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Coronavirus Disease (COVID-19) Update

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04/23/2020

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Key Updates:

  • The Department of Health and Human Services (HHS) updated its provider relief webpage to explain how it will distribute the remaining $70 billion it received under the CARES Act.
    • HHS will supplement the initial $30 billion it distributed from its Provider Relief Fund with an additional $20 billion, bringing total Provider Relief Fund payments to what HHS now refers to as its “general allocation” to $50 billion.
    • The initial $30 billion was distributed based on each provider’s Medicare payments in 2019. HHS justified using Medicare payments to calculate how it distributed the $30 billion by explaining it was the fastest way to get the funding to providers. However, this formula was criticized because some providers see low volumes of Medicare patients and therefor received a smaller share of the funding.
    • HHS will distribute the new $20 billion of the general distribution to “augment their allocation so that the whole $50 billion general distribution is allocated proportional to providers' share of 2018 net patient revenue.”
    • HHS will calculate 2018 net patient revenue from cost reports that providers submit. HHS has cost report data on file for some providers. Providers without adequate cost report data on file will need to submit their revenue information to a portal opening this week linked on the provider relief webpage for additional general distribution funds.
    • Similar to the first distribution, recipients must attest that they agree to the Terms and Conditions. HHS has not yet updated the Terms and Conditions – which we expect them to do to address some ambiguous or unclear information. 
    • Payments from the new $20 billion distribution will go out weekly, on a rolling basis, as information is validated, with the first wave being delivered on April 24, 2020.
    • Providers must use this funding for healthcare-related expenses or lost revenue attributable to coronavirus. HHS is warning there will be significant anti-fraud and auditing work done by HHS, including the work of the Office of the Inspector General (OIG) to ensure compliance.
    • Separate from the $50 billion “general allocation” described above, HHS will distribute $10 billion to hospitals in areas that are highly impacted by the coronavirus. Hospitals should apply for a portion of the funds by providing four simple pieces of information via an authentication portal before midnight PT, Thursday April 23. This portal is live, and hospitals have already been contacted directly to provide this information. The four pieces of information they must provide are:
      • Tax Identification Number.
      • National Provider Identifier.
      • Total number of Intensive Care Unit beds as of April 10, 2020.
      • Total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020 to April 10, 2020.
    • Though no specific amount is listed, a portion of the remaining funding will go towards compensating providers for providing COVID-19 testing and treatment for uninsured people. Every health care provider 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. Providers who submit claims for this funding must enroll as a provider participant through a portal. Providers can also use the portal for checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit.
    • Providers can register for the program on April 27, 2020, and begin submitting claims in early May 2020. For more information, visit coviduninsuredclaim.hrsa.gov.
    • An additional $10 billion will be distributed to rural hospitals and rural health clinics (RHC). This money will be distributed as early as next week on the basis of operating expenses, using a methodology that distributes payments proportionately to each facility and clinic.
    • $400 million will be allocated for Indian Health Service facilities.
    • An unspecified amount of the total funding will be distributed to skilled nursing facilities, dentists, and providers that solely take Medicaid.
  • The House of Representatives is scheduled to vote tomorrow on bipartisan legislation that will provide an additional $75 billion to HHS for its Provider Relief fund and $310 billion to the Small Business Administration for the Paycheck Protection Program (PPP), among other things. The Senate passed the bill yesterday. President Trump supports the bill and is expected to sign it into law soon after it is passed by the House.
  • CMS updated its list of blanket waivers that apply to all affected provider-types without the need for a waiver request. CMS is creating additional flexibilities to allow licensed independent freestanding emergency departments (EDs) to participate in Medicare and Medicaid to help address the urgent need to increase hospital capacity to provide care to patients.
  • CMS also announced a new toolkit to help states understand all of the medical workforce flexibilities at their disposal.
  • Senator Jeanne Shaheen (D-NH) issued a statement that President Trump agreed to her request to modify the terms of the accelerated and advance Medicare payments during the public health emergency. Senator Shaheen is part of a bipartisan group of Senators who have advocated for legislation to modify interest rates that apply if the payments are not paid back within a certain time and to extend the period of time for upfront payments to be paid back in full.
  • Centers for Disease Control and Prevention (CDC) Director Dr. Robert Redfield warned of the dangers of a second wave of COVID-19 in the fall.
  • The Department of Education began distributing payments to institutions of higher education from the $14 billion CARES Act Higher Education Emergency Relief Fund. Recipient institutions must distribute a significant amount of the funding to students in the form of grant payments. The Department issued FAQs to clarify some of the details for the student payments.
  • The Internal Revenue Service (IRS) will hold a webinar on the CARES Act payments to individual and joint tax filers. The webinar will be held on Thursday, April 23rd at 2 p.m. eastern.
  • The HHS Office of Inspector General issued a new proposed rule to update the civil monetary penalties (CMP) it will enforce for health information data blocking. 
  • The U.S. Navy Hospital Ship Comfort, which was dispatched to New York City to help relieve its overwhelmed healthcare system, will depart New York and return to Virginia. New York no longer needs the ship’s assistance.