• CARES Act Provider Relief Fund

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    Updated June 15, 2021

    Information You Need on the Provider Relief Fund

    On April 10, HHS announced the immediate disbursement of the first $30 billion of the $100 billion that Congress allocated to hospitals, physicians, and other health care providers in the Public Health and Social Services Emergency Fund in the Coronavirus Aid, Relief and Economic Security Act, also known as the Provider Relief Fund.

    The distribution policy reflects recommendations that the AAFP and other medical societies made to the administration.

    Provider Relief Fund Taxability

    Updated IRS guidance on the taxability of the Provider Relief Fund is now in the updated PRF FAQs.


    Phase 3 Provider Relief Funding

    On October 1, 2020, HHS announced Phase 3 of the provider relief fund. Providers who previously received the maximum amount of relief funds (equal to 2% of their total 2018 patient revenue) were eligible to apply for an additional payment, based on changes in operating revenues and additional operating expenses caused by the coronavirus. The application window closed November 6.

    Eligible providers for the additional payments include:

    • providers who previously received, rejected or accepted a General Distribution Provider Relief Fund payment; providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment;
    • behavioral health providers, including those that previously received funding and new providers; and
    • health care providers that began practicing January 1 through March 31, 2020; this includes Medicare, Medicaid, CHIP, dentists, assisted living facilities and behavioral health providers.

    HHS Begins Phase 3 Distribution and Increases Total Payouts

    On Dec. 16, 2020, HHS completed review of Phase 3 applications from the Provider Relief Fund and added another $4 billion to the $20 billion budgeted to meet the needs of lost revenues and net changes in expenses. The funding will satisfy up to 88% of reported losses. HHS notes that more than 35,000 applicants will not receive an additional payment either because they experienced no change in revenues or net expenses attributable to COVID-19, or because they have already received funds that equal or exceed reimbursement of 88% of reported losses. Payments have begun and will continue through January. Recipients must attest to the terms and conditions for funding using the provider attestation portal.


    General Distributions

    Phase 1

    On April 10 HHS distributed $30 billion automatically to providers in order to provide financial relief during the coronavirus (COVID-19) pandemic. These funds were allocated proportional to providers' share of 2019 Medicare Fee-For-Service Payments. An additional $20 billion was distributed based on the most recent tax year annual gross receipts.

    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.

    Phase 2

    HHS re-opened the Provider Relief Fund portal and extended the deadline to September 13 to apply. The portal is open to providers who did not receive an initial payment that totals approximately 2% of their annual patient revenue, who missed prior deadlines to submit revenue information for additional funds, were previously ineligible due to a change in ownership, or who previously rejected Phase 1 general distribution payments and are now interested in reapplying. Providers should apply on the Provider Relief Fund Application and Attestation Portal.   

    How is money distributed and repaid?

    These are grants, not loans, and do not have to be repaid. Note that the funds go to each organization's TIN that normally receives Medicare payments, not to each individual physician. HHS partnered with UnitedHealth Group (UHG) to deliver the stimulus payments, and physicians should contact UHG’s Provider Relations at (866) 569-3522 about eligibility, whether a payment has been issued, and where it was sent.

    The automatic payments come to the organizations via Optum Bank with "HHSPAYMENT" as the payment description.

    Note: if you or your practice did not already set up direct deposit through CMS or UHG’s Optum Pay, they will receive a check at a later date. Practices that would like to set up direct deposit now can call the UHG Provider Relations number.

    What are the next steps?

    Sign the attestation statement within 90 days.

    Physicians who received a payment from HHS as part of the Provider Relief Fund must sign an attestation within 90 days of receiving the payment, confirming receipt of the funds and agreeing to the terms and conditions of payment.

    Sign the attestation statement »

    Billing entities will need to provide their Taxpayer Identification Number. If you want to reject the funds, you still must complete the attestation form and indicate your rejection of the funds.

    Please direct any questions to the Provider Relief hotline at (866) 569-3522. 

    View the terms and conditions »

     


    Provider Relief Fund Reporting

    Updated June 15, 2021

    On June 11, 2021, HHS revised the Post-Payment Reporting Requirements for recipients of the Cares Act Provider Relief Funds. This new version supersedes all previous versions. The revisions expand the amount of time providers will have to report information and extends key deadlines for expending PRF payments for recipients who received payments after June 30, 2020.

    Detail of the revisions can be found on the Cares Act Provider Relief Fund Reporting and Auditing webpage and the updated Post-Payment Notice of Reporting Requirements - PDF.

    Key updates include:

    • The period of availability of funds is based on the date the payment is received (rather than requiring all payments be used by June 30, 2021, regardless of when they were received).
    • Recipients who received one or more payments exceeding $10,000 in the aggregate during a Payment Received Period are required to report in each applicable Reporting Time Period as outlined in the table below.
    • Recipients will have a 90-day period to complete reporting (rather than a 30-day reporting period).
    • The reporting requirements are now applicable to recipients of the Skilled Nursing Facility and Nursing Home Infection Control Distribution in addition to General and other Targeted Distributions.
    • Providers should register now in the PRF Reporting Portal in advance of the relevant Reporting Time Period dates. The registration process will take approximately 20 minutes to complete and must be completed in one session. (The portal is compatible only with the most current versions of Edge, Chrome, and Mozilla Firefox.) For more information about the registration process, refer to the PRF Reporting Portal User Guide and the Reporting Portal FAQs.
    • The PRF Reporting Portal will open for providers to start submitting information on July 1, 2021.

    Summary of Reporting Requirements

    Period

    Payment Received Period

    (Payments Exceeding $10,000 in Aggregate Received)

    Deadline to Use Funds

    Reporting Time Period

    Period 1

    From April 10, 2020 to June 30, 2020

    June 30, 2021

    July 1 to Sept. 30, 2021

    Period 2

    From July 1, 2020 to Dec. 31, 2020

    Dec. 31, 2021

    Jan. 1 to March 31, 2022

    Period 3

    From Jan. 1, 2021 to June 30, 2021

    June 30, 2022

    July 1 to Sept. 30, 2022

    Period 4

    From July 1, 2021 to Dec. 31, 2021

    Dec. 31, 2022

    Jan. 1 to March 31, 2023

    Note: These reporting requirements do not apply to the Rural Health Clinic COVID-19 Testing Program; HRSA’s COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program; or the COVID-19 Coverage Assistance Fund.

    HHS has posted the names of payment recipients and their amounts on a public website. AAFP members should work closely with their financial and tax advisers to complete the reporting process.


    Targeted Distributions

    HHS is allocating targeted distribution funding to providers in areas particularly impacted by the COVID-19 outbreak, rural providers, and providers requesting reimbursement for the treatment of uninsured Americans.

    • $22 billion: COVID-19 High-Impact Distribution (hospitals in hot spots)
    • $11.3 billion: Rural Distribution (rural health care providers and certain urban/small metropolitan areas)
    • $500 million: Indian Health Service
    • $14.7 billion: Safety Net Hospitals (safety net, acute care, and children’s hospitals)
    • $4.9 billion: Skilled Nursing Facilities

    Take Action: Funding for the Treatment of the Uninsured

    A portion of the CARES Act's $100 billion Provider Relief Fund will be used to reimburse health care providers, at Medicare rates, for COVID-related treatment of the uninsured.

    Every family physician and clinician who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through the program and will be reimbursed at Medicare rates, subject to available funding.

    Physician services provided to uninsured patients, such as office and emergency visits, including those provided via telehealth, may be reimbursed in this manner. The exact amount available for this fund has yet to be announced.

    To request reimbursements and learn how the program works, visit the COVID-19 Uninsured Program Portal.

    View information for uninsured patients on balance billing »

    Additional Information on Targeted Distributions can be found on the CARES Act Provider Relief Fund: General Information page.