The CARES Act established a relief fund for providers that is being automatically paid to those providers who have billed Medicare in 2018. The first round has been distributed as of April 17, 2020. The Second round is now distributed as of April 24, 2020.
The formulas used to determine the automatic payment amounts are:
Based on 2018 Medicare revenue
Total 2018 revenue (not limited to Medicare) divided by $2.5 trillion times $50 billion - approximately 2% of 2018 revenue.
April 10 - 17
Began April 24
Please note: While the first allocation favored Medicare-heavy revenues, the new allocation is based on a provider's net revenue and the formula weights all revenue streams together, in addition to Medicare, including Medicaid and state and county funding streams.
What should providers do if they have not received one or both automatic payments?
Providers believe they qualify for an automatic payment but have not received one should go to the Provider Relief portal at hhs.gov/providerrelief.
What can payments be used for?
Payments may only be used for health care-related expenses or lost revenues associated with efforts to prevent, prepare for and respond to COVID-19. If an organization receives funds greater than the amount of lost revenues or increased expenses, those funds must be returned. A facility or provider must have a Medicare billing TIN in order to qualify for these payments.
How will relief payments be distributed?
Payments are made to provider billing organization based on their Taxpayer Identification Numbers (TINs) and delivered via the Automated Clearing House (ACH) to the Medicare routing number and account number on file with HHS. The automatic payments will come via Optum Bank with "HHSPAYMENT" as the payment description.
What action should recipients take upon receiving an automatic payment?
Each recipient must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment within 30 days of receiving the payment. The recipient will then be guided to a portal to confirm any payments and submit revenue information.
If a recipient chooses to decline or return the funds, it is still required to complete the attestation.
Organizations that do not return the payment within 30 days of receipt will be viewed as accepting the terms and conditions.
Providers who received their additional money automatically will still need to submit their revenue information so that it can be verified via the portal. For additional, general information, please visit https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html or call the CARES Provider Relief line at (866) 569-3522.
Will Medicaid-Only Funds Be Coming?
Likely. We are told that the HHS is working on a Medicaid-only funding formula for a forthcoming $30.9bn in a Public Health and Social Service Emergency Fund appropriated through the CARES Act that will specifically include behavioral health providers. The HHS announcement may come as soon the second or third week of May, 2020.
Please let me know if you have any questions,