CARES Act Provider Relief Fund Provides $30 Billion of Rapid Funding to Healthcare Providers

The CARES Act, which was signed into law by President Trump on March 27, 2020, established a $100 billion “Public Health and Social Services Emergency Fund.”  On Friday, April 10, 2020, the U.S. Department of Health and Human Services (HHS), in partnership with UnitedHealth Group (UHG), began disbursing $30 billion of these funds (“Provider Relief Fund”) to healthcare providers.

Key details of the Provider Relief Fund

• All healthcare providers who received Medicare fee-for-service (FFS) during 2019 are eligible for the Provider Relief Fund.
• The $30 billion of funding is being automatically distributed pro-rata based on a provider’s 2019 Medicare FFS reimbursements. Total 2019 Medicare FFS reimbursements were $484 billion.
• Providers with banking information on file with UHG or the Centers for Medicare & Medicaid Services (CMS) began receiving their share of the funding via direct deposit on Friday, April 10, 2020.
• Providers who typically receive a paper check from CMS will receive a paper check for their share of the funding in the coming weeks.
• These funds are not a loan and do not need to be repaid but are subject to terms and conditions.
• Providers who receive this funding must complete an attestation within 30 days of receiving funding confirming receipt of the funds and acceptance of the terms and conditions of payment. A portal for completing the attestation will be posted on the HHS website.  If a provider chooses not to accept the terms and conditions, the funds must be returned.  Failure to submit an attestation or return funds within 30 days will be deemed as acceptance of the terms and conditions.
• The remaining $70 billion of the Public Health and Social Services Emergency Fund will be allocated with a focus on providers in areas particularly impacted by COVID-19 such as rural providers, providers with a lower share of Medicare funding, providers serving the Medicaid population, and providers serving uninsured Americans.

Highlights of terms and conditions - Note that this is only a summary.  Full text can be found here.

• Providers must have billed Medicare in 2019 and must be current and in good standing with Medicare, Medicaid, and other federal health care programs.
• Providers must have provided care to individuals with actual or possible cases of COVID-19 after January 31, 2020. The HHS indicates that they broadly view every patient as a possible case of COVID-19.
• Payment must only be used to prevent, prepare for, and respond to coronavirus, and shall be used as reimbursement for health care related expenses or reimbursement of lost revenues attributable to COVID-19.
• Payment must not be used to reimburse expenses or lost revenues reimbursed from “other sources.” The terms and conditions are not clear at this time what constitutes a “reimbursement from other sources.”
• Providers receiving funding may be subject to reporting requirements as stipulated in the terms and conditions and must maintain appropriate records and cost documentation to substantiate use of funds.
• Providers must not seek to collect from patients out-of-pocket expenses in excess of in-network costs. This condition applies to all care for a possible or actual case of COVID-19, which the HHS has broadly interpreted to include every patient at this time.
• Providers are subject to a number of additional statutory provisions prohibiting funds from being used:
  • To pay a salary to an individual in excess of $197,300, annualized.
  • To advocate or promote gun control.
  • For lobbying.
  • For abortions (certain exceptions apply).
  • For embryo research.
  • For legalization of controlled substances.
  • For pornography.
  • To Association of Community Organizations for Reform Now (ACORN) or its affiliates.
  • For propaganda.

Providers may refer to the HHS website for further information.  HoganTaylor will continue to monitor the Public Health and Social Services Emergency Fund and will provide further updates when more information is made available.