The CARES Act includes $100 billion in relief to health care providers fighting the COVID-19 pandemic; $30 billion of the funds will be distributed to eligible providers and facilities based on their share of 2019 Medicare fee-for-service (FFS) reimbursements. Total FFS payments were approximately $484 billion in 2019.A provider can estimate its payment by dividing its 2019 Medicare FFS payments received (not including Medicare Advantage) by $484 billion and then multiplying that ratio by $30 billion. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.According to HHS, these are payments, not loans, to health care providers, and will not need to be repaid.
Providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment within 30 days of receiving the payment. The portal for signing the attestation will be open the week of April 13, 2020 and will be linked from hhs.gov/providerrelief.HHS is partnering with UnitedHealth Group (UHG) to distribute the initial $30 billion to providers. Providers will be paid via Automated Clearing House account information on file with UHG, UnitedHealthcare, or Optum Bank. Providers who normally receive a paper check for reimbursement from CMS will receive a paper check in the mail for this payment as well, within the next few weeks.
The remaining funds from the CARES Act will focus on providers in areas particularly impacted by the COVID-19 outbreak, rural providers, and providers of services with lower shares of Medicare FFS reimbursement or who predominantly serve the Medicaid population. This supplemental funding will also be used to reimburse providers for COVID-19 care for uninsured Americans.
New Regulatory Waivers, Including Items Sought by HCA
Also today, the state Department of Health (DOH) issued a Dear Administrator Letter (DAL) for CHHAs, LHCSAs, LTHHCPs, AIDS Home Care Programs and Hospices temporarily suspending some key areas of regulation, including many areas requested by HCA. Please see the new April 10 DAL here. Among the items sought by HCA and included in the DAL are as follows:
- The annual health assessment has been temporarily suspended for all employees.
- Annual performance evaluations of current employees by home care agencies and programs are temporarily suspended.
- The time in which a home care aide training program must be completed is extended to 90 days (HCA asked for 120 days).
- The Alternate Competency Demonstration look-back period is expanded to 3 years, from 2 years, and the prospective employee must have 3 months of experience, rather than 6 months.
- The time period is extended by which home health aide training programs must submit an intent to submit a class schedule to regional offices (April 1, 2020 to July 1, 2020).
- New employees may have health assessments completed by telehealth or by an RN. New employees must follow guidelines in place for all staff, including daily symptom screenings and at least daily temperature checks.
- All CHHAs, LTHHCPs, AIDS home care programs and LHCSAs serving individuals affected by the COVID-19 public health emergency may conduct in-home and in-person supervision through indirect means, including by telephone or video communication, as soon as is practicable after the initial visit.
- All CHHA, LTHHCP, AIDS home care and LHCSA home care cases may be opened using remote technology.
HCA will post this new guidance to our COVID-19 resource page. Please see Monday’s edition of the Situation Report for other key updates in our weekly wrap-up of COVID-19 news.