In response to increased expenses related to the COVID-19 response, financial relief to nursing homes is being released as part of the COVID-19 Stimulus Package. Spending for PPE and supplies; establishing isolation units, hazard pay or other staff incentives, overtime, staff leaves and declining occupancy rates leading to decreased revenues has had a significant impact on nursing homes and the planned Stimulus Package relief aims to offset these effects.
Distribution of Funds
HHS will partner with United Health Group to deliver the initial $30 billion distribution to Medicare providers including nursing homes.
- Providers will be paid electronically where possible.
- Providers who normally receive paper check reimbursement from CMS will receive a paper check in the mail for this payment as well, within the next few weeks.
- Eligibility: All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution. Payments to practices that are part of larger medical groups will be sent to the group’s central billing office.
- All relief payments are made to the billing organization according to its Taxpayer Identification Number.
- As a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.
- This dispersal of funds is intended to 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 canceled elective services. This provision will aid providers with declining occupancy rates.
- Providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. This means that CMS, as with calculating the Accelerated and Advance Payments, has used net reimbursement based upon claims to calculate the award amounts. 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 they received by$484,000,000,000, and multiply that ratio by $30,000,000,000. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system. Providers should work with their financial management, revenue cycle divisions or third-party billing contractors to arrive at their own estimates.
A provider billed Medicare FFS $121 million in 2019. To determine how much they would receive, use this equation:
$121,000,000 / $484,000,000,000 x $30,000,000,000 = $7,500,000
Future Distributions of Funds
In the coming weeks, funds will be released for providers in areas particularly impacted by the COVID-19 outbreak, rural providers, low volume Medicare providers of services, providers who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans.
Terms and Conditions
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.
Sources: AHCA, NASL, HHS Learn more at: https://www.hhs.gov/provider-relief/index.html