HHS announced the release of provider relief funds and launched a new telehealth toolkit, while CMS issued additional guidance on prior authorization and utilization management, and Medicare enrollment for hospitals.
On April 22, the Department of Health and Human Services (HHS) announced an additional $70 billion dollars of the $100 billion authorized by the Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund bill will be distributed starting April 24 to provide relief funds to hospitals and other healthcare providers on the front lines of the COVID-19 pandemic.
The Provider Relief Fund allocated $50 billion for general distribution to Medicare eligible health care providers (EHCPs) impacted by COVID-19, based on eligible providers’ 2018 net patient revenue. An initial $30 billion of the funds were distributed to eligible physicians between April 10 and April 17 based on Medicare Fee-for-Service reimbursements in 2019. HHS used this formula to distribute funds as quickly as possible.
On April 24, HHS will begin distributing the remaining $20 billion of the general distribution to those providers to augment their allocation, so that the whole $50 billion general distribution is allocated proportional to providers’ share of 2018 net patient revenue. A portion of providers will automatically be sent an advance payment based on revenue data submit in CMS cost reports. Providers who have been allocated a payment must attest to receipt of the funds using the CARES Act Provider Relief Fund Attestation Portal and agree to certain terms and conditions within 30 days of payment. According to HHS, starting April 24, payments will be distributed weekly, on a rolling basis, as information is validated.
Providers without adequate cost report data on file still need to submit their revenue information through the portal to receive additional general distribution funds. Providers who receive their money automatically will still need to submit their revenue information so that it can be verified. For more information on general distribution and how the other $50 billion in relief funds will be allocated, visit the CARES Act Provider Relief Fund website.
The Department of Health and Human Services (HHS) recently created new toolkits to help patients understand how telehealth works during the COVID-19 pandemic and find telehealth options, and to assist providers with getting started with telehealth technology, prepare patients and get information about insurance and reimbursement. HHS created an additional toolkit to further support state and local healthcare providers responding to workforce concerns in their communities. The toolkit includes a full suite of available resources such as information on funding flexibilities, liability protections, and workforce training, to maximize responsiveness based on state and local needs.
CMS issued new guidance to individual, small group, Medicare Advantage, and Part D plans, to encourage use of flexibilities related to utilization management and prior authorization during the COVID-19 public health emergency, as permitted by state law, to ensure that staff at hospitals, clinics, and pharmacies can focus on care delivery and ensure that patients do not experience care delays.
April 20, the Centers for Medicare & Medicaid Services (CMS) issued guidance to allow licensed, independent freestanding emergency departments (IFEDs) in Colorado, Delaware, Rhode Island, and Texas to temporarily certify as a hospital quickly and effectively provide care to Medicare and Medicaid patients with COVID-19. Currently, IFEDs are not recognized as certified Medicare providers, meaning they cannot bill Medicare and Medicaid for services. However, during the public health emergency, these entities can be temporarily certified as a hospital to increase healthcare system capacity as part of each state’s pandemic plan.