• CARES Act Provider Relief Fund

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    Updated December 17, 2020

    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

    HHS will post the names of payment recipients and their amounts on a public website. HHS will require recipients to submit future reports on how the funds were used. Recipients will be provided details at a later date. Recipients of provider relief fund payments may be subject to auditing to ensure the accuracy of the data submitted to HHS for payment.

    HHS Issues Guidance on COVID-19 Provider Relief Fund Reporting System

    On October 22, HHS released a policy memo and updated detailed guidance outlining reporting requirements for health care providers that receive payments from the $175 billion COVID-19 Provider Relief Fund. The new guidelines allow a provider to apply PRF payments against all lost revenues without limitation. Refer to the HHS website on PRF reporting and auditing for a summary of reporting guidelines for payments exceeding $10,000 and additional information.

    The reporting system will be available in early 2021. Reporting requirements will apply to PRF recipients that received one or more payments exceeding $10,000 in the aggregate. The reporting requirements do not apply to the Nursing Home Infection Control distribution, the Rural Health Clinic Testing distribution, or reimbursement from the HRSA Uninsured Program.

    If recipients do not expend PRF funds in full by the end of calendar year 2020, they will have an additional six months in which to use remaining amounts toward expenses attributable to coronavirus but not reimbursed by other sources, or to apply toward lost revenues in an amount not to exceed the 2019 net gain. For example, the reporting period from January to June 2021 will be compared with the same period in 2019.

    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.