• Financial Relief for Family Physicians During COVID-19

    Updated March 11, 2021

    What is the CARES Act?

    On March 27, the President signed the Coronavirus Aid, Relief and Economic Security (CARES) Act.

    The law allocates $2 trillion for financial relief to small businesses, to support health care workers, to get medical supplies to the front lines, to fund research for treatments and vaccines, and to stimulate the U.S. economy.

    Read the AAFP CARES Act Summary »

    Was the AAFP involved in the CARES Act?

    Yes. The Academy lobbied Congress to support the primary care workforce on the front line of the pandemic with resources for telehealth expansion and funding for community health centers and teaching health centers so that more U.S. patients could be seen.

    What exactly does the CARES Act do?

    The CARES Act includes several provisions that are important for family medicine:

    • Financial relief for small businesses, including private family medicine practices.
    • Addressing supply shortages.
    • Coverage for COVID-19 testing and medical services and provisions for Medicare and Medicaid.
    • Health care workforce support, including primary care extensions.
    • Telehealth benefits for a variety of health care services beyond COVID-19 support.

    What does financial relief really mean? How do I apply?

    There are several pathways to financial relief during the COVID-19 crisis. Some family physicians will be qualified for:

    Financial Assistance Programs by State

    The AAFP has assembled a chart listing COVID-19 financial assistance programs by state using information found on zenefits.com. The AAFP does not endorse any of the financial assistance programs below. This is for informational purposes only and is not an exhaustive list.

    View financial assistance programs available in your state »

    Small Business Administration (SBA) PPP and EIDL loans

    The Small Business Administration is providing forgivable loans though the Paycheck Protection Program (PPP) and targeted, low-interest Economic Injury Disaster Loans (EIDL) loans to qualifying small businesses, including family physician practices.

    Learn more about what the SBA is doing for small businesses during COVID-19 »

    Financial Relief Pathways

    Some family physicians may qualify for financial relief through loans from the Small Business Administration (SBA), HHS Health Care Provider funding, and the Medicare Accelerated and Advance Payment program.

    Use the AAFP COVID-19 Related Loss Calculator to identify the impact of COVID-19 on revenue and expenses for your practice in case you choose to apply for federal funds available to support family physician practices and other small businesses economically affected by COVID-19.

    HHS Health Care Provider Funding

    The CARES Act includes $100 billion for grants from the U.S. Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response. Recipients will include health care providers affected by COVID-19, including Medicare- and Medicaid-enrolled practices, hospitals, public entities, and nonprofit entities. The grants are meant to cover unreimbursed health-care-related expenses or lost revenues.

    • Expenses include increased staffing and training, personal protective equipment, and lost revenue.
    • The application process is still being developed by HHS and will be released shortly.
    • Funding will be based on economic and financial harm to physicians.

    Tool to use: the AAFP COVID-19 Related Loss Calculator, which helps members to quantify economic harm to their practices in order to apply for the funding. View an example of the type of output you can expect from the calculator here.

    Additional information about the CARES Act provider relief fund »

    COVID-19 Uninsured Program Portal Now Open

    On April 27, HHS launched the COVID-19 Uninsured Program Portal to allow family physicians and clinicians who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020, to submit claims for reimbursement. HRSA has contracted with UnitedHealth Group to be the sole administrator of the program.

    Learn more about how this program works and where to apply »

    CMS Accelerated and Advance Payment Program for Medicare Providers and Suppliers

    October 1 Update: Medicare Loan Repayment Terms Loosened by Congress

    Loan repayment terms for family physicians who took out a Medicare Accelerated and Advance Payment (AAP) program loan were relaxed in legislation signed September 30.

    Acute and critical access hospitals received the great majority of AAP loans. The loans were supposed to come due starting in August, and recoupment would have caused every claim submitted by the provider/supplier to be offset from the new claims to repay the accelerated/advance payment.

    Physicians now have one year after the AAP loan was issued before recoupment begins, a 120-day extension. The recoupment rate will be lowered from its current 100% level to 25% for the first 11 months of repayment, and 50% for the six months afterward. Physicians have 29 months after the receipt of a loan to pay back the funds in full before interest begins to accrue. The interest rate has been lowered from 9.6% to 4%. Refer to this fact sheet on repayment terms for details. Physicians should contact their Medicare Administrative Contractor (MAC) with any questions. Find MAC contact information here.

    As of April 26, CMS has stopped accepting new applications for its Accelerated and Advance Payment Program; the agency says it is re-evaluating all pending and new applications for accelerated payments in light of historical direct payments made available through HHS’s Provider Relief Fund.

    CMS had expanded the program for all Medicare providers during the COVID-19 public health emergency. The payments could be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers.

    The AAFP has put together FAQs on the Medicare Accelerated and Advance Payment program — emergency funding for which the Academy strongly advocated.

    To qualify for accelerated or advance payments, the provider or supplier must:

    • have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider's/supplier's request form,
    • not be in bankruptcy,
    • not be under active medical review or program integrity investigation, and
    • not have any outstanding delinquent Medicare overpayments.

    Physicians will have 210 days from the date the accelerated or advance payment was made to repay the balance.

    Rural Provider Relief Fund: Distribution on the Way

    On May 1, 2020, HHS published additional details about the distribution of $10 billion from the Provider Relief Fund to rural health clinics, rural federally qualified health centers, and rural hospitals.

    RHCs and FQHCs will receive a minimum base payment plus a percentage of their annual expenses. The base payment will account for RHCs with no reported Medicare claims, such as pediatric RHCs and FQHCs lacking expense data, by ensuring that all clinical, nonhospital sites receive a minimum level of support no less than $100,000, with additional payment based on operating expenses. 

    Payments will be distributed the week of May 4 via direct deposit, based on the physical address of the facilities as reported to CMS and the Health Resources and Services Administration, regardless of their affiliation with organizations based in urban areas.

    CMS to Implement Merit-based Incentive Payment System Flexibilities for 2020 Performance Year

    CMS announced on February 25 that it will apply the Merit-based Incentive Payments System's (MIPS') automatic extreme and uncontrollable (EUC) circumstances policy to MIPS-eligible clinicians for the 2020 performance year. The agency also has reopened the period to apply for an EUC exception and extended the deadline to March 31 to allow participants to request MIPS performance category reweighting.