HHS Announces Additional Allocations of CARES Act Provider Relief Fund

HHS Announces Additional Allocations of CARES Act Provider Relief Fund

The president signed the bipartisan CARES Act legislation to provide relief to American families, workers, and the heroic healthcare providers on the frontline of the COVID-19 outbreak. $100 billion is being distributed by the Administration to healthcare providers, including hospitals battling this disease.

In allocating the funds, the Administration is working to address both the economic harm across the entire healthcare system due to the stoppage of elective procedures, and addressing the economic impact on providers incurring additional expenses caring for COVID-19 patients, and to do so as quickly and transparently as possible.

This tranche will look at a provider’s total revenue based on 2018.  The first tranche looked at Medicare Fee For Service (FFS) claims.  The next tranche will look at Medicaid/Medicare Advantage revenue.  For example, if a provider has a high Medicare FFS rate, then the next payment will be lower.  But if the Medicaid/MA book of business is higher, the next payment will be larger.  On net, providers will see their percentage of the $50 billion based on their share of Medicare and Medicaid payments from 2018.

While some providers will start receiving funds this week, all providers will need to go on to the portal on https://www.hhs.gov/provider-relief/index.html to fill verify revenue data.  That portal will go live later this week.  More funds will go out on a rolling basis as data is verified.

GENERAL ALLOCATION

  • $50 billion of the Provider Relief Fund is allocated for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers' 2018 net patient revenue.
  • To expedite providers getting money as quickly as possible, $30 billion was 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.
  • This simple formula, working with the data we had, was used to get the money out the door as quickly as possible. We were very clear that additional funds would be going out quickly to help providers with a relatively small share of their revenue coming from Medicare fee-for-service, such as children's hospitals.
  • Those funds are beginning to be delivered this week. HHS will begin distribution of the remaining $20 billion of the general distribution to these providers to augment their allocation so that the whole $50 billion general distribution is allocated proportional to providers' share of 2018 net patient revenue.
  • On April 24, a portion of providers will automatically be 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 a portal opening this week at https://www.hhs.gov/providerrelief 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.
  • Payments will go out weekly, on a rolling basis, as information is validated, with the first wave being delivered at the end of this week (April 24, 2020).
  • Providers who receive funds from the general distribution have to sign an attestation exit disclaimer icon confirming receipt of funds and agree to the terms and conditions of payment and confirm the CMS cost report.
  • The terms and conditions also include other measures to help prevent fraud and misuse of the funds. All recipients will be required to submit documents sufficient to ensure that these funds were used for healthcare-related expenses or lost revenue attributable to coronavirus. There will be significant anti-fraud and auditing work done by HHS, including the work of the Office of the Inspector General.
  • The administration is committed to ending surprise bills for patients. As part of this commitment, as a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a presumptive or actual COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.

Source: https://www.hhs.gov/about/news/2020/04/22/hhs-announces-additional-allocations-of-cares-act-provider-relief-fund.html