CARES Act Provider Relief Fund – How much amount a private practice will get?
The healthcare providers are on the front lines of the COVID-19 response. Recognizing the importance of healthcare providers and their practise survival, President Tump signed the bipartisan CARES legislation that provides $100 billion in relief funds to hospitals and other healthcare providers. Department of Health and Human Services (HHS) is distributing $30 billion of the relief funds immediately. These are not loans and will not need to be repaid. This is a relief fund for healthcare providers.
Who is eligible for initial $30 billion?
- All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
- Payments to practices that are part of larger medical groups will be sent to the group’s central billing office.
- All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN).As a condition to receiving these funds, providers including physical therapists must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.
- This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.
How are payment distributions determined
- Providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.
- A provider can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments they received by $484,000,000,000, and multiply that ratio by $30,000,000,000. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.
- As an example: A family practice billed Medicare FFS $1 million in 2019. To determine how much they would receive, use this equation:
$1000,000/$484,000,000,000 x $30,000,000,000 = $61,983
How will payments be distributed?
HHS is partnering with UnitedHealth Group to deliver funds. You will receive payment within two weeks via Automated Clearing House (ACH). The automatic payments will come via Optum Bank with “HHSPAYMENT” as the payment description. Payments to practices that are part of larger medical groups will be sent to the group’s central billing office. All relief payments are made to provider billing organizations based on their Taxpayer Identification Numbers (TINs).
What action should I take?
Within 30 days of receiving the payment, you must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. Terms and conditions can be found on hhs.gov/providerrelief. The CARES Provider Relief Payment Portal for signing the attestation will be open the week of April 13, 2020, and will be linked from hhs.gov/providerrelief.
Whom can I contact for more information?
For additional information, please visit hhs.gov/providerrelief or call the CARES Provider Relief line at (866) 569-3522.