Rural America was slower to report cases of COVID-19. But the disease is now spreading at least as quickly in rural areas as urban ones. Read more here.

The COVID-19 crisis is forcing layoffs at rural hospitals at a time when clinics need more help caring for coronavirus patients. Will the system respond in time? Read more here.

With the U.S. experiencing a record number of initial unemployment claims, WalletHub today released its report on the States with the Biggest Increases in Unemployment Due to Coronavirus, along with accompanying videos.

To identify which states have experienced the largest unemployment increases, WalletHub compared the 50 states and the District of Columbia across two key metrics. These metrics compare initial unemployment claim increases for the week of March 23, 2020 to both the same week in 2019 and the first week of 2020. Below, you can see highlights from the report, along with a WalletHub Q&A.

The Centers for Disease Control and Prevention (CDC) has released interim guidance for responding to COVID-19 among people experiencing unsheltered homelessness. The guidance provides information and actions for health departments, homeless service organizations, housing authorities and others serving people without homes during the COVID-19 pandemic. You can also access resources on the National Health Care for the Homeless website.

The U.S. Department of Education announced on March 20 that the Office of Federal Student Aid is providing student loan relief to tens of millions of borrowers during the COVID-19 national emergency. All borrowers with federally held student loans will automatically have their interest rates set to 0% for a period of at least 60 days. In addition, each of these borrowers will have the option to suspend their payments for at least two months to allow them greater flexibility during the national emergency. This will allow borrowers to temporarily stop their payments without worrying about accruing interest. Sec. DeVos has directed all federal student loan servicers to grant an administrative forbearance to any borrower with a federally held loan who requests one. The forbearance will be in effect for a period of at least 60 days, beginning on March 13, 2020. To request this forbearance, borrowers should contact their loan servicer online or by phone. The Secretary has also authorized an automatic suspension of payments for any borrower more than 31 days delinquent as of March 13, 2020, or who becomes more than 31 days delinquent, essentially giving borrowers a safety net during the national emergency. See the Department of Education website for more information.

The Pennsylvania Department of State issued a directive indicating that due to COVID-19, additional healthcare practitioners will be needed to treat ill Pennsylvanians. This need may extend beyond the capacity of the professionals currently licensed by Pennsylvania’s health-licensing boards. To increase the available number of practitioners, the Department of State requested from Gov. Wolf a suspension to several provisions that create barriers to temporary licensure. Click on the links below for detail on the suspensions granted by the Governor and additional information for healthcare professionals on how to obtain temporary licenses:

• Pennsylvania to Allow Retired Health Care Professionals to Bolster COVID-19 Response
• Pennsylvania Expands Access to Pharmacy Services
• Some License Requirements for Qualified Physicians Assistants Are Suspended During Coronavirus Emergency
• Pennsylvania Suspends Certain Licensure Requirements for State Board of Psychology, and State Board of Social Work, Marriage and Family Therapy and Professional Counselors
• Some Continuing-Education Restrictions Suspended for Licensed Professionals
• Pennsylvania Waives Some Nurse Licensing Requirements to Aid Coronavirus Response
• Medical Doctors’ Two-Facility Institutional License Limit Suspended During Coronavirus Emergency
• Certain Regulations Suspended for Nurse-Midwives
• Issuance of Temporary Licenses to HealthCare Practitioners Not Licensed In Pennsylvania to be Expedited During Coronavirus Emergency
• Application for a Temporary License for Physicians Not Licensed in Pennsylvania
• Licensed HealthCare Practitioners Can Provide Telemedicine Services to Pennsylvanians During Coronavirus Emergency

COVID-19 has impacted nearly every aspect of the world we are living in and enrollment is not exempt from the impact. Here are some actions that do or will have an effect on enrollment:

• State Waiver Request for Reduction of Administrative Burden. The Pennsylvania Department of Human Services (DHS) submitted an 1135 Waiver to ease some of the administrative burden and procedures for Medicaid, Medicare and CHIP in Pennsylvania, tapping into the authority and temporary flexibility given when a disaster and public health emergency are declared.
• County Assistance Offices (CAOs). CAOs are closed to the public but operating. CAOs do not currently have a policy for telework. Staff shifts have been adjusted and staggered to allow processing of applications to continue.
• Marketplace Open Enrollment. Last week, Gov. Wolf sent a formal letter to the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services requesting the federal marketplace,Healthcare.gov, be re-opened to individuals who are uninsured or underinsured in response to the COVID-19 outbreak. Other states have joined the push for this administration to make significant changes to allow for additional enrollment opportunities. In addition, nine states, who operate their own state-based Marketplaces, have issued special enrollment periods with some ending as late as June for uninsured consumers.
• Enrollment Assistance. Navigators, Certified Application Counselors and enrollment assisters are permitted to assist consumers remotely and virtually, permitted prior consent is obtained in accordance with CMS Guidance. Questions, contact Tia Whitaker, Statewide Director for Outreach and Enrollment at the Pennsylvania Association for Primary Care.

Using new temporary rules allowing for remote voting, the House and Senate unanimously approved, and Governor Wolf indicated he will sign, a proposal to move Pennsylvania’s April 28 primary to June 2. The bill also provides flexibility for counties to consolidate polling places as an additional safety precaution.

CMS has been hosting regular calls with a variety of clinicians, hospitals, and other facilities in an effort to keep stakeholders updated on our COVID-19 efforts.  As we know not everyone is available to attend the calls live, we are happy to share that you can access recordings of the calls along with transcripts on the following link: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts. We will continue to host calls and share information through our list serves and media.

To keep up with the important work of the White House Coronavirus Task Force in response to COVID-19, visit https:/www.coronavirus.gov.  For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.