Rural Health Information Hub Latest News

CMS Summary of Actions Taken

Here is a summary of recent Centers for Medicare & Medicaid Services (CMS) actions taken in response to the COVID-19 virus, as part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, click here For information specific to CMS, please visit the CMS News Room and Current Emergencies Website. CMS updates these resources on an ongoing basis throughout the day; the information below is current as of April 3, 2020 at 10:00 AM.

Trump Administration Issues Key Recommendations to Nursing Homes, State and Local Governments

Recently, CMS, in consultation with the Centers for Disease Control and Prevention (CDC), issued critical recommendations to state and local governments, as well as nursing homes, to help mitigate the spread of the 2019 Novel Coronavirus (COVID-19) in nursing homes. The recommendations build on and strengthen recent guidance from CMS and CDC related to effective implementation of longstanding infection control procedures.

Press Release


CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic

CMS approved its 44th state Medicaid waiver delivering urgent regulatory relief to ensure States can quickly and effectively care for their most vulnerable citizens. In light of the urgent and evolving needs of states during the COVID-19 crisis, CMS developed a toolkit to facilitate expedited application and approval of State waivers requests in record time. The waivers support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported. Recently approved states include Alaska, Arkansas, and Nebraska.

CMS also approved one more state waiver amendment requests for California to give emergency flexibilities in their programs that care for the elderly and people with disabilities, bringing the total to 17 approvals across 15 states.

Section 1135 Waivers

1915(c) Appendix K Waivers

Medicare and Telehealth Services Blog

The Social Security Administration (SSA) featured a guest blog by CMS Administrator, Seema Verma with important information on Medicare coverage and recently expanded coverage of telehealth services. CMS actions protect beneficiaries while maintaining trusted access to care in the face of the coronavirus pandemic.

Social Security Matters Blog

Medicaid Telehealth Flexibilities for Rural Health Care Substance Use Disorder

CMS released an Informational Bulletin to states that explains how states can use telehealth delivery methods to expand access to Medicaid services, including substance use disorder (SUD) treatment and services. The guidance outlines how telehealth may be used to service rural communities, high-risk individuals, school-based health centers and SUD programs. It provides information about Medicaid coverage and reimbursement of SUD treatment services and supports CMS actions in response to the COVID-19 virus as well as the opioid epidemic.

Informational Bulletin

Updates Available to Medicaid and CHIP Frequently Asked Questions

CMS issued additional Frequently Asked Questions for State Medicaid and Children’s Health Insurance Program (CHIP) agencies to aid states in their response to the COVID-19 outbreak.  Topics include: emergency preparedness and response; flexibilities around eligibility and enrollment; benefits, premiums and cost sharing; financing; managed care; fair hearings; health information exchanges; and COVID-19 T-MSIS coding guidance.

 Frequently Asked Questions

National Labor Exchange Launches Job Resource to Support Displaced Workers during Coronavirus Pandemic

April 1–Today, nonprofits DirectEmployers Association and the National Association of State Workforce Agencies (NASWA), announce the launch of, a job site dedicated to providing a centralized location for displaced workers to access employment opportunities from U.S. corporations with immediate hiring needs due to the novel coronavirus (COVID-19). Powered by the National Labor Exchange (NLx), the site houses jobs from vetted employers in all industries and provides an opportunity for Americans to return to work and gain meaningful employment.

“The National Labor Exchange’s mission is to provide a cost-effective national employment system that improves labor market efficiency. We are working together to align and leverage the assets and power of major U.S. corporations and all workforce partners to minimize the economic impact on displaced workers due to COVID-19,” says Candee Chambers, DirectEmployers Association’s Executive Director. contains over 400,000 job openings and continues to grow daily. While many employers are downsizing their staff, others are significantly increasing their hiring efforts due to current demands. Through this initiative, DirectEmployers and NASWA will assist in bridging the gap between job supply and demand by offering an easy way for job seekers to gain access to current open positions and for employers to fill positions quickly and efficiently during these difficult times.

“This new tool will help states quickly connect workers to employers with urgent job openings,” said Scott B. Sanders, NASWA Executive Director. “The Need A Job Now site will provide new opportunities for our workforce during these unprecedented times and we are proud to be a partner in this NLx initiative.”

As part of the NLx, this resource is offered at no cost to job seekers or employers. All jobs found on will be refreshed daily with current job content from employers across the country. Employers wishing to have their jobs included within the site can visit for more information.

Trump Administration Issues Key Recommendations to Nursing Homes, State and Local Governments

On April 3, at the direction of President Trump, the Centers for Medicare & Medicaid Services (CMS), in consultation with the Centers for Disease Control and Prevention (CDC), issued critical recommendations to state and local governments, as well as nursing homes, to help mitigate the spread of the 2019 Novel Coronavirus (COVID-19) in nursing homes. The recommendations build on and strengthen recent guidance from CMS and CDC related to effective implementation of longstanding infection control procedures.

Press Release


Payment Protection Program Interim Final Rule Released

The U.S. Department of Treasury (Treasury) and Small Business Administration (SBA) released an interim final rule on the Paycheck Protection Program (PPP). While SBA still needs to confirm some administrative details, loans will be provided on a first-come, first-served basis and producers can get started on the application now.

Below please find additional details about the PPP program. We will answer outstanding issues once SBA provides further guidance.

  1. Program Eligibility
    1. All businesses (including farm and ranch businesses) are eligible for a PPP loan if they (1) have fewer than 500 employees; (2) meet the definition of a “small business concern”; and (3) are subject to SBA’s affiliation rules (unless those rules were specifically waived in the CARES Act).
  2. Waiting on SBA to clarify the definition of “small business concern” – do not anticipate any undue restrictions.
  3. Waiting on SBA to confirm whether H2A workers are counted as “employees” for the purposes of determining size.
    1. Financial institutions, including the Farm Credit system, will be responsible for processing loan applications and administering the loan.
  1. Loan Terms
    1. Loan amounts are calculated based on the payroll costs for all employees whose “principal place of residence” is in the U.S. Please note that this definition excludes H-2A workers, which will likely reduce the loan amount available to some agricultural producers.
    2. This loan has a maturity of 2 years and an interest rate of 1%. Loan payments will be deferred for the first six months.
    3. The loan will be fully forgiven if at least 75% of the funds are used for payroll costs, and the remainder is used for interest on mortgages, rent, and utilities.
  1. Forgiveness is based on the employer maintaining or quickly rehiring employees and maintaining salary levels.  Forgiveness will be reduced if full-time headcount declines, or if salaries and wages decrease.
  1. The best POC for questions on the Paycheck Protection Program is the Lender Relations Specialist in your local SBA Field Office.  The local SBA Field Office may be found at

Management Checklist for Teleworking Surge During the COVID-19 Response

While teleworking has become a routine way of doing business in many industry sectors and
government, teleworking during wide-scale public emergencies such as what we are experiencing with
the emergence of the COVID-19 virus introduces significant management, technology and bandwidth
challenges to ensuring uninterrupted and efficient workflow and provision of services to the public.
Added strain on the public telecommunications infrastructure over the “last mile” to the home, in
particular, requires critical healthcare entities to assess risk, prioritize tasks and apportion bandwidth
resources to ensure continuity of mission-essential functions that may migrate off premises to the home
office environment. Continue reading.

Agency Information Collection Activities: Proposed Collection; Request

March 18, 2020


For the “Opioid Management in Older Adults” project, AHRQ is seeking to identify innovative approaches to managing opioid medications for chronic pain that are particularly relevant for older adults. Use of long-term opioid therapy in older adults can be especially problematic because of increased risks such as delirium, falls, and dementia.

Learn how to submit here.

FCC Waives Rural Health Care and E-Rate Program Gift Rules to Promote Connectivity for Hospitals and Students During Coronavirus Pandemic

WASHINGTON, March 18, 2020—The Federal Communications Commission today
announced important changes to the Rural Health Care (RHC) and E-Rate programs that will
make it easier for broadband providers to support telehealth and remote learning efforts during
the coronavirus pandemic. Specifically, the FCC’s Wireline Competition Bureau has waived
the gift rules until September 30, 2020 to enable service providers to offer, and RHC and ERate program participants to solicit and accept, improved connections or additional equipment
for telemedicine or remote learning during the coronavirus outbreak.

Read more

Realizing The Vision of Advanced Primary Care: Confronting Financial Barriers to Expanding the Model Nationwide

This article describes how advanced primary care models help to bring person-centered, affordable care to high-risk patient populations. Addresses challenges to implementing the model, such as high operating costs and lack of structure to operate in rural areas, and highlights opportunities to overcome these barriers. Read more here. (May require a subscription to view full article).