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THE PROVIDER RELIEF FUND: What Healthcare Providers Need To Know

On March 27, 2020, the President signed the bipartisan CARES Act that provides $100 billion in relief funds to hospitals and other healthcare providers. The funds are intended to help providers on the front lines of the COVID-19 pandemic and those who face financial struggles.

According to the U.S. Department of Health and Human Services (HHS), facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 will receive a relief payment. These funds will be distributed via both a general distribution, as well as a targeted distribution.

Notably, payments received under the Provider Relief Fund are NOT loans and do NOT need to be repaid.

GENERAL DISTRIBUTION

$50 billion of the Provider Relief Fund is allocated for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers’ net patient revenue. The initial $30 billion was distributed between April 10 and April 17.  HHS began distributing the remaining $20 billion on Friday, April 24.

To expedite distribution, HHS immediately distributed $30 billion to providers, proportionate to providers’ share of Medicare FFS reimbursements in 2019. HHS then began distribution of the remaining $20 billion of the general distribution to providers on April 24 to augment their allocation so that the whole $50 billion general distribution is allocated proportionally to providers’ share of net patient revenue.

A portion of providers will automatically be sent an advance payment based on the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to provide their revenue information to the General Distribution Portal for additional general distribution funds.

Providers who receive their money automatically from the HHS under the CARES Act Provider Relief Fund have various obligations, such as verifying their revenue information via the General Distribution Portal. Providers must also sign an attestation to confirm receipt and agree to certain the terms and conditions. This attestation must be signed within 30 days of receipt of payment.

TARGETED ALLOCATION

The remaining allocation from the Provider Relief Fund will be distributed among certain medical groups, including:

  • Providers treating the uninsured
  • COVD-19 high impact areas
  • Rural providers
  • Indian Health service providers

Specifically, on May 1, 2020, HHS began the targeted distribution of payments to hospitals with High COVID-19 Admissions and Rural Providers, including rural hospitals and clinics. In addition, providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020, can request claims reimbursement.

Finally, the HHS has stated there will be additional future allocations for other providers, including skilled nursing facilities, dentists, and providers that solely take Medicaid. These providers will receive further, separate funding.

Our team is diligently working with our clients to provide legal services, and to help healthcare providers during this COVID-19 pandemic. If you are a medical provider or medical facility with questions or need assistance with the Provider Relief Fund, we can assist you.

Please contact us at 716-849-6500 or [email protected] for more information.