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CMS Makes Initial Distribution from CARES Act Provider Relief Fund

April 17, 2020 | No Comments
Posted by Beth Christian

If you are a health care provider, you may have received a direct deposit identified as “HHSPAYMENT” into your business bank account in the past week.  The funds are being disbursed in order to provide financial assistance to health care providers that have been impacted by the Covid-19 pandemic.  The funds distributed to providers are grants, rather than loans.  Therefore, providers who meet the conditions for receipt of these funds will not have to repay them.  Payments are based on the amount of a provider’s share of total Medicare fee for service payments in 2019.

While CMS did not require providers to submit an application in order to receive a CARES Act Provider Relief Fund payment, providers who receive such funds are required to submit an attestation which: (1) confirms their receipt of the funds and (2) accepts the Terms and Conditions for the receipt of the funds.

The Terms and Conditions require provider recipients  to certify that they: (1) billed Medicare in 2019; (2) after January 31, 2019, provided (or are providing) diagnoses, testing, or care for individuals with possible or actual cases of Covid-19; and (3) are not currently terminated or excluded from participating in Medicare, Medicaid, and other Federal health programs, and do not have their Medicare  billing privileges revoked.  Recipients must also certify that the payment will be only be used to prevent, prepare for, and respond to coronavirus, and must also certify that the payment will reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. Recipients must certify that they will not use the funds to pay for expenses that have been reimbursed (or will be reimbursed) by other sources.   In addition, recipients must certify that they will not balance bill patients for any out of pocket expenses greater than those that the patient would be required to pay if the care had been provided by an in-network recipient.   The full list of Terms and Conditions can be found here.  The attestation statement that recipients will need to submit can be found here.   The Terms and Conditions also specify that recipients will be subject to reporting requirements.

CMS has indicated that eligibility for funding is not limited to providers who have treated confirmed cases of Covid-19. CMS indicated that it views every patient as a possible case of Covid-19.  Therefore, if a recipient provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 (whether or not the care provided was specific to treatment of a confirmed Covid-19 case), they are eligible for funding.

CMS has also announced that more funding is planned for those areas hardest-hit by the Covid-19 pandemic.  If you are a provider who has received a CARES Act Provider Relief Fund payment, you will need to review the terms and conditions and submit an attestation confirming that you are in compliance with the Terms and Conditions within 30 days of the date that you received the payment. If a provider cannot comply with the terms and conditions, the funds must be returned.

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