COVID-19 Loan & Grant Programs - Provider Relief

Public Health and Social Services Emergency Fund – Provider Relief Fund

The Provider Relief Fund (PRF) includes $100 billion to bolster healthcare-related expenses and mitigate the impact of lost revenue caused by COVID-19. Totaling $50 billion in general distribution, these payments to healthcare providers are grants which will not need to be repaid at any time. The first tranche of the funds was distributed on April 10, 2020, via direct deposit and paid via Automated Clearing House account information on file with UnitedHealth Group or the Centers for Medicare and Medicaid Services (CMS). The remaining $20 billion was released on April 24, 2020.

The Department of Health and Human Services partnered with UnitedHealth Group (UHG) to deliver the stimulus payments, and physicians should contact UHG’s Provider Relations at 866-569-3522. Note, if a physician or practice did not already set up direct deposit through CMS or UHG’s Optum Pay, they will receive a check at a later date. Practices that would like to set up direct deposit now can call the UHG Provider Relations number.

Terms

  • Payments for the first tranche ($30 billion) are based on an HHS-determined methodology, which can be estimated by providers as their individual 2019 Medicare FFS payments divided by total 2019 FFS payments ($484,000,000,000) and multiplied by $30,000,000,000.
  • Payments for the second tranche ($20 billion) is allocated proportional to a providers’ share of 2018 net patient revenue. Payments will be based on the lesser of either (1) 2% of a provider’s 2018, or most recent complete tax year, net patient revenue or (2) the sum of incurred losses for March and April.
    • This payment can be calculated as (Individual Provider Revenues/$2.5 trillion) x $50 billion = Expected Combined General Distribution.
  • If the initial general distribution payment received between April 10-April 17 was at least 2% of annual patient revenue, there will not be a second payment.
  • Within 45 days of receipt of the funds, providers are required to sign an attestation confirming receipt and agreeing to the terms and conditions in the CARES Act PRF Payment Attestation Portal.
  • If there is evidence of grave misuse or illegal use of the funds, or if the provider balance bills for COVID-19 related treatment, HHS has the authority to require repayment of the grant.

Eligibility

  • All facilities and providers that received Medicare Fee-for-Service (FFS) reimbursement in 2019 will be eligible for these funds and provided diagnoses, testing, or care to individuals with possible or actual COVID-19 cases after January 31, 2020.
  • For practices that are members of larger medical systems, the payments will be sent to the system’s central billing office.
  • Even if normal operations have been postponed as a result of COVID-19, providers will still be eligible to receive the funds if they provide diagnoses, testing, or care for individuals with possible or confirmed cases of COVID-19.
  • The care provided does not need to be specific to COVID-19, and HHS is emphasizing that every patient may be considered as a possible case of COVID-19.
  • For payments prior to 5pm on April 24, all providers will be required to submit their revenue information for verification through the HHS General Distribution Portal. Submitting tax forms on the portal will act as an application for additional funding from the General Distribution.
  • For payments beginning on April 24, the funds will be distributed on a weekly, rolling basis as information is validated.

Disclaimer: The information on this page is meant to serve as an educational summary of federal loan and grant programs related to COVID-19. It does not constitute or substitute legal or financial advice. Interested parties should continue to consult their legal and financial professionals.