HHS Updates Allocation of the Provider Relief Fund

The Department of Health and Human Services (HHS) updated how it will distribute the remaining $70 billion of the Provider Relief Fund. The framework consists of 6 sections, general allocation, COVID-19 high impact areas, treatment of the uninsured, rural providers, Indian Health Service, and additional allocations.

General Allocation ($50 Billion)

HHS will supplement the initial $30 billion it distributed from the Provider Relief Fund with an additional $20 billion

  • The remaining $20 billion will begin distribution on April 24 to augment their allocation, so the whole $50 billion is allocated proportionally to providers’ share of 2018 net patient revenue.
    • HHS will calculate 2018 net patient revenue from cost reports that providers submit. Providers without adequate cost report date on file will need to submit their revenue information to the following portal: CARES Act Provider Relief Fund
  • Similar to the first distribution, recipients must sign the attestation and accept the Terms and Conditions
  • Payments will go out weekly, on a rolling basis, as information is validated.
  • All recipients will be required to submit documents to ensure that the funds are used for healthcare-related expenses or lost revenue attributable to coronavirus.

COVID-19 High Impact Areas ($10 Billion)

$10 Billion will be distributed to hospitals in areas that are highly impacted by the coronavirus. Hospitals can apply for funding by providing four (4) pieces of information via an authentication portal before midnight PT, Thursday, April 23. The portal is live, and hospitals have already been contacted directly to provide the following information:

  • Tax Identification Number
  • National Provider Identifier
  • Total number of Intensive Care Unit beds as of April 10, 2020
  • Total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020, to April 10, 2020

Treatment of the Uninsured

Although no specific amount is listed, healthcare Providers who provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursements through the program and will be reimbursed at Medicare rates, subject to available funding.

  • To participate, providers must attest to the following:
    • Agree not to balance bill the patient
    • Agree to program terms and conditions any maybe be subject to post-reimbursement audit review
    • Confirmed that the patient is uninsured, verified the patient does not have coverage such as individual, employer-sponsored, Medicare or Medicaid coverage, or no other pay will reimburse you for COVID-19 testing or treatment.
    • Accept defined program reimbursement as payment in full
  • Steps will involve: enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit
  • Providers can register for the program on April 27, 2020, and began submitting claims in early May. For more information: coviduninsuredclaim.hrsa.gov

Rural Providers ($10 Billion)

$10 Billion will be distributed to rural hospitals and rural health clinics (RHC).

  • The money will be distributed as early as next week on the basis of operating expenses.
  • The method recognizes the precarious financial position of many rural hospitals.

Indian Health Service ($400 Million)

$400 million will be allocated for the Indian Health Service facilities, distributed on the basis of operation expenses

  • The money will be distributed as early as next week
  • This will be used to complement other funding provided to IHS and work done to expand IHS capacity for telehealth

Additional Allocations

There are some providers who will receive further, separate funding as followed:

  • Skilled nursing facilities
  • Dentist
  • Providers that solely take Medicaid

For more information on the Provider Relief Fund please visit HHS website CARES Act Provider Relief Fund