COVID-19: CARES Act Provider Relief Fund
Updated: July 21, 2020
Congress passed the CARES Act — what happens next?
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.
Medicaid and CHIP Provider Relief Fund Extension
HHS has extended the Medicaid and CHIP Provider Relief Fund distribution provider application deadline to August 3, 2020.
The fund is open to eligible providers who participate in state Medicaid and CHIP programs and have not yet received a payment from the $50 billion General Distribution.
Read the fact sheet(click.icptrack.com) explaining the application process has also been created to address frequently asked questions.
Quarterly Reports No Longer Needed for COVID-19 Relief Fund Recipients
HHS has eased reporting requirements for recipients of at least $150,000 in aggregate from CARES funds. Previously HHS required quarterly reporting due 10 days after the close of the quarter.
As indicated in the FAQs(www.hhs.gov), HHS will instead post the names of payment recipients and their amounts on a public website(taggs.hhs.gov) to meet the requirement. Recipients will not need to report directly. However, HHS will require recipients to submit future reports on how the funds were used. Recipients will be provided details at a later date.
- CARES Act Provider Relief Fund Provider(www.hhs.gov) (scroll to Medicaid/CHIP Provider Relief Fund)
- FAQs CARES Act Provider Relief Fund(www.hhs.gov)
- CARES Act Provider Relief Fund: General Information(www.hhs.gov) about eligibility and the application process
- Public List of Providers and Payments(data.cdc.gov) that received funds through the Provider Relief Fund
Targeted Payments to Medicaid and CHIP Providers
HHS announced plans to distribute $15 billion from the Provider Relief Fund targeted to eligible providers that participate in state Medicaid and CHIP programs and have not yet received a payment from the Provider Relief Fund General Distribution. This funding will supply relief to Medicaid and CHIP clinicians experiencing lost revenues or increased expenses due to COVID-19. Additional payments will also be made to safety-net hospitals.
To be eligible for this funding, health care clinicians must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed-care plans for health-care-related services between January 1, 2018, and May 31, 2020.
The Provider Relief General Distribution directed $50 billion to Medicare facilities and providers affected by COVID-19, based on eligible providers' 2018 net patient revenue, in April and May. This distribution reached approximately 62% of all providers participating in state Medicaid and CHIP programs. For this reason, many family physicians may not be eligible for the Medicaid targeted payments.
This new Medicaid and CHIP Targeted Distribution will make monies from the Provider Relief Fund available to the remaining 38% of providers that participate in state Medicaid and CHIP programs and have not yet received a payment from the Provider Relief Fund General Allocation.
Action Required to Receive Payments
HHS launched the Enhanced Provider Relief Fund Payment Portal(cares.linkhealth.com) on June 10. To receive a payment, clinicians who participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations, and who have not yet received General Distribution funding, should report their annual patient revenue through this portal. The distribution will be equal to at least 2% of reported gross revenues from patient care. The final amount each provider receives will be determined after the data are submitted, including information about the number of Medicaid patients served. The deadline to submit an application for the Medicaid Targeted Distribution is August 3, 2020.
Instructions(www.hhs.gov), a fact sheet(www.hhs.gov), and the application form(www.hhs.gov) are provided to assist applicants in applying for funds. Once a payment is received, providers must sign an attestation confirming receipt of the funds and agree to the Terms and Conditions(www.hhs.gov) within 90 days.
Apply Now for Relief Funds
Visit the portal for instructions on how to claim the second general distribution. Note: these payments will not come automatically.
Need help on what information to gather? Check this list.
How will money be distributed?
This initial $30 billion is being directed to hospitals and physician practices in direct proportion to their share of Medicare fee-for-service spending from a portion of 2019.
The total amount of Medicare FFS spending in 2019 was $484 billion. Hypothetically, if a Medicare provider with a taxpayer ID Number accounted for 1% of total Medicare FFS spending in 2019, the TIN would receive 1% of the $30 billion.
- A physician can estimate his or her payment by dividing 2019 Medicare FFS (not including Medicare Advantage) payments received by $484,000,000,000, and multiplying that ratio by $30,000,000,000. Clinicians can obtain their 2019 Medicare FFS billings from their organization's revenue management system.
These are grants, not loans, and do not have to be repaid. Note that the funds will go to each organization's TIN that normally receives Medicare payments, not to each individual physician. Disbursement began on April 10.
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 will 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.
Is my practice eligible?
All facilities and health professionals that billed Medicare FFS in 2019 are eligible for the funds. Based on your practice type, here’s how the payments will be made.
Employed physicians should not expect to receive an individual payment directly. The employer organization will receive the relief payment as the billing organization, and it is up to that entity how to spend the grant dollars. Family physicians should ask their administrators how they plan to disburse these funds to frontline primary care clinics in the system.
Physicians in a group practice:
Individual physicians and providers in a group practice are unlikely to receive individual payments directly; the group practice will receive the relief fund payment as the billing organization. Family physicians should ask the practice administrators how funds will be used to support frontline primary care clinics.
Solo practitioners who bill Medicare will receive a payment under the TIN used to bill Medicare. Family physicians can use these funds to support their health care–related expenses or lost revenue attributable to COVID-19.
Sign the attestation statement within 90 days
Physicians who received a payment from HHS as part of this 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. For example, physicians who received funds on April 10 will have a new deadline for attestation of July 9. Furthermore, physicians who do not accept the terms and conditions after 90 days of receipt will be deemed to have accepted the funds and associated terms and conditions.
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.
Additional Allocations of CARES Act Provider Relief Funding General Distribution
On April 22, HHS additional funding of $20 billion to the Provider Relief Fund(www.hhs.gov). The deadline for practices to submit revenue information for consideration for additional payment from the Provider Relief Fund $20 billion General Distribution was June 3, 2020.
If you have questions, visit the General Distribution Portal FAQs(aafp-mid-prod1-t.campaign.adobe.com) or call the CARES Provider Relief line at (866) 569-3522.
Targeted Provider Relief Fund Allocations
- $10 billion: hospitals in hot spots
- $10 billion: rural hospitals
- $400 million: the Indian Health Service
Take Action: Funding for the Treatment of the Uninsured
As announced in early April, 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.
Steps will involve:
- enrolling as a provider participant,
- checking patient eligibility and benefits,
- submitting patient information,
- submitting claims, and
- receiving payment via direct deposit.
Family physicians and other clinicians can register for the program starting April 27, 2020, and begin submitting claims in early May 2020. More information »(www.hrsa.gov)