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April 24, 2020

Updates on New PPP Funding, Additional HHS Provider Relief Funds, and More

Here's the latest on federal movement on a new stimulus package, new direct deposit funds starting this week, and several updates on financial assistance measures underway.

Congress passes The Paycheck Protection Program and Health Care Enhancement Act

The U.S. Senate and House of Representatives passed a new stimulus package, which aims to replenish the funds for the small business loan program. The Trump administration has promised a quick signature once on the president's desk.

Highlights of the Act include:

  • $321 billion in new funding for the Paycheck Protection Program.
  • $75 billion for reimbursement to hospitals and health care providers to support the need for COVID-19-related expenses and lost revenue. This funding is in addition to the $100 billion provided in the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
  • $25 billion for necessary expenses to research, develop, validate, manufacture, purchase, administer, and expand capacity for COVID-19 tests. Specific funding is provided for:
    • $11 billion for states, localities, territories, and tribes to develop, purchase, administer, process, and analyze COVID-19 tests, scale-up laboratory capacity, trace contacts, and support employer testing. Funds are also made available to employers for testing.
      • $2 billion provided to States consistent with the Public Health Emergency Preparedness grant formula, ensuring every state receives funding.
      • $4.25 billion provided to areas based on relative number of COVID-19 cases.
      • $750 million provided to tribes, tribal organizations, and urban Indian health organizations in coordination with Indian Health Service.

The AMA provides a detailed summary of the legislation.

ICYMI: The WSMA offers an archived webinar, featuring attorneys from K&L Gates, which provides guidance on how to tap into federal financial assistance programs. Visit the WSMA website to view the webinar.

New HHS provider relief funds released this week

The U.S. Department of Health & Human Services announced more funds from the $100 billion CARES Act Provider Relief Fund will be released starting this week. In good news for physicians, this new dispersion takes into consideration practices that were disadvantaged by the previous payment methodology. Here's what you need to know—and note that some practices that do not see many Medicare patients will need to be proactive. From the HHS press release:

  • HHS has indicated funds will be going out quickly to help providers with a relatively small share of their revenue coming from Medicare fee-for-service, such as children's hospitals.
  • Those funds are beginning to be delivered this week. HHS will begin distribution of the remaining $20 billion of the general distribution to these providers to augment their allocation so that the whole $50 billion general distribution is allocated proportional to providers' share of 2018 net patient revenue.
  • On April 24, a portion of providers will automatically be sent an advance payment based off the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to submit their revenue information to the CARES Act Provider Relief Fund Payment Attestation Portal opening this week for additional general distribution funds.
  • Providers who receive their money automatically will still need to submit their revenue information so that it can be verified.
  • Payments will go out weekly, on a rolling basis, as information is validated, with the first wave being delivered at the end of this week (April 24, 2020).

Read the HHS announcement for details.

A reminder: Physicians who have been allocated a payment from the Provider Relief Fund general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment. The terms and conditions are listed here. Access the attestation portal here.

Physicians should note that, as a condition of receiving the HHS funds, balance billing is prohibited. From the press release:

President Trump is committed to ending surprise bills for patients. As part of this commitment, as a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a presumptive or actual COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.

Medicare 2% payment increase to take effect on May 1

The CARES Act temporarily suspends the -2% sequestration payment adjustment on Medicare fee-for-service payment. This means that physicians will see a 2% payment increase on Medicare claims effective May 1, 2020. The increase is effective for claims with dates of service from May 1, 2020, through December 31, 2020.

Since the passage of Sequestration Transparency Act of 2012, Medicare payments have been subject to a 2% sequestration reduction. These cuts are the result of a congressional deal to address the debt ceiling crisis.

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