HHS Provider Relief Fund set to Distribute Additional $20 Billion

The Department of Health and Human Services (HHS) announced late yesterday that an additional $20 billion in payments from the Provider Relief Fund will begin to be distributed this Friday, April 24^th.  While there are still many questions yet remaining on the initial $30 billion dispensed two weeks ago, these new funds, are part of the $100 billion allocated to HHS through the passage of the CAREs act.

This additional $20 billion in payments will be available to all physicians and hospitals. However, there are some significant differences in this round of distributions, specifically to fee-for-service providers when compared to the initial distribution from two weeks. Details of the general allocation of the additional $20 billion starting April 24^th are described below (as reported on HHS.gov):

GENERAL ALLOCATION

• $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' 2018 net patient revenue.
• 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.
• This simple formula, working with the data we had, was used to get the money out the door as quickly as possible. We were very clear that additional funds would be going out quickly to help providers with a relatively small share of their revenue coming from Medicare fee-for-service, such as children's hospitals.
• Those funds are beginning to be delivered this week. HHS will begin distribution of the remaining $20 billion of the general distribution to these 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 an advance payment based off the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file (fee-for-service providers) will need to submit their revenue information to a portal opening this week at https://www.hhs.gov/providerrelief for additional general distribution funds.

·         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 have to sign an attestation  confirming receipt of funds and agree to the terms and conditions of payment and confirm the CMS cost report.

·         The terms and conditions also include other measures to help prevent fraud and misuse of the funds. 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. There will be significant anti-fraud and auditing work done by HHS, including the work of the Office of the Inspector General.

·         President Trump is committed to ending surprise bills for patients. As part of this commitment, 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.

HHS has also released additional details on how the remaining $50 billion will be distributed, and can be reviewed here.

As with HHS’s initial distribution of the $30 billion, many questions surround this second round of payments. There is no clear documentation that indicates whether all providers who have received a payment from the HHS Provider Relief Fund will receive an additional payment, and if they do, what that amount will be. HHS has not provided a formula, like they did with the initial $30 billion, to determine and or estimate the providers potential payment. It is also unclear how the attestation process will be changed if the provider ends up receiving another payment.

HHS continues to provide updates regularly, and we anticipate additional information will follow to address these questions and others pertaining to the term and conditions of the initial $30 billion. Until then, please visit the HHS CARES Act Provider Relief Fund website for more details. You may also call the Provider Relief Fund help line at 866-569-3522.

We will continue to keep you informed as new information becomes available.