HHS & CMS: Provider Relief Updates

Currently, there are two types of financial relief that healthcare providers can possibly receive:  

  1. CARES Act – Provider Relief Stimulus Check funded by HHS (Providers do not pay back)
  2. Accelerated and Advance Payments Program by CMS  (Providers payback in 120 Days via their regular Medicare payment checks)

What Is The CARES Act? 

This March, the bipartisan CARES Act was approved by the President and put into effect to provide substantial relief to the healthcare industry. Beginning in early April, The U.S. Department of Health and Human Services (HHS) has been issuing stimulus checks to eligible medical providers and hospital facilities throughout the country. With funds totaling $30 billion, the purpose of these payments is to provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those who are struggling to keep their doors open due to patient visit cancellations and local business closures. Furthermore, this act is intended to support any COVID-19 related healthcare expenses as well ensure the safety of all Americans during this crisis, even for those without means of medical insurance. 

In terms of eligibility, these stimulus checks are being distributed to medical providers based on their tax identification numbers (TIN) and filing information. Large organizations such as hospitals and rehabilitation centers in addition to group practices and single practitioners will receive relief payments according to their Medicare billing TINs. Employed physicians, therapists and medical assistants will not receive individual funds, as payments will only be made to billable organizations identified by the IRS. 

How Is It Different?

The CARES Act is not to be confused with other laws that have been passed due to the pandemic, as it is a portion of the $100 billion Provider Relief Fund. Other sources of financial stimulus include the Families First Coronavirus Response Act that helps American families cover the costs of COVID-19 testing as well as the CMS Accelerated and Advanced Payment Program. 

CMS Accelerated and Advance Payments Program 

In just one week, CMS has already received over 25,000 requests from providers and suppliers throughout the United States and over 17,000 have already been approved. However, those who do receive these reimbursements must agree not to seek collection of out-of-pocket payments from a COVID-19 related case that are greater than what the patient would have otherwise been required to pay if treatments had been provided by an in-network provider. Additionally, within 30 days of receiving the payment, providers must sign an attestation that confirms receipt of the funds and agrees to the terms and conditions of payment. Click here to access the portal for signing this attestation

  • The distribution of funds are conditioned on the provider’s acceptance of these terms and conditions. Once accepted, compliance reports will be issued to the Secretary of HHS.
  • The recipient certifies that it billed Medicare in 2019. 
  • The recipient currently provides diagnosis testing or care for individuals with possible or actual cases of covid-19.
  • The recipient certifies that the payment will only be used to prepare for/respond to coronavirus related events such as reimbursements for healthcare related expenses or lost revenues that are attributable to the pandemic.
  • The recipient certifies that it will not use the payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.

Click here to read the full list of terms and conditions released by HHS.

Our recommendation to Raintree clients who are recipients of funds from CMS, is to post and track these funds in a general PLB (Provider Level Balance) account. After 120 days, Medicare will begin recouping the Accelerated and Advance Payment money via approved patient services. We advise you to post these paid services as normal then deduct from the credit balance in your PLB account to track where you are in the repayment process. 

Check in next week to learn more about additional relief that was passed by the Senate on April 21, 2020. This bill is intended to financially aid small businesses and support America’s economy. It includes billions of dollars specifically allocated to local community organizations through the Paycheck Protection Program (PPP) as well as offers disaster relief for the small business administration (SBA).