UPDATED: April 20, 2020
HHS again updated the Provider Relief Fund’s Terms & Conditions that recipients must attest. Key changes include the preamble to the Terms and Conditions document, and update the Balance Billing provisions:
Previous language: “Accordingly, for all care for a possible or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.” (Emphasis added.)
Updated language: “Accordingly, for all care for a presumptive or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.” (Emphasis added.)
UPDATED: April 16, 2020
The Attestation Portal is now live on HHS. gov. Please be certain to read the terms and conditions closely. Recipients have 30 days to attest or return the funds.
UPDATED: April 14, 2020
As a result of the concerns raised by APMA, AMA, and other medical societies, HHS has updated the terms and conditions of the provider relief fund as well as the guidance provided on its website.
The relevant language in the terms and conditions now states that “[t]he Recipient certifies that it…provides or provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19…” (Emphasis added). According to HHS guidance, offices that closed are eligible to receive the funds, and HHS takes a broad view that every patient could be a possible COVID-19 patient for purposes of providers being eligible for these funds.
Specifically, HHS states,
“If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.”
APMA believes that this clarification should satisfy many of the questions and concerns raised by members. We encourage members to read the terms and conditions closely before attesting, and seek guidance from their legal counsel if necessary. The attestation portal should be made available this week at www.hhs.gov/providerrelief.
Updated HHS guidance: https://www.hhs.gov/provider-relief/index.html
Updated Terms and Conditions: https://www.hhs.gov/sites/default/files/relief-fund-payment-terms-and-conditions-04132020.pdf
UPDATED: April 13, 2020
APMA is aware of the concerns raised in the attestation that recipients must sign in order to keep any monies they received through this fund. We are working to get clarification from the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS). APMA strongly recommends that podiatric physicians refrain from spending these monies until we have additional information to provide. In general, if you have any financial concerns, APMA recommends seeking the advice of a licensed accountant or financial planner to assist with practice financial questions.
On April 10, 2020, the Department of Health and Human Services (HHS) began distributing the initial $30 billion in relief funding to Medicare fee-for-service (FFS) facilities and providers in support of the national response to COVID-19, and part of the $100 billion provider relief fund provided for in the Coronavirus Aid, Relief, and Economic Security (CARES) Act recently passed by Congress and signed by President Trump. Some providers have already received payments from this initial distribution. These are grants, not loans, and do not have to be repaid.
This initial $30 billion is being directed to hospitals and physician practices in direct proportion to their share of Medicare fee-for-service spending. The total amount of Medicare FFS spending in 2019 was $484 billion. Hypothetically, if a Medicare provider with a Taxpayer ID Number (TIN) accounted for 1 percent of total Medicare FFS spending in 2019, the TIN would receive 1 percent of the $30 billion. All facilities and health professionals that billed Medicare FFS in 2019 are eligible for the funds.
Note that the funds will go to each organization's TIN which normally receives Medicare payments, not to each individual physician. The automatic payments will come to the organizations via Optum Bank with "HHSPAYMENT" as the payment description. Within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The portal for signing the attestation will be open the week of April 13 and will be linked from hhs.gov/providerrelief.
APMA is currently reviewing this announcement, but for immediate questions about distribution of funds contact CARES Provider Relief line at 866-569-3522.
Visit hhs.gov/providerrelief for additional information.