CARES Act

CARES ACT Relief Fund Payment FAQ

By Dinsmore's Tim Cahill and Joe Wheeler

What is the Relief Fund Payment?

Under the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”), the Department of Health and Human Services (“HHS”) was allocated $100 billion dollars to provide immediate financial relief to health care providers in support of the national response to the COVID-19 pandemic. On April 10, 2020, HHS began distributing the initial $30 billion tranche of those funds. The funding is intended to support health care-related expenses and lost revenues attributable to the coronavirus.


Am I eligible for the Relief Fund Payment?

All facilities and providers that received Medicare fee-for-service reimbursements in 2019 are eligible, except individuals and entities with unpaid federal tax liability, for which all judicial and administrative remedies have been exhausted or lapsed, and individuals or entities that have been convicted of a felony criminal violation under any federal law within the preceding 24 months.


How much will I receive?

Each provider will receive a portion of this initial tranche based on their share of total Medicare fee-for-service reimbursements. Medicare’s fee-for-service reimbursements during 2019 were approximately $484 billion. You can use the following formula to estimate how much you will receive:


What do I need to do to receive the payment?

Nothing, at least initially. HHS has arranged for the payments to be made via ACH to each provider’s account using information on file. The payment will be marked “HHSPAYMENT.” For larger practice groups, the payment will be sent to the central billing office. If you normally receive reimbursements through a paper check, you will receive a paper check for this payment as well.

After receipt of the payment, each provider will have 30 days to certify and accept the Terms and Conditions of the payment using an online portal. The Terms and Conditions are available here: https://www.hhs.gov/sites/default/files/relief-fund-payment-terms-and-conditions-04092020.pdf. The web portal for signing the attestation is expected to go live the week of April 13, 2020.


What terms and conditions are there if I accept the Relief Fund Payment?

All facilities or providers that accept the Relief Fund Payment must certify that:

  • It billed Medicare in 2019;
  • It currently provides diagnoses, testing, or care for individuals with possible or actual cases of COVID-19;
  • It is not currently terminated from participation in Medicare;
  • It is not currently excluded from participation in a federal health care program;
  • It does not currently have its Medicare billing privileges revoked;
  • The payment will only be used to prevent, prepare for, and respond to coronavirus;
  • The payment shall reimburse the Recipient only for health care-related expenses or lost revenues that are attributable to coronavirus;
  • It will not use the payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse; and
  • It will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.

If I accept the Relief Fund Payment, am I required to take any additional steps aside from signing the attestation?

Yes. Facilities and entities that accept Relief Fund Payments must do the following:

  • Submit reports as HHS determines are needed to ensure compliance with conditions that are imposed on the payment;
     
  • Not later than 10 days after the end of each calendar quarter, any entity receiving more than $150,000 total in funds under the CARES Act, the Coronavirus Preparedness and Response Supplemental Appropriations Act (P.L. 116-123), the Families First Coronavirus Response Act (P.L. 116-127), or any other act primarily making appropriations for the coronavirus response and related activities, shall submit to HHS and the Pandemic Response Accountability Committee a report that contains: (i) the total amount of funds received from HHS under one of the acts; (ii) the amount of funds received that were expended or obligated for each project or activity; (iii) a detailed list of all projects or activities for which large covered funds were expended or obligated, including: the name and description of the project or activity, the estimated number of jobs created or retained by the project or activity, and detailed information on any sub-contracts; and
     
  • Maintain appropriate records and cost documentation including, as applicable, documentation required by 45 CFR § 75.302 – Financial Management and 45 CFR § 75.361 through 75.365 – Record Retention and Access, and other information required by future program instructions to substantiate the reimbursement of costs under this award.

Are there any restrictions on what the Relief Fund Payment can be used for?

Generally, Relief Fund Payments cannot be used:

  • To pay the salary of an individual, through a grant or other extramural mechanism, at a rate in excess of Executive Level II ($197,300.00);
  • To advocate or promote gun control;
  • For lobbying;
  • To cover abortions or health care benefits coverage that includes coverage for abortions except under certain conditions;
  • For embryo research;
  • To promote the legalization of controlled substances listed in Schedule 1;
  • To maintain a computer network, unless the network blocks the viewing and downloading of pornography;
  • To purchase sterile needles/syringes for the injection of any illegal drug; or
  • To engage in human trafficking or forced labor.

Why is HHS paying me before I sign the Terms and Conditions?

HHS has stated that the primary objective of the Relief Fund Payment is to provide immediate financial assistance. Rather than wait for attestations, HHS has decided to issue the payments first and collect the attestations after.


What if I do not sign the terms and conditions?

Then you will be required to return or repay the Relief Fund Payment.


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