April 23, 2020
The U.S. Department of Health and Human Services (HHS) has announced a $20 billion second wave of funding for providers from the $100 billion CARES Act Provider Relief Fund. These payments do not need to be repaid.
On April 10, 2020, HHS deposited $30 billion of the $100 billion in Medicare physician TIN bank accounts based on each provider’s portion of Medicare fee-for-service spending in 2019. (More information on this allocation and the appeals process is in CMA’s COVID-19 Financial Toolkit for Medical Practices.)
HHS is now dispersing the additional $20 billion to providers based on a percentage of each provider’s 2018 net patient revenue from all payors, not just Medicare fee-for-service payments. Physicians must use the funding to cover unreimbursed expenses or lost revenue due to the COVID-19 pandemic.
While HHS has not released further details, it appears that most physicians will need to apply for funding through a portal that HHS said will open this week. Physicians will likely be asked to submit revenue data for HHS to determine payment. The American Medical Association (AMA) and the California Medical Association (CMA) are seeking additional information about the physician allocation process. CMA urges physicians to be prepared to submit information and to watch for information about the application portal. The funding could go quickly.
For providers that already provide cost reports to HHS—such as hospitals and other health care facilities—allocations will be direct deposited on April 24, 2020. These providers must subsequently submit revenue data for verification.
HHS also announced that a third wave of funding will be distributed soon to other clinicians that rely more on Medicaid revenues, such as pediatricians and OB-GYNs.
In addition to the new $20 billion allocation, there is an another targeted allocation of $10 billion for hospitals in hot zones and another $10 billion for hospitals and clinics in rural areas.
HHS has also established a process for physicians to receive yet another $10 billion for physicians to receive reimbursement at Medicare rates for treatment and testing provided to COVID-19. See “HHS allocates $10 billion to cover COVID-19 treatment for uninsured.”