How can I find out what sources of federal funding are available to my hospital during this time?
How can hospitals access the $175 in federal funding authorized under the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act?
The U.S. Department of Health and Human Services (HHS) has automatically distributed funding to hospitals via two rounds of general allocations – totaling $50 billion – and several targeted allocations. As of July, HHS has announced targeted allocations for hospitals in high-impact COVID-19 areas, safety-net hospitals, rural hospitals, rural health clinics, and other hospitals that serve rural communities, skilled-nursing facilities, and Medicaid and CHIP providers. As of September, approximately $50 billion of the $175 billion remains unallocated. Additional information on how the allocations were distributed is available in CHA’s summary of the Provider Relief Fund. CHA continues to advocate for a balanced, fair, and inclusive distribution of the remaining Provider Relief Funds for hospitals that have been left out of previous distributions. (12/22)
What steps must hospitals take to attest to receipt of Provider Relief Funds, and what are the reporting requirements to document how the funds are spent?
Within 90 days of receiving a payment from the Provider Relief Fund, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The CARES Act Provider Relief Fund Payment Attestation Portal is open, and providers should review the terms and conditions for various distributions. According to the CARES Act, the funds may be used for building or construction of temporary structures; leasing of properties, medical supplies and equipment, personal protective equipment and testing supplies; increased workforce and training; emergency operation centers; retrofitting facilities; and surge capacity.
Recipients that received one or more payments exceeding $10,000 in the aggregate from the Provider Relief Fund will be required to submit reports to HHS on how the funds have been expended. On September 19, HHS published a notice providing additional details on reporting requirements. This notice includes the categories of data elements that recipients must submit for calendar years 2019 and 2020, and is a supporting document to its post-payment notice of reporting requirements published in August. HHS states that the reporting system will be available in early 2021.
HHS also states that if recipients do not expend PRF funds in full by the end of calendar year 2020, they will have an additional six months in which to use remaining amounts toward expenses attributable to COVID-19 but not reimbursed by other sources, or to apply toward lost revenues in an amount not to exceed the 2019 net gain. The reporting requirements apply for all distributions except the Nursing Home Infection Control and Rural Health Clinic Testing distributions, for which separate reporting requirements will be announced. The reporting requirements also do not apply to reimbursement from the Health Resources and Services Administration (HRSA) Uninsured Program, but HHS noted that additional reporting may be announced in the future for these payments.
Notably, CHA is aware that HHS’ September 19 notice includes revised definitions for determining “lost revenues” that may require many hospitals to return PRF funds at a significant loss. CHA is advocating with our national and state association colleagues to ensure that HHS reverts to previous guidance on defining lost revenues as detailed in a June 2020 FAQ.
For more information, view HHS’ responses to frequently asked questions. (9/30)
Who can I contact if I have questions about my Provider Relief Fund payments?
HHS has established the CARES Act Provider Hotline at (866) 569-3522. (7/22)
Has HHS provided data on how much money each hospital has received?
Are these funds specifically for hospitals that have treated COVID-19 positive patients, or will all hospitals receive some funds?
The emergency funds are available to all Medicare or Medicaid enrolled providers and suppliers that provide diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. The emergency funds must compensate providers for health care-related expenses or lost revenue directly attributable to COVID-19 and not reimbursed from other sources. (4/12)
Did the CARES Act increase Medicare payments to hospitals?
The CARES Act includes a number of provisions that will increase payments for hospitals caring for Medicare patients, including the elimination of the 2% sequestration cut from May 1 to December 31, 2020, a 20% add-on payment to the DRG rate for patients with COVID-19 at rural and urban IPPS hospitals, and expanded options for the Medicare accelerated payment program for children’s hospitals, cancer hospitals, and critical access hospitals. CMS has published guidance to hospitals on implementation of the 20% add-on payment. On May 11, CMS provided additional guidance on how this applies to payments made by Medicare Advantage plans. (7/22)
I’m worried that given the nationwide crisis, $175 billion will be insufficient. Are there plans for additional funding support for hospitals in the future?
CHA will continue to work with congressional leadership and the delegation to address the growing needs of California’s health care delivery system. (4/12)
How can hospitals seek reimbursement for providing care to uninsured patients with COVID-19?
Health care providers who have conducted COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020, can request claims reimbursement through the COVID-19 Uninsured Program electronically and will be reimbursed generally at Medicare rates, subject to available funding. To participate, providers should register with the COVID-19 Uninsured Program Portal. Both CHA and HRSA have developed comprehensive FAQs on this topic. (7/23)
Are there other channels for hospitals to request funding to purchase PPE?
The Federal Emergency Management Agency Public Assistance Program is a grant program that may assist nonprofit hospitals and health systems in covering 75% of the cost of emergency protective measures. (4/12)
Can hospitals receive accelerated or advanced payments from Medicare to assist with cash flow while elective and other procedures are on hold?
The CARES Act authorized inpatient acute care, critical access, children’s, and cancer hospitals to request up to six months of accelerated payments, based on historical payment amounts. Other providers, including long-term care hospitals, inpatient rehabilitation facilities, and inpatient psychiatric facilities, can request up to three months of advanced payments. Hospitals should contact Noridian – California’s Medicare administrative contractor – to apply for these funds. However, on April 26, CMS announced it will suspend and reevaluate the Accelerated and Advanced Payment programs in light of the funding provided by the CARES Act and subsequent legislation. (4/29)