COVID-19 Funding for Providers in CARES 2.0: New Money and More Guidance

More money to offset the impact of COVID-19.

EDITOR’S NOTE: During recent weeks, the Centers for Medicare & Medicaid Services (CMS) has been announcing revisions to its regulatory requirements on a near-daily basis to ease administrative and logistical burdens on providers amid the ongoing COVID-19 pandemic. As such, articles published on one day may later be found to contain outdated information just several days later. RACmonitor.com and ICD10monitor.com are committed to providing comprehensive coverage of these changes as they continue to be made, so please stay tuned as new developments unfold. 

President Trump signed off on more funding to combat COVID-19’s impacts on hospitals and the economy on Friday, April 24, specifically by putting more money into the Paycheck Protection Program directed at all small businesses and the Healthcare Provider Relief Fund of the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Paycheck Protection Program

First, the Paycheck Protection Program has been given about $320 billion more after running out of its first $350 billion in the first few weeks of April. This program is open to most small businesses with fewer than 500 employees, including healthcare offices and facilities. In fact, about 12 percent of recipients of that first chunk of money were healthcare providers.

The good thing about this program is that, in most cases, most or all of the loans obtained through the program do not have to be paid back.

Banks warn that the additional funds that Congress just put into the Paycheck Protection Program may run out in a matter of days. The program will start to accept applications again on Monday morning (April 27), so you may want to act quickly if you think you are eligible.

The Small Business Association’s (SBA’s) Paycheck Protection landing page has more information and a relatively brief application form. You’ll want to take that form to your bank, as the actual lending of money will be through commercial banks.

Provider Relief Fund

The other set of funds is in the Provider Relief Fund, which now has a total of $175 billion in it. These are grants – they don’t have to be paid back – and the Centers for Medicare & Medicaid Services (CMS) is disbursing this money in phases. They’ve already distributed $30 billion, and over the weekend, CMS released guidance (in these FAQs) on how they would hand out the rest of the money.

First, they’ve divided the disbursement into two categories: general and targeted.

For general disbursement, the U.S. Department of Health and Human Services (HHS) is distributing only to providers who a) billed Medicare in 2019 and b) provided care to COVID-19 patients in 2020.

For targeted disbursement, HHS will distribute to specific categories of facilities or claims. For instance, they’ll target disbursement to facilities for treating uninsured patients, facilities that have been hit particularly hard by COVID-19, rural providers, and the Indian Health Service, plus other categories that will be announced in the future.

To date, facilities have not been able to apply for this money proactively – either for the general or targeted disbursements – but rather, payments are being sent automatically to providers, which are then to certify to certain terms and conditions in a Provider Relief Portal on the HHS website. Some things to remember about this Provider Relief Portal:

  • If you’ve already received funds from this program, you could apply for additional funds by providing some more information through the relief portal.
  • If you have not received funds from this program, you should not use the portal. If you’re in this group, you’ll want to pay attention to the HHS Provider Relief Fund webpage to see when targeted disbursements might take place and how to get in line for them.

As mentioned, part of this funding is also going toward paying COVID-19 claims for patients who are not insured. The Health Resources & Services Administration (HRSA) is running this program, and registration for the next iteration starts Monday, April 27 (more info here). You can begin submitting claims for the program next Wednesday, May 6. The program will provide reimbursement for COVID-19 care given to uninsured, back to the beginning of February, and providers will be reimbursed at the Medicare rate.

Just recently, CMS stopped its Advanced Payment Program for Part B Medicare, and the agency is re-evaluating the Accelerated Payment Program for Part A. The implication from the press release is that these programs have been stopped or slowed because the government would rather providers use the Provider Relief Programs, which, unlike advanced or accelerated payments, don’t have to be paid back.

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Matthew Albright

Matthew Albright is the chief legislative affairs officer at Zelis Healthcare. Previously, Albright was senior manager at CAQH CORE, and earlier, he was the acting deputy director of the Office of E-Health and Services for the Centers for Medicare & Medicaid Services.

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