Volume 20.32
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced $20 billion in new funding for providers on the frontlines of the coronavirus pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Previously ineligible providers, such as those who began practicing in 2020 will also be invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.
All eligible providers will be considered for payment against the below criteria.
- All provider submissions will be reviewed to confirm they have received a Provider Relief Fund payment equal to approximately two percent (2%) of patient care revenue from prior general distributions. Applicants that have not yet received Relief Fund payments of 2% of patient revenue will receive a payment that, when combined with prior payments (if any), equals 2% of patient care revenue.
- With the remaining balance of the $20 billion budget, HRSA will then calculate an equitable add-on payment that considers the following:
- A provider’s change in operating revenues from patient care,
- A provider’s change in operating expenses from patient care, including expenses incurred related to coronavirus, and
- Payments already received through prior Provider Relief Fund distributions.
Providers will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding. HHS’s top priority is ensuring as many providers as possible have an opportunity to apply. HHS will continue to host webinars to assist providers through the application process and the call center is also available to address questions.
To be eligible to apply, the applicant must meet at least one of the following criteria:
- Billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan. 1, 2018-Mar. 31, 2020; or
- Billed a health insurance company for oral healthcare-related services as a dental service provider as of Mar. 31, 2020; or
- Be a licensed dental service provider as of Mar. 31, 2020 who does not accept insurance and has billed patients for oral healthcare-related services; or
- Billed Medicare fee-for-service during the period of Jan. 1, 2019-Mar. 31, 2020; or
- Be a Medicare Part A provider that experienced a CMS approved change in ownership prior to Aug. 10, 2020; or
- Be a state-licensed / certified assisted living facility as of Mar. 31, 2020, or
- Be a behavioral health provider as of Mar. 31, 2020 who has billed a health insurance company or who does not accept insurance and has billed patients for healthcare-related services as of Mar. 31, 2020.
Additionally, to be eligible to apply, the applicant must meet all of the following requirements:
- Filed a federal income tax return for fiscal years 2017, 2018, and 2019 if in operation before Jan. 1, 2020; or be exempt from filing a return; and
- Provided patient care after Jan. 31, 2020 (Note: patient care includes health care, services, and support, as provided in a medical setting, at home, or in the community); and
- Did not permanently cease providing patient care directly or indirectly; and
- For individuals providing care before Jan. 1, 2020, have gross receipts or sales from patient care reported on Form 1040 (or other tax form).
A PDF version of the application form is available here. Complete HHS information is available here.
RENEWAL OF PHE
Alex M. Azar II, Secretary of Health and Human Services, has renewed, effective October 23, 2020, the determination that a public health emergency exists and has existed since January 27, 2020, nationwide.