The updates and response to COVID-19 rapidly change each day. As you are responding to the needs of your patients, ASC and community, we are working to provide you with resources to assist you in navigating the pandemic response.
This morning, the US Department of Health & Human Services (HHS) announced how it will allocate $30 billion in grants to Medicare providers, including ambulatory surgery centers. These grants are part of the $100 billion in relief funds included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020 that was signed by President Donald Trump on March 27, 2020.
The $30 billion is being distributed immediately—with payments arriving via direct deposit beginning today, April 10, 2020—to eligible providers. An email with the subject line “CARES Act Provider Relief Fund: Action Required” was sent this morning on behalf of HHS to eligible providers. According to the HHS 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.”
All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution. All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN).
Providers will receive a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.
A provider can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments by $484,000,000,000 and multiply that ratio by $30,000,000,000. This comes to approximately 6.2 percent of your FFS payments in 2019.
HHS gave the example of a community hospital that billed FFS Medicare $121 million in 2019.
$121,000,000 / $484,000,000,000 x $30,000,000,000 = $7,500,000
Providers will be paid via Automated Clearing House account information on file with the Centers for Medicare & Medicaid Services (CMS) or United Health Group (UHG), who CMS is partnering with to distribute the funds. The automatic payments will come to providers via Optum Bank with "HHSPAYMENT" as the payment description. 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.
Within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the Terms and Conditions of payment. The portal for signing the attestation will be open the week of April 13, 2020. If a provider receives payment and does not wish to comply with the Terms and Conditions, the provider must contact HHS within 30 days of receipt of payment and remit the full payment to HHS.
Please note this program is separate from the accelerated and advance payments. The CMS accelerated and advance payments are a loan that providers must pay back. For more information, visit the CMS website.
The remaining $70 billion will be allocated shortly, and targeted distributions will focus on providers in areas particularly impacted by the COVID-19 outbreak, rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans.
This information was provided by the Ambulatory Surgery Center Association (ASCA). CASA works collaboratively with ASCA and we thank ASCA for their strong advocacy efforts at the federal level.