On April 22, The U.S. Department of Health and Human Services (HHS) announced it would release the remaining $70 billion in funding for healthcare providers. HHS previously released $30 billion weeks earlier, part of the $100 billion in relief funds to hospitals and healthcare providers on the front lines of the coronavirus response. For complete details, please refer to: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html
Here is an outline of key provisions in the Public Health and Social Services Emergency Fund (PHSSEF):
Next $20 billion in General Distribution, Total of $50 billion.
- Beginning April 24, 2020, this next $20 billion will be distributed on a rolling basis in proportion to a provider’s 2018 net patient revenue.
- Some providers will receive an advance payment based off the revenue data in cost reports.
- $30 billion was previously distributed immediately, proportionate to providers’ share of Medicare fee-for-service reimbursements in 2019. On Friday, April 10, $26 billion was delivered to bank accounts. The remaining $4 billion of the expedited $30 billion distribution was sent on April 17.
$10 billion for Rural Health Clinics, Rural Hospitals
- Funds will be distributed on the basis of operating expenses, using a methodology that distributes payments proportionately to each provider, facility and clinic.
- Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through the program and will be reimbursed at Medicare rates, subject to available funding.
- Steps will involve: enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit.
- Providers can register for the program on April 27, 2020, and begin submitting claims in early May 2020. For more information, visit coviduninsuredclaim.hrsa.gov.
- Reimbursements will be made for: qualifying testing for COVID-19 and treatment services with a primary COVID-19 diagnosis, including the following: Specimen collection, diagnostic and antibody testing; Testing-related visits including in the following settings: office, urgent care or emergency room or via telehealth; Treatment: office visit (including via telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, and others. For a complete list, visit https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html
What to do next
On April 24, a portion of providers were automatically sent an advance payment based off the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to submit their revenue information to the General Distribution Portal for additional general distribution funds.
Providers who receive their money automatically will still need to submit their revenue information so that it can be verified via the General Distribution Portal .
HHS has outlined frequently asked questions on its website, including:
- Who is eligible?
- How are payment distributions determined?
- What to do if you are an eligible provider?
- Is this different than the CMS Accelerated and Advance Payment Program?
- How does this apply to different types of providers?
For more information, visit: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html
We are here to help
The Healthcare Practice Group at Lurie is available to help you navigate through this topic and help with any other questions you may have. Please contact our team to speak with a Lurie trusted advisor.