On July 31, HHS announced that certain Medicare providers would be given another opportunity to receive additional Provider Relief Fund payments. These are providers who previously missed the June 3, 2020 deadline to apply for additional funding equal to 2 percent of their total patient care revenue. These funds stem from the $20 billion portion of the $50 billion Phase 1 General Distribution, including many Medicaid, Children's Health Insurance Program (CHIP), and dental providers with low Medicare revenues. Eligible providers could receive 2 percent of their 2018 or 2019 net patient revenue from all payors. In addition, certain providers who experienced a change in ownership, making them previously ineligible for Phase 1 funding, will also be given an opportunity to apply for financial relief.
Starting August 10th, these eligible providers may now submit their application for possible funds by August 28, 2020 at 11:59 pm ET. This deadline aligns with the extended deadline for other eligible Phase 2 providers, such as Medicaid, Medicaid managed care, CHIP, and dental providers.
In addition, Medicaid, CHIP and Dental providers can apply for a Phase 2 General Distribution. This was as $15 Billion allocation. The original deadline of July 20, 2020, was extended several times, first to August 3, 2020 and now to August 28, 2020. Regardless of which Phase you are applying for, you may be eligible for up to 2 percent of annual patient revenue.
There is a 6 step process to apply for these funds.
The following is a description of the eligibility requirements. This is the initial step in the process.
To be eligible to apply, the applicant must have either:
Billed Medicare fee-for-service during the period of Jan.1, 2019-Dec. 31, 2019; or
Be a Medicare Part A provider that experienced a change in ownership and billed Medicare fee-for-service in 2019 or 2020 that prevented the otherwise eligible provider from receiving Phase 1 General Distribution payment; or
Billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan.1, 2018-Dec.31, 2019; or
Billed a health insurance company for oral healthcare-related services as a dental service provider; or
Be a licensed dental service provider who does not accept insurance and has billed patients for oral healthcare-related services.
Once you determine your eligibility, you must validate your TIN (Step 2). Again, the deadline for validation is August 28, 2020 at 11:59 pm ET. This step should only take a few days. All providers who register before the deadline will be considered. The application can be found here.
Once your TIN is validated, you can then apply for funding (Step 3). Documentation required for the application includes:
There are some very useful resources from HHS in the section under Step 3, Apply for Funding.
Step 4 is to receive the payment. Providers may receive up to 2 percent of total reported revenue from patient care. This may take five to seven weeks to receive.
Once providers receive the money, they have 90 days to accept the payment and attest to the terms and conditions.
Requirements from the Provider Relief Fund terms and conditions include (not exhaustive):
Provider Relief Fund payments may be used to cover lost revenue attributable to COVID-19 or health-related expenses purchased to prevent, prepare for, and respond to coronavirus, including but not limited to:
All providers that receive in excess of $10,000 will be required to file reports with HHS on the use of the Provider Relief Funds. The first report will be for activity through 12/31/2020 and will be due February 15, 2021. HHS announced in July that reporting guidance and instructions would be released by August 17, 2020. However, on August 14, they announced a delay and declared that guidance would be released soon.
For those providers that receive more funds than documented eligible expenses or lost revenues, HHS expects that providers will pay the excess funds back to HHS. Therefore, it is vitally important to properly document these eligible expenses and lost revenues.
Additionally, since some providers may expend more than $750,000 of federal awards in a year, this may subject the provider to a requirement for a Single Audit. This applies whether you are a not-for-profit or a for-profit organization. You should discuss these issues with your audit representatives.
Many healthcare providers can utilize the benefits of these funds. We encourage providers to apply by the August 28, 2020 deadline.
We also recommend that providers continually monitor the Frequently Asked Questions (FAQs) on the HHS website, which are updated on a regular basis. The FAQs can be found here.
For any questions related to the CARES Act Provider Relief Fund, or healthcare reimbursement in general, contact Dave Macke, VonLehman’s reimbursement specialist, at firstname.lastname@example.org or 800.887.0437.