March 2020

March 2020

Dear Flex Coordinators,

I wanted to take this opportunity to thank you all for your support and flexibility during these unprecedented times. We thank you for bringing your questions and concerns to our attention. We are working closely with the Health Resources and Services Administration (HRSA) on guidance around COVID-19. We understand that meetings, both virtual and in-person, may be reduced or canceled as a result of guidance related to COVID-19.  If you need to make changes to your work plan, please stay in contact with your Federal Office of Rural Health Policy (FORHP) point of contact to keep us informed of specific changes in your HRSA approved work plan goals and objectives, and the impact those specific changes would have on your HRSA project. We recommend abiding by the recommendations and regulations of your state and local officials as well as using your best judgment regarding grant-funded travel. Please continue to monitor the Centers for Disease Control and Prevention (CDC) website for updates and to find information about COVID-19, including what to do if you become sick.

As rural hospitals prepare to address COVID-19, the Centers for Medicare and Medicaid (CMS) is waiving the requirements that critical access hospitals limit the number of beds to 25, and that the length of stay be limited to 96 hours. CMS has developed a COVID-19 fact sheet for health care providers that addresses this and other frequently asked questions. The Rural Health Information Hub (RHIhub) is compiling rural-specific resources to help communities and providers in rural areas.

Your Flex NCC is currently available and due in EHB on May 15, 2020. I recommend downloading the guidance from the TASC website for the most up to date links. A major change is the temporary suspension of Medicare Beneficiary Quality Improvement Project (MBQIP) Eligibility/Waivers. For Fiscal Year (FY) 2020 (September 1, 2020 – August 31, 2021), we are suspending the MBQIP Eligibility criteria which would make all CAH eligible to participate in Flex funded activities. This is a temporary suspension that will only be in effect for FY 2020 as we evaluate the MBQIP strategy. State Flex programs should continue encouraging CAHs to report on as many measures as appropriate.

Please reach out to your Flex Project Officer for any questions or concerns.

Stay Healthy,


This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.