Additional guidance on Provider Relief Fund

The Department of Health and Human Services (HHS) has released additional guidance on the allocation of funds from the $100 billion Provider Relief Fund established in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. According to a “General Distribution Portal FAQs” HHS has distributed $30 billion of the $100 billion to health care providers in proportion to their Medicare Fee for Service (FFS) payments in 2019, and some providers were sent a second payment based on their Medicare Cost Reports. The FAQ outlines that “Medicare providers who have already received a payment from the Provider Relief Fund are now eligible to apply for additional funds by submitting data about their annual revenues and estimated COVID-related losses via the Provider Relief Fund Application Portal.” It goes on to say that “providers who have NOT yet received any payments from the Provider Relief Fund may still receive funds in other distributions” but that they “should NOT use the General Distribution Portal.” The FAQ provides information on eligibility, an overview of the application process, and additional information about current and expected future payments.

HHS also published a user guide for providers, outlining the process for requesting or confirming additional funds. The guide notes that HHS “is asking providers who have already received payments from the initial distribution of $30 billion to supply information from IRS tax filings and to supply estimates of lost revenues in March and April of 2020, if they wish to be eligible to receive additional funds.” HHS will be distributing an additional $20 billion to these providers, totaling $50 billion for general distribution. Health care providers may also be eligible for payments from the remaining Provider Relief funds, such as through Targeted Distributions that have not yet been announced but which “will be shared when publicly available.” CMS has indicated that these distributions may be directed towards providers in COVID-19 “hot spots”, rural providers, Indian Health Services, children’s hospitals and other Medicaid providers, and those treating the uninsured. A detailed description of the entire program can be found here.

Reevaluation of Accelerated Payment Program and suspension of Advance Payment Program

In addition, the Centers for Medicare & Medicaid Services (CMS) has announced that it is “reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment Program to Part B suppliers effective immediately.” Both programs were expanded under the CARES Act, which have historically been used to give providers emergency funding and address cash flow issues during times when there is a disruption in claims submission or processing, such as during a public health emergency or disaster. CMS said in the announcement that “funding will continue to be available to hospitals and other healthcare providers on the front lines of the coronavirus response primarily from the Provider Relief Fund,” noting the suspension comes amid the “successful payment of over $100 billion to healthcare providers and suppliers through these programs and in light of the $175 billion recently appropriated for healthcare provider relief payments.” CMS will not be accepting any new applications for the Advance Payment Program and will be reevaluating all pending and new applications for Accelerated Payments. An updated fact sheet on the Accelerated and Advance Payment Programs is available here.

———————————————