Late last week, the Paycheck Protection Program and Health Care Enhancement Act was passed. The new legislation provides an additional $75 billion to the Public Health and Social Services Emergency Fund (PHSSEF). To date, the PHSSEF has been utilized to provide hospitals and healthcare providers with a funding mechanism to offset lost revenue – for more on this, you can review our blog from April 15.
The Department of Health and Human Services (HHS) recently outlined their funding goals for the original $100 billion in the PHSSEF which is supporting healthcare operating expenses and lost revenue attributable to COVID-19 and ensuring uninsured Americans can get testing and treatment for COVID-19. This CARES Act Provider Relief Fund, via the PHSSEF, dispensed $30 billion in direct deposit payments beginning April 10,2020. Recipients need to agree to the Terms and Conditions and submit an attestation to HHS within 30 days of receiving the funds.
The remaining $70 billion will be distributed as follows:
$20 Billion Augmentation
HHS indicated the additional $20 billion would be distributed on a weekly and rolling basis for the first set of payments. To certain providers, HHS will automatically send an advance payment based on revenue data contained in their Centers for Medicare and Medicaid Services (CMS) cost reports. These providers will need to go on to the CARES Provider Relief Fund Payment Portal, attest to the funds, and also submit revenue information to HHS for verification. There is a helpful online user guide on the portal that clearly explains what documentation will need to be provided to HHS for verification.
For those without adequate cost report data on file with CMS, providers will need to submit revenue information in the portal. It is unclear how HHS is determining the adequacy of the data. Providers can call the CARES Provider Relief Hotline at 1-866-569-3522 for further information on this tranche of funding.
Reimbursement for Treating the Uninsured
Healthcare providers who provided testing and treatment of uninsured COVID-19 patients on or after 2/4/2020 can request claims reimbursement at the Medicare rates, subject to funding availability. Hospitals and providers can register for the program on April 27, 2020 and will be able to begin submitting claims in early May.
To participate, hospitals and providers must attest to certain terms and conditions (not balance bill, prohibit duplication of payment, and accept the reimbursement in full) of the program. Providers must also:
- Enroll as a provider;
- Check patient eligibility and benefits;
- Submit patient information; and
- Submit the claim.
Payments will be received via direct deposit and can be expected around mid-May. Additional details on what services are covered and not covered, visit the COVID-19 Uninsured Claim Website.
For hospitals and healthcare systems seeking to leverage federal funding opportunities, Hagerty can provide expert advice and assist your organization with short-term liquidity and long-term recovery funding guidance. To learn more about COVID-19 recovery funding opportunities and to learn more about Hagerty’s cost recovery practice, visit our Recovery Page.
Jeff Bokser is Hagerty Consulting’s Vice President of Healthcare Programs with strategic expertise in all aspects of healthcare operations, finance, crisis management, and recovery. Jeff has over 20 years of experience as a senior leader at NewYork-Presbyterian and Yale New Haven Health. He advanced performance and increased revenue in clinical and nonclinical settings and led innovation in daily operations and care delivery processes. Jeff is nationally recognized in the healthcare sector for his transformational leadership in the areas of emergency and crisis management; security and safety; pandemic and surge planning; and business continuity. Jeff was the system-level executive responsible for Emergency Medical Services, Emergency Management, Business Continuity, Crisis Management, Safety, Security, and Regulatory Compliance for the entire continuum of the NewYork-Presbyterian Hospital & Healthcare System enterprise. He served as Incident Commander guiding 40,000+ employees through numerous internal and external emergency response and recovery operations including Hurricane Sandy, Ebola, H1N1, and 9/11.
