NOSORH and the fifty State Offices of Rural Health congratulate and appreciate the work of the National Rural Health Association team for their great work advocating for rural providers across the nation during this public health crisis. These are tough times for all. We value NRHA’s “rural voice louder” now more than ever. Thank you Alan Morgan, Maggie Elehwany, Mason Zeagler, Max Isaacoff, and the entire NRHA team for exemplary leadership and advocacy.

The Senate returns to Washington on  May 4 for the first time since late March.  The House will most likely return on May 11.

Putting together and passing a CARES 2.0 will be the main priority for Congress during the spring session. The legislation will likely include additional relief for hospitals, some form of liability protection, and funding for state and local governments to respond to COVID. Congress may consider a number of rural health-related provisions in the next recovery package including: increased flexibility for telehealth, supporting increased funding for broadband access, allowing CAHs to cost settle after the COVID pandemic, and updates to the Medicare Rural Hospital Flexibility Program.

Unlike the first three stimulus bills passed by Congress, members are considering including other non-COVID health priorities like surprise billing and drug pricing (H.R. 3/S. 2543) into CARES 2.0. The timeline for Congress moving a fourth stimulus is unclear, with Republican leadership indicating they would like to see how current virus funding impacts states and regions.

HHS Begins Distribution of Payments to Rural Hospitals, Providers with Elevated COVID Admissions:  On May 1, HHS announced that $10 billion will be distributed to rural acute care general hospitals and Critical Access Hospitals, Rural Health Clinics, and Community Health Centers located in rural areas. Funds will be directly deposited, rural providers need not apply. Each RHC will receive a minimum of $100,000. CAHs will each receive a minimum of $1 million with the median receiving $3.6 million. HHS released a chart detailing the rural payment amount by State. Texas, Iowa, and Minnesota appear to receive the biggest share.

HHS also announced that $10 billion will be distributed to 395 hospitals who provided inpatient care for 100 or more COVID patients through April 10, 2020. $2 billion will be distributed to certain hospitals based on their Medicare and Medicaid disproportionate share and uncompensated care payments. HHS released a chart detailing the payment amounts by State.

Appropriations Update:  With Congress returning in May, House and Senate appropriators will have limited time to pass their Fiscal Year (FY) 2021 funding bills. With Congress already approving trillions of dollars in stimulus funding this year, many programs are bracing to see how the committees write their FY 21 spending bills. Some of the house appropriations subcommittees are targeting late June as a date to move their bills.