$20 billion based on net patient revenue, $10 billion for high-impact areas, and allocations for treatment of the uninsured, rural providers, the IHS and additional facilities and providers

On April 22, the Department of Health and Human Services (HHS) announced how it plans to disburse additional funding from the CARES Act's $100 billion provider relief fund, of which $30 billion has already been allocated based on provider's share of 2019 Medicare fee-for-service reimbursements. Secretary Alex Azar said their goal in distributing the funds is "to get the money … out the door as quickly as possible while targeting it to those suffering the most from the pandemic." The Administration has been under scrutiny for the way in which the first batch of funding was delivered, with Congressional Democrats and others urging them to take a more targeted approach with the additional funds. An additional $75 billion in funding for provider relief is also expected to be passed through Congress this week and is not included as a part of this announcement.

The additional disbursements will include the following:

$20 billion based on net patient revenue. On April 24, a portion of providers will be automatically sent an advance payment of funds based off revenue data previously submitted to CMS, which they will need to further verify by submitting additional information through a portal opening this week. Providers without adequate cost report data on file will need to submit their revenue information via the portal to receive their share of funds, which will be provided on a rolling basis. All providers who receive funds must sign an attestation confirming receipt of funds, agree to the terms and conditions of payment, and confirm CMS cost reports.

$10 billion for COVID-19 high-impact areas. $10 billion will be targeted to hospitals in areas CMS deems particularly hard-hit by COVID-19. According to CMS, "hospitals serving COVID-19 patients in New York, which has a high percentage of total confirmed COVID-19 cases, are expected to receive a large share of the funds."Hospitals applying for funds must provide four pieces of information via an authentication portal by midnight PT this Thursday (April 23): 1) Tax Identification Number, 2) National Provider Identifier, 3) Total number of intensive care beds as of April 10 and 4) Total number of admissions with a positive diagnosis for COVID-19 from January 1 to April 10, 2020. CMS has already contacted hospitals directly to provide this information.

Reimbursement for the treatment of the uninsured. Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement at Medicare rates, subject to available funding. Providers can register for the program on April 27, 2020, and begin submitting claims in early May 2020. More information is available at: coviduninsuredclaim.hrsa.gov.

$10 billion for rural providers.This money will be distributed as early as next week on the basis of operating expenses, "using a methodology that distributes payments proportionately to each facility and clinic."

$400 million for Indian Health Service facilities. This money will be distributed as early as next week and will also be provided on the basis of operating expenses.

Additional allocations. According to the announcement, "there are some providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid."

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