What You Need to Know: Provider Relief Funding

Clinicians and practices across the country started to receive funds via direct deposit on April 10, as the Department of Health and Human Services (HHS) disbursed the first $30 billion directly to eligible Medicare providers out of the $100 billion CARES Act Provider Relief Fund.

HHS announced the allocation of the remaining provider relief funding on April 23, with funds being disbursed different general, targeted, rural, Indian Health Service, and uninsured funding streams.

Here is what you need to know:

  • Received Provider Relief Funds as Part of the First Initial Disbursement?
    Clinicians and practices that received Medicare fee-for-service (FFS) payments from the Centers for Medicare and Medicaid Services (CMS) in 2019 should have received the first distribution of provider relief funding allocated for general distribution to Medicare providers between April 10 and April 17.

    If you or your practice was part of this group, you must go to the CARES Provider Relief Fund Payment Portal to confirm your eligibility, billing TIN(s) and payment information and complete attestations confirming receipt of funds and agreeing with terms and conditions within 45 days of payment. HHS extended the original 30-day deadline for health care providers to attest to receipt of payments and accept Terms and Conditions on May 7. For example, the initial 30-day deadline for providers who received payment on April 10, is extended to May 24 from May 9.

    Note: With the extension, not returning the payment within 45 days of receipt of payment will be viewed as acceptance of the Terms and Conditions. Otherwise, an attestation must also be completed if you choose to reject the funds.
  • Seeking Additional Provider Relief Funds?
    Distribution of the remaining $20 billion of the $50 billion general distribution to Medicare providers has also begun. Medicare providers and practices must complete an application process, which includes submitting revenue information, to receive additional general distribution funds. Facilities for whom CMS had 2018 cost report data should have received additional funds automatically.

    Both facilities and practices must go through the attestation process and agree to the Terms and Conditions for this additional distribution. All those receiving additional funding will need to upload their most recent IRS tax filings as well as estimates of lost revenues for March and April 2020.
  • Terms, Conditions and Taxes
    Keep in mind that by signing the terms and conditions, ALL RECIPIENTS of Provider Relief funds will be required, upon request, to submit documents sufficient to ensure the funds were used for health care-related expenses or lost revenue attributable to COVID-19.

    Additionally, 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.
  • Provided COVID-19 Testing or Treatment for Uninsured Patients?
    Providers who conducted COVID-19 testing or provided treatment for uninsured individuals with COVID-19 on or after Feb. 4 can begin to request claims reimbursement for testing and treating the uninsured. Providers will be reimbursed generally at Medicare rates, subject to available funding.

    Steps include: enrolling as a provider participant, checking patient eligibility, submitting patient information, submitting claims, and receiving payment via direct deposit. Access the portal at coviduninsuredclaim.linkhealth.com. For more information on the process and eligibility read the FAQ document.

Keywords: ACC Advocacy, Coronavirus, Coronavirus Infections, Centers for Medicare and Medicaid Services (U.S.), Medicare, Medicaid, COVID-19, severe acute respiratory syndrome coronavirus 2, United States Dept. of Health and Human Services


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