The Department of Health and Human Services (HHS) announced its plan for allocating and disseminating the remaining $70B of the $100B appropriated to the Provider Relief Fund under the CARES Act.
- HHS will distribute $20M to providers weekly, on a rolling basis, beginning April 24, 2020 as part of $50B in general distributions ($30B was delivered to providers on April 10, 2020 based on providers’ share of Medicare FFS reimbursement for 2019; see WHG client summary). The $20B will augment the earlier $30B, ensuring the total $50B in general distribution is allocated proportional to providers’ share of 2018 net patient revenue.
- Next Steps: Some providers will automatically receive an advance payment based off the revenue data they submit in CMS cost reports on April 24. Providers without adequate cost report data on file must submit their revenue information to a portal opening this week. HHS notes that providers who receive automatic payments are still required to submit their revenue information for verification. Providers are required to submit an attestation, and are bound by the terms and conditions of the funds as they were under the initial $30B distribution, including refraining from balance billing presumptive or actual COVID-19 patients.
- High-Impact Areas: $10B will be provided to hospitals in areas that have been particularly impacted by the COVID-19 outbreak. HHS notes that, for example, hospitals serving COVID-19 patients in New York, which has a much higher percentage of total confirmed COVID-19 cases than elsewhere in the country, are expected to receive a large share of the funds.
- Next Steps: Hospitals can apply for a portion of the funds by submitting information via an authentication portal before midnight PT, Thursday April 23. Hospitals have already been contacted to provide this information (see WHG client summary). The administration will use the data to ensure funds are distributed to where the impact from COVID-19 is greatest. Further, HHS notes it will take into consideration the challenges of serving a significantly disproportionate number of low-income patients, as reflected by hospitals’ Medicare Disproportionate Share Hospital (DSH) Adjustment.
- Treatment of the Uninsured: HHS does not provide a dollar amount, but some portion of the Provider Relief Fund will be used to reimburse providers for COVID-related treatment of the uninsured. Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, is eligible to request claims reimbursement. Providers will be reimbursed at Medicare rates, subject to available funding.
- Next Steps: Providers must take action to enroll as a participant; check patient eligibility and benefits; submit patient information; submit claims; and receive payment through direct deposit. Registration for the program will open on April 27, 2020, and claims submission will commence in early May 2020. More information is available here.
- Rural Providers: $10B will be provided to rural health clinics and hospitals, with distribution as early as next week. The funding will be allocated on the basis of operating expenses, using a methodology that distributes payments proportionately to each facility and clinic. HHS notes that precarious financial circumstances facing many rural hospitals informed the decision for a separate, targeted allotment.
- Indian Health Service: $400M will be provided to Indian Health Service facilities, with distribution as early as next week. The funding will be allocated on the basis of operating expenses for facilities. This funding is in addition to separate funding available through other provisions of the CARES Act.
HHS notes that certain providers, including skilled nursing facilities, dentists, and providers that solely take Medicaid, will receive further, separate funding. The administration did not provide further insight into how much these providers should expect or what factors will be considered when determining the additional amounts.