The CARES Act, signed by President Trump on March 27, 2020, included $100 billion in relief funds to hospitals and other healthcare providers in support of healthcare-related expenses and lost revenue resulting from the COVID-19 pandemic. $30 billion of those funds is being distributed immediately to facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019. The amount each provider will receive is based on its share of the approximately $484 billion Medicare FFS reimbursements for 2019. The U.S. Department of Health & Human Services (HHS), in partnership with UnitedHealth Group (UHG), is overseeing the distribution of the relief funds. Unlike the CMS Accelerated and Advance Payment Program, these payments are not loans and will not need to be repaid.

According to HHS, payments to eligible providers began on Friday, April 10, 2020 by Taxpayer Identification Number (TIN):

• Large Organizations and Health Systems: Large organizations will receive relief payments for each of their billing TINs that bill Medicare. Each organization should look to the part of their organization that bills Medicare to identify details on Medicare payments for 2019 or to identify the accounts where they should expect relief payments.
• Employed Physicians: Employed physicians should not expect to receive an individual payment directly. The employer organization will receive the relief payment as the billing organization.
• Physicians in a Group Practice: Individual physicians and providers in a group practice are unlikely to receive individual payments directly, as the group practice will receive the relief fund payment as the billing organization. Providers should look to the part of their organization that bills Medicare to identify details on Medicare payments for 2019 or to identify the accounts where they should expect relief payments.
• Solo Practitioners: Solo practitioners who bill Medicare will receive a payment under the TIN used to bill Medicare.

Payments are being issued through direct deposit by Optum Bank and designated with the description “HHSPAYMENT”; however, providers that normally receive paper checks for such reimbursements will continue to do so and can expect payment in the next few weeks.

Even practices that have closed as a result of the pandemic are eligible to receive relief payments as long as they provide diagnoses, testing, or care for potential and actual COVID-19 patients. The HHS considers every patient as a possible COVID-19 case.

According to the terms and conditions for accepting payment, “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.” The provisions also state that providers must sign an attestation within 30 days of receiving funds, confirming the payments were deposited and agreeing to the terms and conditions associated with accepting payment. To do so, you will need to access the CARES Act Provider Relief Fund Payment Attestation Portal on the HHS website. It will be viewed as an acceptance of the terms if a provider does not sign the attestation within the 30 day time frame. Providers that do not agree with the provisions must contact HHS within 30 days of receiving payment and return the funds in full per instructions.

Click HERE to learn more about these payments and how they are being distributed.