Rural transit agencies are a lifeline to the communities they serve and have stayed open during the coronavirus pandemic to ensure residents are able to access essentials. This article discusses how they have adapted, the impact COVID-19 has had on rural transit agencies financially, and how they get their funding. Read more here.

From The Daily Yonder:

This article summarizes an analysis that identified economic patterns in the distribution of COVID-19 cases. Findings show more than a third of new cases emerging in rural counties originated where manufacturing is the predominant economic driver. It also identifies prisons as a driver of coronavirus infections, as well as recreation economies. Read more here.

This site serves as a pre-publication notice of interim final rule with comment period from the Health Resources and Services Administrations and Centers for Medicare and Medicaid Services giving flexibility to those providing services to Medicare, Medicaid, Basic Health Program, and Exchange beneficiaries in order to respond effectively to the COVID-19 pandemic. It provides a table outlining flexibilities and the dates in which they are applicable, including those for providers and facilities in rural areas. This interim rule is effective upon publication in the Federal Register, which is scheduled for May 8, 2020. Comments are due within 60 days of publication. Find the site here.

In rural settings, Community Health Workers (CHWs) act as liaisons between providers and consumers, providing culturally-appropriate health education, making referrals for health and social services, and advocating for individuals and communities within the health service system.  This free online training from the global public health organization, Medical Care Development (known as MCD), covers the various roles CHWs can take in combating the spread of the coronavirus.

The Association of State and Territorial Health Officials (ASTHO) is providing a free online course for entry-level COVID-19 contact tracers.  Contact tracing is a control measure for preventing further spread of disease.  The training will be augmented by protocols specific to state and local jurisdictions and focus on building knowledge for remote contact tracing.

Recently, CMS issued a Memorandum that conveys information in response to inquiries from hospitals and Critical Access Hospitals (CAHs) concerning implications of COVID-19 for their compliance with the Emergency Medical Treatment and Labor Act (EMTALA). The memo was revised to include additional guidance related to the establishment of drive through testing sites, clarification of expectations in relation to the triage process and the medical screening examination, and use of telehealth. Among other topics, the memo address transfers to and from rural hospitals.

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On April 30, CMS updated its MLN Matters® Special Edition Article is for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) during the COVID-19 Public Health Emergency for services provided to Medicare beneficiaries. The update provides additional details about the new payment for telehealth services, cost-sharing related to COVID-19 testing, additional telehealth flexibilities, and the revision of the bed count methodology for determining the provider-based RHCs exemption to the RHC payment limit.

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If a health care provider is eligible to participate in the Medicare Promoting Interoperability Program, they must successfully demonstrate meaningful use of their certified electronic health record (CEHRT) each year to avoid a downward payment adjustment. Eligible hospitals and CAHs may be exempted from the Medicare downward payment adjustment if they can show that compliance with the requirement for being a meaningful EHR user would result in a significant hardship. To be considered for an exception (to avoid a downward payment adjustment), eligible hospitals and CAHs must complete and submit a Hardship Exception Application. CMS recently extended the deadline to September 1 for hospitals (previously July 1). The deadline to submit a Hardship Exception Application is November 30 for CAHs.

On April 30, CMS issued another round of regulatory waivers and rule changes during the COVID-19 Public Health Emergency. These changes build on temporary regulatory waivers and new rules CMS announced March 30 and April 10. Highlights of the waivers and rule changes include flexibilities to increase hospital capacity, health care workforce changes, efforts to reduce administrative burden, and a number of expansions of telehealth in Medicare. For more information on the COVID-19 waivers and guidance, and the Interim Final Rule, please go to the CMS COVID-19 flexibilities webpage.