On the morning of April 10, 2020 the department of Health and Human Services (HHS) announced the plan to disburse the first $30 billion of the $100 billion authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act recently passed by Congress.

For the full news release, click here:
https://www.hhs.gov/provider-relief/index.html

While the news release only refers to “providers”, it is the current understanding of AAMS that these funds will be distributed to all providers and suppliers billing Medicare.

HHS plans to distribute the remaining $70 billion in the coming weeks, disbursing those funds via “targeted distributions that will focus on providers in areas particularly impacted by the COVID-19 outbreak, rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population”.

Some key points from the HHS news release:

  • All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
    • This means that all facilities (hospitals) and providers should expect these payments. The announcement does not mention suppliers, which is how HHS defines non-hospital affiliated air ambulances.
  • As a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a 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.
  • Providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.
  • A provider can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments they received by $484,000,000,000, and multiply that ratio by $30,000,000,000. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.
  • As an example: A community hospital billed Medicare FFS $121 million in 2019. To determine how much they would receive, use this equation: $121,000,000/$484,000,000,000 x $30,000,000,000 = $7,500,000

What to do if you are an eligible provider:

  • Providers will be paid via Automated Clearing House account information on file with UHG or the Centers for Medicare & Medicaid Services (CMS). The automatic payments will come to providers via Optum Bank with “HHSPAYMENT” as the payment description.
    • Payments will not be distributed via paper check; monies will simply be deposited in accounts pursuant to the above parameters. A paper check will be sent in the coming weeks as evidence of the deposit.
  • Within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The portal for signing the attestation will be open the week of April 13, 2020, and will be linked on this page.
    • This means that any provider receiving these funds must commit not to balance bill COVID-19 patients and make an attestation to that effect within 30 days.

AAMS continues to monitor additional guidance from HHS and other agencies as the CARES Act is implemented; we are also currently reviewing additional asks for the fourth bill providing relief and stimulus during the pandemic crisis.