Washington practices get $11 million in latest provider relief
The U.S. Department of Health and Human Services announced $560
million in new Provider Relief Fund Phase 4 payments targeting medical
practices and suppliers. The disbursement includes 68 Washington
who will receive
$11,428,573. These payments come on the heels of the more than $2
billion released by HHS in January 2022 and nearly $9 billion in
funding released in December 2021, which together included nearly $268
million in payments to Washington state. Factoring in the new
payments, 1,522 Washington state practitioners are receiving a total
of $278,349,863 through Phase 4. Like the earlier Phase 4 payments,
the newly announced monies will be based on changes in operating
revenue and expenses between Jul. 1, 2020 and Mar. 31, 2021, due to
COVID-19 and will be made to physicians who previously applied for
relief funds. Visit the
HRSA Provider Relief Fund dedicated webpages
for more information.
Financial relief news in brief (Dec. 11)
CMS Delays EPCS Mandate Until Jan. 2022
The SUPPORT Act, passed by Congress in 2018 to address the opioid
epidemic, requires electronic prescribing of controlled substances for
the Medicare Part D Prescription Drug Program starting Jan. 1, 2021.
In the final Medicare Physician fee schedule, CMS delayed the
effective date of this requirement until Jan. 1, 2022. The WSMA
submitted a letter to CMS in September, urging the agency to delay the
mandate for at least one year due to the financial impact the COVID-19
public health emergency has had on physician practices. We are pleased
to see CMS adopt this request.
Financial relief news in brief (Oct. 8)
Financial relief news in brief (Aug. 3)
Financial relief news in brief (July 10, 2020)
$15 billion Is being distributed to Medicaid providers. Has your
practice received its share?
The Washington State Health Care Authority has raised concerns with
HHS about its recent Medicaid distribution, asserting the funds
allotted are insufficient and that it's administratively burdensome
for practices to tap into. Perhaps most concerningly, practices were
not aware that accepting the Medicare general distribution would
preclude them from receiving Medicaid funds.
Learn more. (June 30, 2020)
Financial relief news in brief (June 25, 2020)
HHS updates FAQs on the Provider Relief Fund general distribution (May
U.S. Department of Health & Human Services has updated its
frequently asked questions document regarding the CARES Act
Provider Relief Fund. Several of the FAQs dated May 14 seek to clarify some of the recent
confusion around the general distribution, particularly these two
How did HHS determine the additional payments under the general
HHS is distributing an additional $20 billion of the general
distribution to providers to augment their initial allocation so that
$50 billion is allocated proportional to providers' share of 2018 net
patient revenue. The allocation methodology is designed to provide
relief to providers, who bill Medicare fee-for-service, with at least
2% of that provider's net patient revenue regardless of the provider's
payer mix. Payments are determined based on the lesser of 2% of a
provider's 2018 (or most recent complete tax year) net patient revenue
or the sum of incurred losses for March and April. If the initial
general distribution payment you received between April 10 and April
17 was determined to be at least 2% of your annual patient revenue,
you will not receive additional general distribution payments.
How can I estimate 2% of patient revenue to determine my
approximate general distribution payment?
In general, providers can estimate payments from the general
distribution of approximately 2% of 2018 (or most recent complete tax
year) patient revenue. To estimate your payment, use this equation:
(Individual Provider Revenues/$2.5 Trillion) X $50 Billion =
Expected Combined General Distribution.
To estimate your payment, you may need to use "Gross Receipts or
Sales" or "Program Service Revenue." Providers should work with a
tax professional for accurate submission.
This includes any payments under the first $30 billion general
distribution as well as under the $20 billion general distribution
allocations. Providers may not receive a second distribution payment
if the provider received a first distribution payment of equal to or
more than 2% of patient revenue.
Download the FAQ (modified May 29,2020).
Financial relief news in brief (May 29, 2020)
CMS reevaluates Accelerated Payment Program and suspends Advance
The Centers for Medicare & Medicaid Services announced that it is
reevaluating the amounts that will be paid under its Accelerated
Payment Program and suspending its Advance Payment Program to Part B
suppliers effective immediately.
CMS had expanded these temporary loan programs to ensure providers and
suppliers had the resources needed to combat the beginning stages of
the 2019 Novel Coronavirus (COVID-19). Unlike other funding programs,
the advance and accelerated payments were not grants and had to be
paid back within one year or less, depending on provider type.
Funding will continue to be available to physicians and providers
Provider Relief Fund, and these payments do not need to be repaid.
for more information on the CARES Act Provider Relief Fund and how to
apply, visit this website. For an updated fact sheet on the
Accelerated and Advance Payment Programs,
click here. (April 27, 2020)
Updates on new PPP funding, additional HHS provider relief funds, and
Congress passed The Paycheck Protection Program and Health Care
Enhancement Act, injecting $321 billion of new funding into the small
business loan program and allocating additional funding to assist the
COVID-19 response. Also 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.
Learn more about these federal relief efforts. (April 24, 2020)
FCC offers financial support for telehealth services
The Federal Communications Commission offers new programs for
physicians and other providers aimed at assisting with your telehealth
program setup and enhancing capacity.
HHS announces immediate infusion of $30 billion into health care
To support health care-related expenses or lost revenue attributable
to COVID-19, the federal government is distributing $30 billion
immediately—with payments arriving via direct deposit beginning April
10, 2020—to eligible providers throughout the American health care
system. These are payments, not loans, to health care providers, and
will not need to be repaid.
Learn more . (April 10, 2020)
CMS issues new guidance on advance payments
The Centers for Medicare & Medicaid Services provides information
on how physicians can request accelerated and advance payments. The
agency clarifies that it will prioritize assistance to those states
hardest hit by COVID-19, including Washington. Additionally, CMS
provides coding guidance for testing and claims reporting. Download
CMS Letter to Clinicians to Summarize Actions CMS Has Taken to
Ensure Clinicians Have Maximum Flexibility to Reduce Unnecessary
Barriers to Providing Patient Care . (April 7, 2020)
Insurers announce accelerated, advance payment programs
UnitedHealth Group has announced a new accelerated payment program to
pay claims faster, helping physician practices that are being impacted
by COVID-19. Accelerated claim payments will be available to medical
and behavioral care providers in UnitedHealthcare's fully insured
commercial, Medicare Advantage, and Medicaid businesses. UHG is also
suspending prior authorization requirements in some settings to assist
patients and providers. Read the
UnitedHealth Group announcement
for details. Premera Blue Cross has also announced it's providing up
to $100 million in financial support in the form of advance payments
of claims to medical, dental, and behavioral health providers facing
significant financial pressures due to the COVID-19 pandemic. Premera
is also extending prior authorization timeframes in light of the
non-urgent medical procedure delay order. Learn more about Premera's
advance payment program and related policies on its
website. (April 9, 2020)
Financial relief news and resources in brief
Physician practices qualify for federal small business loan program
A recent WSMA survey of physician clinics in our state found that
virtually all respondents are being financially impacted by COVID-19,
with several having to close their doors altogether. The federal
stimulus package (a.k.a. CARES Act) is intended to provide financial
relief to individuals and businesses through a number of programs. The
Paycheck Protection Program is likely to be of most utility to
physician practices, as it provides loans of up to $10 million to
qualifying businesses of less than 500 employees that under some
circumstances do not need to be repaid.
Intended primarily as a tool for businesses impacted by COVID-19 to
cover payroll costs as well as some operational expenses, the PPP
loans do not require collateral and can cover up to two months of your
average monthly payroll costs from the last year, plus an additional
25% of that amount (with payroll calculations capped at $100,000 per
employee). Provided that the funds are used to primarily cover payroll
costs, and that staff and payroll are maintained for the duration of
the loan, the loan can be forgiven. Beyond payroll, up to 25% of the
loan may be used for operational expenses such as rent, interest on
mortgages, and utilities.
The PPP launches on Friday, April 3, and given the projected demand
for loans, early participation is strongly encouraged. As a first
step, consider reaching out to the bank your practice works with as
all federally-insured financial institutions are eligible lenders.
A fact sheet on the program from the Treasury Department can be
found here , and the
application form can be found here.
Other financial assistance during COVID-19
The US Small Business Administration is offering a low-interest loans
to help small business owners meet financial obligations, cover
operating expenses, and alleviate economic injury caused by COVID-19.
Click here to determine your eligibility. For
more information and to apply, click here. For questions, 800.659.2955 or
email@example.com. (March 20, 2020)