April 23 deadline looms for hospitals in ‘high-impact’ COVID-19 areas to provide information to receive CARES Act funds

• Hospitals with many COVID-19 patients have only until 11:59 p.m. PT on April 23 to tell HHS they are interested in receiving some of the available $10 billion in new assistance.
• $20 billion is available for all providers based on their net revenue from all health plans.
• $10 billion has been set aside for rural providers.

Hospitals in areas strongly affected by the coronavirus pandemic have until 11:59 p.m. PT on April 23 to submit basic information that will qualify them to receive some of $10 billion in funding, federal officials announced April 22.

The “high-impact” funding, said Alex Azar, secretary of the U.S. Department of Health and Human Services (HHS), was one of four new tranches totaling $40.4 billion in provider assistance released from the total of $100 billion included in the $2.2 trillion Coronavirus Aid, Relief and Economic Security (CARES) Act.

The other new CARES Act provider funding tranches are:

• $20 billion as a general fund for providers based on net patient revenue from all payers
• $10 billion for rural hospitals and health centers
• $400 million for providers serving tribal populations

The new tranches follow the release of $30 billion to providers earlier in April.

Data requirements for ‘hot zone’ hospitals to receive funding

Data that “hot zone” hospitals must submit by midnight April 23 in order to be considered for the $10 billion tranche HHS will distribute next week include:

• Tax Identification Number
• National Provider Identifier
• Total number of intensive care unit beds as of April 10, 2020
• Total number of admissions with a positive diagnosis for COVID-19 from Jan. 1, 2020, to April 10, 2020

HHS has not yet finalized the specific formula it will use to determine amounts that each “hot zone” hospital will receive, Azar said, but will publicize it after it is finalized.

“We want to see that data first to ensure that we don’t have any unanticipated gaps in our approaches,” Azar said.

The funds should be electronically transferred to hospitals by the middle of next week.

Regarding the tight deadline to submit the data, HHS officials said it only should take providers “five minutes” to complete the process. Azar said he has not heard about any provider problems accessing the webpage.

In evaluating how much of the funds to send to providers in hard-hit areas, HHS will consider “challenges faced by facilities serving a significantly disproportionate number of low-income patients, as reflected by their Medicare Disproportionate Share Hospital adjustment,” a release stated.

The rural provider funding, which HHS plans to begin distributing next week, will be based on operating expenses and will use a methodology “that distributes payments proportionately to each facility and clinic,” HHS said.

General fund requirements include acceptance of terms and conditions

The $20 billion HHS plans to begin distributing electronically next week to providers will be based on either Medicare cost reports or the net revenue data they submit to hhs.gov/providerrelief. Even if CMS uses a provider’s cost report to determine funding under this tranche, the provider still is required to submit its net revenue data, starting April 24.

The funds will require providers to accept controversial terms and conditions within 30 days of receipt of payment. The acceptance process recently was made available.

Not returning the payment within 30 days of receipt will be viewed as acceptance of the terms and conditions, according to an HHS provider page. Providers that review and reject the terms must return the full payment to HHS within 30 days of receipt — even as they scramble to address an ongoing pandemic.

A senior HHS official said some providers have returned some of the $30 billion HHS began to distribute in recent weeks to Medicare providers, but he did not know why they did so.

Among the many areas of provider concern with the terms and conditions was an apparent contradiction between statutory language allowing hospitals to use the CARES Act funding to replace lost revenue and terms limiting the use of the funds to preventing, preparing for and responding to the coronavirus.

The only time Azar addressed the possible conflict during an April 22 media call was when he said, “All recipients will be required to submit documents sufficient to ensure that these funds were used for healthcare-related expenses or lost revenue attributable to coronavirus.”

Asked about provider concerns with the terms and conditions, a CMS spokesperson said in a written statement, “While some providers may choose not to comply with the terms and conditions outlined for the CARES Act provider grants, with some choosing to return funds, HHS believes these terms are fair and are in place to help prevent fraud and ensure taxpayer funds are used consistent with statutory requirements.”

Azar also underscored that providers will face scrutiny from federal auditors over receipt of the funds.

“There will be significant auditing and anti-fraud work done by HHS, including the work of the Office of the Inspector General,” Azar said.

Future CARES Act funding tranches

The remaining $29.6 billion from the CARES Act will be released later and target Medicaid-only providers, dental offices, skilled nursing facilities in COVID-19 “hot zones,” other providers in “hot zones” and providers who have treated uninsured patients for COVID-19, Azar said.

Providers can register starting April 27 to receive Medicare-based payment for uninsured patients treated for COVID-19 at coviduninsuredclaim.hrsa.gov.