DHHS Issues Terms and Conditions for Relief Funds
On March 27, 2020, Congress enacted the Coronavirus Aid, Relief, and Economic Security Act or “CARES Act” which includes $100 billion in relief funds for hospitals and other healthcare providers to be used to provide support for healthcare-related expenses or lost revenue attributable to COVID-19. Funding is also available to providers to assist uninsured individuals to obtain testing and treatment for COVID-19.
Beginning April 10, 2020, the government began distributing $30 billion directly to eligible providers. These payments are grants rather than loans and do not need to be repaid. Each provider’s share of the payments is based on that provider’s share of total Medicare fee-for-service (“FFS”) payments in 2019. The payments are made to the organization whose taxpayer identification number is on file with Medicare. In the case of physician practices, the payment is sent to the medical group’s central office.
Any health care facility or provider that (i) received Medicare fee-for-service payments in 2019 and (ii) provided diagnoses, testing or treatment for individuals with possible or actual cases of COVID-19 after January 1, 2020, is eligible for relief fund payments. The provider must certify that it is not currently terminated from participation in Medicare, is not currently excluded from Medicare or any other Federal health care program, and does not currently have its Medicare billing privileges revoked.
Any provider who ceased operations because of the COVID-19 pandemic is eligible to receive funds as long as it provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19.
Conditions to Payment
- The provider must use the relief fund payments only to prepare for and respond to the pandemic and provide diagnoses, testing or treatment for individuals with possible or actual cases of COVID-19.
- The provider may not use payments to reimburse for expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.
- None of the funds may be used to pay a salary or other compensation in excess of $197,300. To the extent that an individual salary exceeds $197,300, the provider may supplement the salary with other non-relief fund money.
- The provider may not collect out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have had to pay if the care had been provided by an in-network provider.
Providers who receive the relief fund payment must sign an attestation confirming receipt of the payment and agreeing to the terms and conditions of payment. The attestation must be submitted within thirty days of receipt of payment on a form which will be available on DHHS’ website. If a provider chooses not to comply with the DHHS terms and conditions, the provider must contact DHHS within thirty days of receipt of payment and return the full payment.
DHHS has also indicated that it will require annual reports from certain providers. Thus, it is imperative that providers keep detailed records of how the payments are used to demonstrate compliance with the terms and conditions of payment in the future.