The Department of Health and Human Services (HHS) has announced its plan for disbursing the remaining $70 billion in CARES Act Provider Relief Funding. Read the HHS Press Release here.

These funds will be distributed to ground ambulance providers and suppliers as follows:

1. General Allocation. HHS will supplement the initial $30 billion allocated to Medicare providers with an additional $20 billion. HHS is distributing these funds to all eligible healthcare providers and suppliers (including ambulance providers and suppliers) based on the provider’s or supplier’s 2018 net patient revenue. “Net patient revenue” is a term used by Medicare to describe all patient revenues (from whatever source) minus: (i) provision for bad debts, (ii) contractual adjustments, (iii) charity discounts, (iv) teaching allowances, (v) policy discounts, (vi) administrative adjustments, and (vii) other deductions from revenue. HHS will calculate each provider/supplier’s proportionate share of the entire $50 billion allocated using their 2018 net patient revenue. HHS will then subtract the amount that the provider/supplier received during the first allocation of funds (i.e., the first $30 billion), and pay out the remaining balance over the next few weeks. Ambulance providers/suppliers will need to submit their revenue information using an online portal that will become available next week, with payments to follow on a rolling basis once the ambulance provider/supplier’s information has been validated. As with the first payment, recipients of these relief funds will be required to sign an attestation confirming receipt of the funds, and agreeing to the terms and conditions, including the restrictions on surprise medical billing for COVID-19 patients.
2. Reimbursement for Uninsured Patients. HHS will allocate a portion of the remaining $29.6 billion (the specific amount to be determined) to reimburse healthcare providers/suppliers for COVID-related treatment of the uninsured. This reimbursement will be available to emergency and non-emergency ground ambulance providers/suppliers. Air and water ambulance services are not eligible to participate.Reimbursement will be available for COVID-related care provided on or after February 4, 2020. Payments will be made at the Medicare rates, subject to available funding. To be eligible for this reimbursement, ground ambulance providers/suppliers will need to enroll as a provider participant through HHS-HRSA beginning on April 27, 2020. Claims will be accepted starting in early May, 2020. As a condition to receiving reimbursement for the care of uninsured COVID-19 patients, ground ambulance providers/suppliers will be required to accept HHS’ payment as payment-in-full, i.e., they will not be permitted to surprise bill these patient. Additional information on HHS’ reimbursement for uninsured COVID-19 patients can be found at: http://www.coviduninsuredclaim.hrsa.gov.

Background

On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES) Act. As part of that Act, Congress allocated $100 billion to the creation of a “CARES Act Provider Relief Fund,” which will be used to support hospitals and other healthcare providers on the front lines of the nation’s coronavirus response. These funds will be used to fund healthcare-related expenses or to offset lost revenue attributable to COVID-10. These funds will also be used to ensure that uninsured Americans have access to testing a treatment for COVID-19. Collectively, this funding is referred to as the “CARES Act Provider Relief Fund.”

HHS began the disbursement of the first $30 billion of the CARES Act Provider Relief Fund on April 10, 2020.

Upcoming Important Dates

1. On or after April 23/24– You will need to access the online portal to submit your revenue information in order to receive the second payment of the $50 billion general allocation of provider relief funds.
2. April 27, 2020– You will need to register for the COVID-19 Uninsured Reimbursement Allocation. Once open, the online portal can be accessed from the following webpage: http://www.coviduninsuredclaim.hrsa.gov.
3. Early May 2020– You will be able to start submitting claims to the COVID-19 Uninsured Reimbursement Allocation.