CARES Act Provider Relief Funding

On March 27, 2020, the President signed the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) which provided $100 billion to hospitals and other healthcare providers and suppliers, including ambulance services.

UPDATE: On October 1, 2020, the President announced $20 billion in additional provider relief funding for Phase 3. Providers could begin applying for funds on Monday, October 5, 2020 and have until November 6, 2020 to apply for Phase 3 General Distribution funding.

HHS will review all applications and calculate payments based on the submitted information. There is no negative impact to applying so we encourage providers to do so. The specifics about how to apply for Phase 3 are located here.

Below is a breakdown of how funding was allocated in Phase 1 and 2.

$50 BILLION GENERAL ALLOCATION

The initial $30 billion was distributed to providers almost immediately. If your agency received Medicare fee-for-service (FFS) payments in 2019, you should have received your allocated funding via direct deposit by April 17, 2020. According to the payment formula, providers were to be distributed a portion of the $30 billion based on their share of the total Medicare FFS payments in 2019. Total Medicare FFS payments were approximately $484 billion in 2019.

To estimate what you should have received, you can plug in your 2019 Medicare FFS payments into the following formula:

[Your share of relief funding] = [(Your Medicare FFS claims in 2019) / ($484,000,000,000) * $30,000,000,000]

Providers were required to accept the HHS Terms and Conditions by June 3, 2020 and submit revenue information to be considered for additional payments from the general distribution. Confirm receipt of previous funds on the CARES Act Provider Relief Fund Payment Attestation Portal.  

The remaining $20 billion of the general distribution was disbursed based on a formula tied to net patient revenues. Providers should calculate 2018 net patient revenues [gross revenues (charges) less allowances and discounts (bad debt, contractual adjustments, charity care, etc.)] and enter this amount in the HHS portal.

Submit your revenue information to the General Distribution Portal for consideration to receive additional general distribution funds.

TARGETED ALLOCATION FOR UNINSURED

Just as it is important to document COVID-presumptive and COVID-positive cases for Medicare cost data collection, there is also an immediate funding opportunity for uninsured that warrants a solid documentation trail. Starting April 27, 2020, ambulance services were allowed to register here to receive COVID-related payments for uninsured. Eligible claims are being reimbursed at the Medicare rate, and no balance billing is allowed on these claims.

Additional targeted allocations were made for COVID-19 high-impact areas ($12 billion), rural providers ($10 billion), and Indian Health Services ($400 million). More information about CARES Act Provider Relief Funding can be found here.

Posted by Sarah Dicicco

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