On April 22, the U.S. Department of Health and Human Services (HHS) announced the allocation of an additional $40.4 billion from the Public Health and Social Services Emergency Fund.
With this announcement, $50 billion from the $100 billion of the Provider Relief Fund has been allocated by HHS for general distribution to Medicare facilities and providers impacted by COVID-19. To expedite providers getting money as quickly as possible, $30 billion was distributed immediately, proportionate to providers' share of Medicare fee-for- service reimbursements in 2019. On Friday, April 10, $26 billion was delivered to bank accounts. The remaining $4 billion of the expedited $30 billion distribution was sent on April 17.
HHS announced on April 22 that they will begin distribution of the remaining $20 billion of the Fund to providers to augment their allocation so that the whole $50 billion general distribution is allocated proportional to providers' share of 2018 net patient revenue.
On April 24, a portion of providers will automatically be sent payment based on the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to submit their revenue information to a portal opening this week at this site. HHS will likely have cost reports from facilities but physicians and others providers may need to submit information through the portal.
Providers who receive their money automatically will still need to submit their revenue information so that it can be verified.
Payments will go out weekly, on a rolling basis, as information is validated, with the first wave being delivered at the end of this week (April 24, 2020). Providers who receive funds from the general distribution must sign an attestation confirming receipt of funds and agree to the terms and conditions of payment and confirm the CMS cost report.
All recipients will be required to submit documents sufficient to ensure that these funds were used for healthcare-related expenses or lost revenue attributable to coronavirus. As a condition to receiving these funds, 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, as well as a longer list of Terms and Conditions. Recipients are urged to closely review the Terms and Conditions to ensure they understand their obligations.
Allocation for COVID-19 High Impact Areas
$10 billion will be allocated for a targeted distribution to hospitals in areas that have been particularly impacted by the COVID-19 outbreak.
Hospitals will need to apply for a portion of the funds via an authentication portal by 3:00 PM Eastern Time, Saturday, April 25, in response to earlier communications directed to them from HHS. (The original deadline of Thursday, April 23 was extended in consultation with hospitals and the extension will not delay the start of the distribution of these funds to high-impact areas, starting next week.) The information provided by hospitals is necessary for the government to determine what facilities will qualify for a targeted distribution. Supplying this information does not guarantee receipt of funds from this distribution.
Providers can register for the program starting on April 27, 2020 and begin submitting claims in early May 2020. For more information, visit coviduninsuredclaim.hrsa.gov.
Allocation for Rural Providers
$10 billion will be allocated for rural health clinics and hospitals. 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.
Allocation for Indian Health Service
$400 million will be allocated for Indian Health Service facilities, distributed on the basis of operating expenses. This money will be distributed as early as next.
There are some providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid.
Treatment of Uninsured Patients
As announced in early April, a portion of the $100 billion Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related 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 through the program and will be reimbursed at Medicare rates, subject to available funding. This portion of the Fund is being administered by the Health Resources and Services Administration (HRSA).
For more details please see the full announcement.
View the COVID-19 resources ASCO compiled to support clinicians, the cancer care delivery team, and patients with cancer, and stay connected to ASCO in Action for policy updates related to COVID-19. In particular, ASCO members will find new resources focused on reimbursement and other policy changes here.