Public Health Emergency Fund Grants | ASCRS
COVID-19 News You Can Use

Public Health and Social Services Emergency Fund (PHSSEF)

April 23, 2020

Department of Health and Human Services (HHS) Provides Additional Information Regarding Allocation of the Remaining $70 Billion in the CARES Act Provider Relief Fund.

As you are aware, on April 10, an initial $30 billion was allocated from the $100 billion to clinicians and facilities based on their proportion of Medicare Part A and B fee-for-service spending in 2019. HHS is now adding an additional $20 billion to this amount for what it describes as a $50 billion “general allocation.” The remaining fund distribution will be based on 2018 net patient revenue, not just Medicare fee-for-service.

Some portion of this distribution is based on cost reports, which are filed with HHS by hospitals and some other facilities. For those without adequate cost reports on file, HHS will open a portal this week for providers to attest to their net 2018 revenue for purposes of determining allocation. The medical community is seeking more information about how the additional funds will be allocated to physicians, including whether physicians will need to use this portal process to receive additional funds.

Of the remaining $50 billion:

  • $10 billion will be allocated for a targeted distribution to hospitals in areas that have been particularly impacted by the COVID-19 outbreak based on information they provide on the number of ICU beds and admissions for patients with a COVID-19 diagnosis.
  • $10 billion is being allocated to rural hospitals and rural health clinics based on their operating expenses, and
  • $400 million is being directed to Indian Health Service facilities.

Some portion of the remaining funds is being used to cover the costs of caring for uninsured patients with COVID-19. These funds may be claimed beginning April 27th at this website. Reimbursement for the uninsured will be based on Medicare payment rates. Physician services provided to uninsured patients, such as office and emergency visits, including those provided via telehealth, may be reimbursed in this manner.

An unspecified portion of the remaining funding will be used for clinicians, such as obstetrician-gynecologists, and facilities that rely more on Medicaid than Medicare revenues.

This updated information is available here .

Updated details will be provided as soon as they are available.

April 20, 2020
HHS Releases Additional Changes to the Terms and Conditions for the PHSSEF

On April 20, HHS again, released an updated set of Terms and Conditions related to the release of the funding from the PHSSEF. As you are aware, they also made changes from their original Terms and Conditions on April 13.

Key changes in this document are as follows:

  • HHS has added the following language at the beginning of the document:

    Acceptance of Terms and Conditions

    If you receive a payment from funds appropriated in the Public Health and Social Services Emergency Fund for provider relief (“Relief Fund”) under Division B of Public Law 116-127 and retain that payment for at least 30 days without contacting HHS regarding remittance of those funds, you are deemed to have accepted the following Terms and Conditions. Please also indicate your acceptance below. This is not an exhaustive list and you must comply with any other relevant statutes and regulations, as applicable.

    Your commitment to full compliance with all Terms and Conditions is material to the Secretary’s decision to disburse these funds to you. Non-compliance with any Term or Condition is grounds for the Secretary to recoup some or all of the payment made from the Relief Fund.

    These Terms and Conditions apply directly to the recipient of payment from the Relief Fund. In general, the requirements that apply to the recipient, also apply to subrecipients and contractors under grants, unless an exception is specified.
  • HHS has updated the balance billing provision: 

Previous language: “Accordingly, for all care for a possible or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.” (Emphasis added.)

Updated language: “Accordingly, for all care for a presumptive or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.” (Emphasis added.)

View the updated terms and conditions here.

April 16, 2020

HHS Clarifies Terms and Conditions of Emergency Fund Grants; Providers are Eligible for Grants – Even if You are Not Directly Providing Care to COVID-19 Patients

After ASCRS, the AMA and other medical organizations raised concerns when the initial HHS Emergency Fund grants were released that, in agreeing to the terms and conditions of the grants, physicians were being required to attest that they diagnose, treat, or test patients for COVID-19, HHS has now modified some of the language to make its meaning more clear, stating that every patient is a possible case of COVID-19. Providers are eligible, even if they are not directly providing care to COVID-19 patients.

The website at CARES Act Provider Relief Fund now includes the following statement:

If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.

Also, the second provision of the Terms and Conditions has been changed to no longer say providers attest to "currently" taking care of patients, just that they did so after 1/31/2020:

The Recipient certifies that it billed Medicare in 2019; provides or provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19; is not currently terminated from participation in Medicare; is not currently excluded from participation in Medicare, Medicaid, and other Federal health care programs; and does not currently have Medicare billing privileges revoked.

Provider Relief Fund Payment Attestation Portal Now Open

The CARES Act Provider Relief Fund Payment Attestation Portal is now open. Providers who have been allocated a payment from the initial $30 billion general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment.

The portal has a variety of steps, including confirmation of eligibility, billing TINs, verifying payment information, attestations (likely related to the Terms and Conditions), and confirmation.

As a reminder, HHS' payment of this first round of payments is conditioned on the healthcare provider's acceptance of the Terms and Conditions, which acceptance must occur within 30 days of receipt of payment. Not returning the payment within 30 days of receipt will be viewed as acceptance of the Terms and Conditions. The portal will guide providers through the attestation process to accept or reject the funds.

Verifying Eligibility for Payment and Contact Information

Since last Friday when HHS announced it would begin disbursing the first $30 million of the emergency fund created under the Coronavirus Aid, Relief, and Economic Security (CARES) Act to physicians and other providers via direct payment, there have been questions about how to verify eligibility for payment and who to contact when a physician believes they are eligible but did not receive a payment. HHS partnered with UnitedHealth Group (UHG) to deliver the stimulus payments, and physicians should contact UHG’s Provider Relations at 866-569-3522 about eligibility, whether a payment has been issued, and where it was sent. Note, if a physician or practice did not already set up direct deposit through CMS or UHG’s Optum Pay, they will receive a check at a later date. Practices that would like to set up direct deposit now can call the UHG Provider Relations number.

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