Additional Allocations of CARES Act Provider Relief Fund

The remaining $70 billion (out of the $100 billion in stimulus version 3.0) is being distributed by the administration to healthcare providers, including hospitals battling the COVID-19 pandemic. The $70 billion will be allocated to the following five buckets.

1. General Allocation ($20 billion)

• HHS will distribute $20 billion in a general distribution allocation; however, the calculation for distribution will be modified from the original format. The first $30 billion, if you remember, was distributed via the Medicare fee-for-service model.  The additional $20 billion, in the general allocation (when added to the original $30 billion distributed beginning a week ago Friday), will use a modified calculation based on the provider share of the 2018 net patient revenue from all sources. This will result in a significant rebalancing for all providers.
• Providers without adequate cost report data on file will need to submit their revenue information to a portal opening this week linked on https://hhs.gov page for additional general distribution funds.
• 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 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 must 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 – PDF 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.

2. Allocation for Rural Providers ($10 billion)

• $10 billion will be allocated for rural health clinics and hospitals, most of which operate on especially thin margins and are far less likely to be profitable than their urban counterparts.
• This money will be distributed as early as next week. The distribution methodology will be based on operating expenses, using a methodology that distributes payments proportionately to each facility and clinic.
• This method recognizes the precarious financial position of many rural hospitals, a significant number of which are unprofitable.
• These funds are in addition to the HRSA funds.

3. Allocation for COVID-19 High Impact Areas ($10 billion)

• $10 billion will be allocated for a targeted distribution to hospitals in areas that have been particularly impacted by the COVID-19 outbreak. For example, if New York treated 40% of the nation’s COVID-19 patients, they would receive 40% of the allocation.
• Hospitals should apply for a portion of the funds by providing four simple pieces of information via an authentication portal before midnight Pacific Time, Thursday April 23. This portal is live and hospitals have already been contacted directly to provide this information.
• Hospitals will need to provide:
• 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

4. Allocation for Indian Health Service ($400 million)

• Recognizing the strain experienced by the Indian Health Service, $400 millionwill be allocated for Indian Health Service facilities. Indian Country is also being impacted by COVID-19.
• This money will be distributed as early as next week based on their proportion of operating expenses for facilities.

5. Allocation for the Treatment of the Uninsured

• As announced in early April, a portion of the $100 billion Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured.
• Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through the program and will be reimbursed at Medicare rates, subject to available funding.
• 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 begin submitting claims in early May 2020.  Providers can register for the program on April 27, 2020, and begin submitting claims in early May 2020. For more information, visit hrsa.gov.
• For more information, visit gov/coviduninsuredclaim.

SDAHO will continue to provide updates as further information becomes available.