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Key Provisions and Eligibility Requirements

On March 27, 2020, the Provider Relief Fund (the “Fund”) was created as part of the CARES Act, the Fund provides $100 billion in relief funds to hospitals and other healthcare providers that must be used to support healthcare-related expenses or lost revenue attributable to COVID-19, and to ensure uninsured Americans can get testing and treatment for COVID-19.  Payments received under this program, which are being administered by the Department of Health and Human Services (”HHS”), are not loans and, therefore, do not have to be repaid.  The Fund is being distributed in two separate tranches – an initial $30 billion distribution and a second $70 billion distribution.

Initial $30 Billion Distribution

Eligibility for Initial $30 Billion

• All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
• All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN).
• If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.

How Payment Amounts Are Determined

• Providers will receive a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.
• A provider can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments they received by $484 billion, and multiply that ratio by $30 billion.

Status of $30 Billion Distribution, What to Do if Payment Is Not Received, and Attestation

• Status of $30 billion & what to do if payment Is not received – we understand that funds have already started to be distributed.  Eligible participants who do not received funding, either as a direct deposit or a paper check from CMS, should contact their Medicare Administrative Contractor.
• Attestation – within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment via the CARES Act Provider Relief Fund Payment Attestation Portal (https://covid19.linkhealth.com/).

Click here for full Terms and Conditions:
https://www.hhs.gov/sites/default/files/relief-fund-payment-terms-and-conditions-04132020.pdf

Second $70 Billion Distribution

The second round of distributions will focus on providers in areas particularly impacted by the COVID-19 outbreak.  These will include rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans.  Guidelines for applying for this second round of distributions are not available as of the date of this article.

For additional assistance, please contact your Gettry Marcus advisor who will work with our COVID-19 Crisis Advisory Task Force to provide additional assistance regarding the CARES Act Provider Relief Fund or other COVID-19 loan programs (CARES Act Payroll Protection Program (PPP) loans , SBA Economic Injury Disaster Loan (EIDL), or the Main Street Lending Program).