The Department of Health and Human Services (HHS) announced that it will distribute $100 billion to healthcare providers, including hospitals, battling the COVID-19 pandemic. HHS will be allocating portions of this $100 billion to different areas of the healthcare arena. Below provides an overview of these allocations.
GENERAL ALLOCATIONS
Half of the funds, $50 billion, will be allocated to Medicare facilities and providers impacted by COVID-19. HHS has already begun distributing these funds. $26 billion was distributed to providers on April 10, 2020 and another $4 billion was distributed on April 17, 2020. The remaining $20 billion will be distributed to providers based on their 2018 net patient revenue. HHS intends to roll payments out weekly until the funds are diminished.
HHS anticipates distributing a portion of the remaining $20 billion on April 24, 2020 as an advance payment to providers based off the revenue data they submit in CMS cost reports. Note that providers without adequate cost report data on file must submit their revenue information to a portal at https://www.hhs.gov/providerrelief. Providers that receive a distribution are still required to submit revenue information for verification purposes. The portal should be live later this week.
Providers that receive these funds are required to sign an attestation confirming receipt of the funds and their agreement with the terms and conditions of payment. Note that one key term requires providers to agree not to collect out-of-pocket payments from a presumptive or actual COVID-19 patient that is greater than what the patient would have otherwise been required to pay had care been provided by an in-network provider. HHS included this term in furtherance of the Trump Administration’s goal of eliminating surprise billing to patients.
ALLOCATIONS TO HOSPITALS IN COVID-19 HIGH IMPACT AREAS.
HHS’ announcement specified that it is allocating $10 billion of these funds solely to hospitals in areas that have been particularly impacted by the COVID-19 pandemic. This includes hospitals serving areas that have high percentages of confirmed COVID-19 cases. Please note that to be eligible for this allocation, hospitals are to provide the following information via an authentication portal before midnight Pacific Time, April 23, 2020:
- Tax Identification Number;
- National Provider Identifier;
- Total number of Intensive Care Unit beds as of April 10, 2020; and
- Total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020 to April 10, 2020.
HHS has not provided a direct link to the authentication portal to submit the information. Rather, HHS announcement stated that the authentication portal is live and that hospitals have already been contacted to submit this information.
HHS will review the data it receives from the hospital to determine where the impact from COVID-19 is greatest and distribute the targeted funds accordingly. HHS assured providers that it would take into consideration the challenges facilities serving a significantly disproportionate number of low-income patients face, as reflected by their Medicare Disproportionate Share Hospital (DSH) Adjustment.
ALLOCATIONS FOR TREATMENT OF THE UNINSURED
HHS announced that a portion of the $100 billion will be allocated specifically to reimburse healthcare providers for treatment of patients without insurance. Such healthcare providers will be reimbursed at Medicare rate for any COVID-19-related treatment of the uninsured on or after February 4, 2020. In order to be reimbursed, healthcare providers must request claims reimbursement through the program. As HHS did not specify a dollar amount to be allocated to treatment of the uninsured, providers may want to submit requests for reimbursement as soon as possible to ensure they receive a portion of this allocation.
ALLOCATIONS FOR RURAL PROVIDERS
HHS’ announcement also specified that $10 billion will be allocated specifically to rural health clinics and hospitals. HHS acknowledged that rural providers often operate on especially thin margins and intend for these funds to provide much needed relief to such providers. These funds will be distributed based on facility operating expenses. Note that each rural health clinic and hospital will receive a proportionate share of the $10 billion. HHS anticipates that it will begin distributing these funds as early as next week.
ALLOCATIONS FOR INDIAN HEALTH SERVICE
HHS also announced that $400 million will be allocated to Indian Health Service (IHS) facilities. These funds will be based on operating expenses. HHS intends these funds to complement prior funds provided to IHS and HHS’ expansion of telehealth services for IHS. HHS intends to begin distributing these funds next week.
ADDITIONAL ALLOCATIONS
HHS also announced that skilled nursing facilities, dentists and providers that solely accept Medicaid will receive a portion of the $100 billion distribution as well. HHS did not provide any specific details on these allocations or whether these providers will need to provide any information to HHS to be eligible for a distribution of the funds. Therefore, such providers should periodically check HHS’ website for further guidance re the allocations.
COST-SHARING WAIVERS
Lastly, HHS reiterated that the Families First Coronavirus Response Act, as amended by the CARES Act, requires private insurers to waive cost-sharing payments for COVID-19 testing. HHS’ announcement also provided that certain private insurers (including Humana, Cigna, UnitedHealth Group and Blue Cross Blue Shield) have agreed to waive cost-sharing payments for COVID-19-related treatment for its plan members.
For more information regarding allocations to healthcare providers combating COVID-19, please contact your regular HLP attorney, or Partners@thehlp.com, or call (212) 734-0128 or (248) 996-8510.