The Department of Health & Human Services (HHS) has released an initial $30 billion distribution from the $100 billion health care relief fund in the CARES Act. As we detailed in ML-56 on Wednesday, every Medicare provider will receive a distribution based on its proportionate share of 2019 Medicare fee-for-service (FFS) payments nationally (Medicare Part A and Part B). The payments are considered grants.

Payment Process

According to e-mails providers began receiving this morning from HHS, UnitedHealth Group is partnering with HHS on this initiative, and payments will be released within two weeks via an Automated Clearing House to providers based on their Taxpayer Identification Number(s)—although several member hospitals have reported that they received their payments this morning. The automatic payments will be released via Optum Bank with “HHS Payment” in the payment description. Payments to large physician group practices will be sent to the group’s central billing office.

Action Required

Providers must sign an attestation confirming receipt of the funds within 30 days of receiving them and agree to the terms and conditions of payment. Terms and conditions can be found here: hhs.gov/providerrelief. The CARES Provider Relief Payment Portal for signing the attestation will be open the week of April 13. HHS has also established a CARES Provider Relief line at (866) 569-3522.

Surprise Billing Requirement

To receive this funding, providers cannot “balance bill” any patient for COVID-19-related treatment services. The Administration announced that it has secured commitments from several health plans to waive cost-sharing payments for treatment related to COVID-19.

Allocation of $70 Billion in Residual Funds

HHS states that it is working on additional distributions to target providers in COVID-19 “hot spot” areas, rural providers, those primarily serving a Medicaid population, and those serving uninsured COVID-19 patients.

GNYHA Advocacy

I want to reiterate that this distribution methodology is woefully insufficient to address the financial challenges facing hospitals at this time, especially those located in hot spot areas such as the New York City region. It also disadvantages providers in regions with high Medicare Advantage penetration (because they are only using Medicare FFS payments), as well as providers treating high proportions of Medicaid beneficiaries. Twenty-five members of the New York Congressional delegation sent a letter to HHS Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma raising major concerns with the distribution methodology (see ML-59).

GNYHA has been totally engaged with the Trump Administration on this issue. Several of our member CEOs have spoken with Secretary Azar, and I have spoken with White House Senior Advisor Jared Kushner. While an exact distribution methodology for the next tranche of funds has not yet been identified, we have been assured that COVID-19 hot spots will be prioritized. Our team is working on a variety of methodologies.