Update April 15 and 16:
Based on concerns raised by the American Medical Association (AMA), the U.S. Health and Human Services (HHS) Department has changed the requirements for physicians to receive money from the Public Health and Social Services Emergency Fund.
AMA had been concerned that in agreeing to the terms and conditions of the grants, physicians had been required to attest that they diagnose, treat, or test patients for COVID-19. The HHS website has been clarified to say, “Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.”
In addition, 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 Jan. 31.
The CARES Act Provider Relief Fund Payment Attestation Portal is now open. Physicians who have been allocated funds must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions within 30 days of payment. Of special note, practices that choose to reject the funds still must complete the attestation indicating their refusal.
Thanks in part to Texas Medical Association advocacy, the federal Health and Human Services (HHS) Department this morning began disbursing $30 billion to hospitals, physicians, and other health care professionals in direct proportion to their share of Medicare fee-for-service (FFS) spending.
Texas physicians already have reported receiving automatic deposits from HHS into their accounts.
The money is part of the $100 billion that Congress allocated from the Public Health and Social Services Emergency Fund in the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
All facilities and health professionals that billed Medicare FFS in 2019 are eligible for the funds, which are separate from the Accelerated and Advanced Payment Program.
“These are payments, not loans, to health care providers, and will not need to be repaid,” HHS said on its website. “This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.”
However, the funds are contingent upon a series of terms and conditions, which require recipients to certify they "currently provide diagnoses, testing, or care for individuals with possible or actual cases of COVID-19,” that the payments won’t be used to reimburse expenses or losses reimbursed from other sources, and that no funds shall be used “to pay the salary of an individual … at a rate in excess of Executive Level II.”
“Unfortunately, the HHS document that more fully describes the approved uses for the funds raises serious questions about how physician practices can utilize the funds and how they should approach documentation for allocations,” said Kelly Kenney, CEO of the Physicians Advocacy Institute. “All of this is subject to audit, so we need help physicians to document their use to ensure that they aren't penalized on the back-end of this crisis.”
In a letter earlier this week, TMA, the American Medical Association (AMA) and more than 130 medical societies made recommendations to HHS Secretary Alex Azar on how to disburse the funds, including tying them to physicians' Medicare FFS spending from a portion of 2019, pre-COVID-19.
“The distribution policy adopted by HHS reflects the recommendations from organized medicine …, although it is not exactly what we proposed,” the AMA said in a message to its members. “In part, the difference stems from the administration's approach of first disbursing $30 billion and later determining how the remainder of the funds will be allocated.
“Instead of using a one-month average of three months of Medicare spending, it uses spending for the entire year 2019; and it does not multiply that amount by three to average all-payor revenue for a month,” the AMA continued. “Also, it does not employ any methodology to pay physicians who may have no or few Medicare claims but rely significantly on Medicaid funding.”
Top priority for funding will be hospitals, Centers for Medicare & Medicaid (CMS) Director Seema Verma said in a White House coronavirus task force briefing last week. Pediatricians, children's hospitals, obstetrician-gynecologists, nursing homes, and other health care professionals and facilities that receive much of their revenue from Medicaid and other sources “will be addressed in the second tranche of funding,” Ms. Verma said.
Funds will go to each organization's Taxpayer Identification Number (TIN) that normally receives Medicare payments, not to each individual physician, HHS said. The automatic payments will come via Optum Bank with "HHSPAYMENT" as the payment description.
Find more information on the funds on the HHS website.
You also can find the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.