHCs will each receive a minimum base payment plus a percent of their annual expenses. This expense-based method accounts for operating cost and lost revenue incurred by rural hospitals for both inpatient and outpatient services. The base payment will account for RHCs with no reported Medicare claims, such as pediatric RHCs, and CHCs lacking expense data, by ensuring that all clinical, non-hospital sites receive a minimum level of support no less than $100,000, with additional payment based on operating expenses. Rural acute care general hospitals and CAHs will receive a minimum level of support of no less than $1,000,000, with additional payment based on operating expenses.

Eligible providers will begin receiving funds in the coming days via direct deposit, based on the physical address of the facilities as reported to the Centers for Medicare and Medicaid Services (CMS) and the Health Resources and Services Administration (HRSA), regardless of their affiliation with organizations based in urban areas.

View the state-by-state breakdown – PDF.

HHS and the Administration are continuing to work rapidly on additional targeted distributions to some providers including skilled nursing facilities, dentists, and providers that solely take Medicaid.

Visit for additional information.

Update to COVID-19 Data Primer from Mathematica

In response to the evolving COVID-19 pandemic, particularly in the area of data analytics, Mathematica created a COVID-19 Data Primer. The primer is designed to help researchers, data scientists, and others who analyze health care claims or administrative data quickly join the effort to better understand, track, and contain COVID-19. Today, Mathematica launched an update adding information on linking claims to public data sources and information on how diagnosis and procedure codes are being used in claims.

Read more.

Policy Brief: Metropolitan/Nonmetropolitan COVID-19 Confirmed Cases and General and ICU Beds

Fred Ullrich, BA; and Keith Mueller, PhD

The spread of COVID-19 across rural areas has fueled concern about the availability of healthcare resources for dealing with the pandemic. This brief looks at a single measure of healthcare resources – hospital beds – and reports of current COVID-19 cases in a single week to assess the impact on rural facilities.

Please click here to read the brief.