More COVID-19 Relief Funds Coming

• April 24, 2020
• Jennifer Boese

There has been significant action this week on two fronts: Congress passed and the President signed into law a fourth package of funding totaling $484 billion; and, the Department of Health & Human Services (HHS) announced how it would release $70 billion to health care providers under the Public Health & Social Services Emergency Fund (PHSSEF).

We’ve got your run-down on both!

Another COVID Package Enacted

Congress passed and the President signed into law on April 24 another funding package. Personally, I want to call this COVID IV since, well, it’s the fourth piece of funding legislation enacted during the pandemic, and it’s far larger than COVID I and II combined! However, others are calling it COVID 3.5 because it basically replenishes key funds under the CARES Act (COVID III). Regardless, officially it’s called the Paycheck Protection Program and Health Care Enhancement Act, H.R. 266, and it provides $484 billion more in funding as follows:

• $310B for the Paycheck Protection Program
• $60 billion for EIDL loans and EIDL Advance grants
• $75B for PHSSEF (as created in CARES)
  
• $25B for testing (roughly half will go to states with rest divvied up to agencies/others)
• $600 million for health centers and Federally Qualified Health Centers
  
• $225 million for rural health clinics

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If you’re trying to keep track of the COVID funding packages to date, here’s a great cheat sheet by Health Policy Source.

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PHSSEF Fund — $100 Billion for Health Care Providers

Also announced this week was how HHS would release the remainder of the initial $100 billion in funds for health care. A reminder that HHS released the first $30 billion from the PHSSEF on April 10. That funding went to facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019. The distribution formula was the individual facility or provider FFS amount in 2019 divided by the total, national Medicare FFS reimbursements in 2019, which HHS set at $484 billion, multiplied by $30 billion.

On April 22, 2020, HHS announced how it would release the remaining $70 billion in the fund.

General Distribution ($20 billion)

• HHS anticipates distributing $20 billion beginning April 24, 2020 and releasing those dollars on a rolling basis
• It will go to those who received a portion of the first $30 billion in funds. Therefore, these providers and suppliers will have received a total of $50 billion from the PHSSEF
• This next $20 billion will be distributed in proportion to a provider’s 2018 net patient revenue. HHS puts total revenues of Medicare facilities and providers at $2.5 trillion. Therefore, providers can estimate their expected revenue distribution by using the following formula: (Individual Provider 2018 revenue/$2.5 Trillion) X $50 Billion = Expected General Distribution
• Beginning April 24, some providers will receive an advance payment based off the revenue data in cost reports
• Providers without adequate cost report data on file will need to submit their revenue information to a portal opening in the near future. HHS opened up the that portal late Friday. It is available on the main HHS provider relief fund page or directly HERE.

Hot Zones ($10 billion)

• Targeted at hospitals in areas particularly impacted by COVID-19
• Hospitals should apply for a portion of the funds by providing four pieces of information via an authentication portal by 3pm ET, Saturday April 25.
• The Administration will use the data it receives to then distribute the targeted funds to where the impact from COVID-19 is greatest, and take into consideration those serving a significantly disproportionate number of low-income patients, as reflected by their Medicare Disproportionate Share Hospital (DSH) Adjustment.

Rural Health Clinics, Rural Hospitals ($10 billion)

• Dollars will be distributed as early as next week on the basis of operating expenses, using a methodology that distributes payments proportionately to each facility and clinic

Indian Health Services ($400 million)

• Allocated to Indian Health Service facilities, distributed on the basis of operating expenses

Uninsured (no specific dollar amount listed)

• https://www.hrsa.gov/coviduninsuredclaim
• For dates of service or admittance on or after February 4, 2020
• Reimbursement will be made for: qualifying testing for COVID-19 and treatment services with a primary COVID-19 diagnosis, including the following: Specimen collection, diagnostic and antibody testing; Testing-related visits including in the following settings: office, urgent care or emergency room or via telehealth; Treatment: office visit (including via telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, DME (e.g., oxygen, ventilator), emergency ground ambulance transportation, non-emergent patient transfers via ground ambulance, and FDA approved drugs as they become available for COVID-19 treatment and administered as part of an inpatient stay.

Other Allocations (no specific amount listed)

• “There are some providers who will receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid”

Closing Reminder, Additional Resources

Details and information continue to evolve on all programs and funds. Please pay close attention to relevant websites, including ours, for updates! We are here to help.

• CLA’s COVID-19 page
• HHS webpage for the PHSSEF
• HHS PHSSEF attestation portal
• HHS PHSSEF terms and conditions  

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