CARES Act Provider Relief Fund: For Providers
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UPDATE: The application deadline for the General Distribution (Phase 2): Medicaid, CHIP and Dental Providers is August 28, 2020. Learn More
Provider Relief Fund: Key Facts for Providers
Qualified health care service and support providers now have access to relief funds for appropriate expenses, lost revenue due to COVID-19, or to help uninsured Americans get testing and treatment for COVID-19.
Through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act (PPPCHE), the federal government has allocated $175 billion in payments to be distributed through the Provider Relief Fund (PRF).
These payments do not need to be repaid to the US government, assuming providers comply with the terms and conditions.
Note: Applications are currently open for the General Distribution (Phase 2) to Medicaid, Medicaid managed care, Children’s Health Insurance Program (CHIP) and dental providers.
Certain Medicare providers who experienced challenges will have a second opportunity to apply for funding from the General Distribution (Phase 1) starting the week of August 10.
Both groups will have until Friday, August 28, 2020 to apply.
6 Step for Providers Applying for Medicaid, CHIP and Dental Distributions
To be considered eligible for funding from the General Distribution (Phase 2), Medicaid, CHIP and Dental Providers must have:
- Received no payment from the Phase 1 $50B general distribution
- Billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan.1, 2018-Dec.31, 2019; or billed a health insurance company for oral healthcare-related services as a dental service provider; or be a licensed dental service provider who does not accept insurance and has billed patients for oral healthcare-related services
- Filed a federal income tax return for fiscal years 2017, 2018, 2019; or be exempt from filing a return
- Provided patient care after January 31, 2020
- Did not permanently cease providing patient care directly or indirectly
- For individuals, reported on Form 1040 (or other tax form) gross receipts or sales from providing patient care
- Must not be declared ineligible by local, state or federal government
For more detailed information on eligibility, please see Medicaid, CHIP and Dental Distribution FAQs.
“Recognized” TIN on curated/pre-approved list from state will directly go to Step 4.
- HHS shares unrecognized provider TINs with Medicaid state/territory and dental agencies; provider is notified (Timing 7-10 days)
- Agencies review provider information for eligibility and share results with HHS (Timing 5-7 days)
- HHS determines eligibility, updates portal, and notifies providers to apply (Timing 3-5 days)
- Provider re-enters portal and completes application for payments
Providers must apply through the Provider Relief Fund Application and Attestation Portal by August 28, 2020.
To learn about the application process:
- Watch a recording: Register/log in to watch a previous webinar session*
*Please note that the application deadline in the recording is incorrect. The application deadline is August 28, 2020.
- Read the Medicaid, CHIP and Dental Provider Distribution Fact Sheet
Before you apply:
- Read the instructions for how to fill out the application for the Medicaid, CHIP, and Dental Providers Distribution
- Download the application form for Medicaid, CHIP, and Dental Providers (For reference only. Visit the Provider Relief Fund Application and Attestation Portal to complete the application.)
Documentation required to submit the application includes:
Providers will receive approximately 2% of reported revenue from patient care.
- Payments will be disbursed on a rolling basis, as information is validated
- All Provider Relief Fund distributions will be paid to the Filing / Organizational TIN, and not directly to subsidiary TINs
Providers have 90 days to attest or reject funds through the PRF Payment Attestation Portal. Not actively attesting within 90 days will be viewed as acceptance.
- Providers that choose to accept funds must attest to the terms and conditions
of payments through the PRF Payment Attestation Portal
- Health and Human Services will post the names of payment recipients and amounts on its public website for all providers that accept PRF distributions
- Recipients of >$10,000 will be required to submit reports about the use of their PRF distribution
For more detailed information on receiving payment, please see Provider Relief Fund FAQs
Providers that receive PRF funds must choose to accept or reject funds through the PRF Payment Attestation Portal within 90 days of receipt of payment.
Providers must attest to meeting the terms and conditions of payment; if they do not attest within 90 days, they are assumed to have accepted payment and terms and conditions.
If provider rejects payment, they must return funds to HHS and may still be considered for future distributions.
Requirements from the PRF terms and conditions include (not exhaustive):
- Provided diagnosis, testing, or care for actual or possible COVID-19 patients on or after Jan.31, 2020 (Note: HSS broadly views every patient as a possible case of COVID-19)
- Payment will be used to prevent, prepare for, and respond to coronavirus, and reimburse health care related expenses or lost revenues attributable to coronavirus
- Payment will not be used for expenses or losses that have been or will be reimbursed from other sources
- Recipient consents to public disclosure of payment
All providers receiving Provider Relief Fund payments are required to comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the HHS Secretary.
HHS will require recipients to submit future reports relating to the recipient’s use of PRF money.
PRF payments may be used to cover lost revenue attributable to COVID-19 or health-related expenses purchased to prevent, prepare for, and respond to coronavirus, including but not limited to:
- Workforce training
- Reporting COVID-19 test results to federal, state, or local governments
- Building or constructing temporary structures for COVID-19 patient care or non-COVID-19 patients in a separate area
- Acquiring additional resources, including facilities, supplies, or staffing to expand or preserve care delivery
- Developing and staffing emergency operation centers
Recipients of >$10,000 will be required to submit reports about the use of their PRF distribution. For more information, read General and Targeted Distribution Post-Payment Notice of Reporting Requirement.For additional information, please see Auditing and Reporting FAQs.
Attestation Portals for Providers
Read the descriptions below to find the appropriate portal to sign an attestation, accept or return the funds, agree to Terms and Conditions, submit revenue information, and request reimbursement.
- Provider Relief Fund Application and Attestation Portal
- General Distribution Portal
- Attestation Portal for Targeted Distribution
Provider Relief Fund Application and Attestation Portal
Providers who have received funding must attest to the funds and agree to the program Terms and Conditions, or agree to return the funds within 90 days of payment. This portal is currently open to Medicaid, Medicaid managed care, CHIP and Dental providers.
|Terms and Conditions||Description|
|Medicaid, Medicaid managed care, CHIP and Dentist Provider Relief Fund Payment Terms and Conditions||The recipients have received a payment appropriated as part of the General Distribution (Phase 2): Medicaid, CHIP and Dental Providers.|
General Distribution Portal
Providers who received payment from distributions below must complete two steps.
General Distribution (Phase 1): Medicare Providers
- Initial $30 Billion General Distribution
- $20 Billion General Distribution
First, they must sign an attestation and agree to the program Terms and Conditions if they wish to keep the funds, or agree to return the funds within 90 days of payment.
Second, all providers who automatically received funds prior to 5:00 pm, Friday, April 24th, and intend to keep the funds must provide HHS with an accounting of their annual revenues by submitting tax forms or financial statements. All providers submitting their financial information were considered for additional funding from the General Distribution if information was submitted June 3, 2020.
|Terms and Conditions||Description|
The recipient automatically received payment from the initial $30 billion general distribution.
The recipient has received payment from the additional $20 billion general distribution.
Attestation Portal for Targeted Distributions
Providers who have received payments from any of the distributions below must sign an attestation confirming receipt of the funds. To accept the funds, they must agree to the program Terms and Conditions within 90 days of payment. To reject the funds, they must agree to return the funds within 90 days of payment.
- COVID-19 High-Impact Distribution
- Rural Distribution
- Allocation for Skilled Nursing Facilities (SNFs)
- Allocation for Indian Health Services (IHS)
- Allocation for Safety Net Hospitals
|Terms and Conditions||Description|
|FFCRA Relief Fund Payment Terms and Conditions||The recipient plans to submit claims for reimbursement for COVID-19 testing and/or testing related items and services provided to FFCRA (Families First Coronavirus Response Act) Uninsured Individuals.|
|Uninsured Relief Fund Payment Terms and Conditions||The recipient plans to submit claims for reimbursement for care or treatment related to positive diagnoses of COVID-19 provided to individuals who do not have any health care coverage at the time the services were provided.|
|High Impact Relief Fund Payment Terms and Conditions||The recipient has received a payment from the COVID-19 High Impact Area Distribution, part of the targeted allocations.|
|Rural Provider Relief Fund Payment Terms and Conditions||The recipient has received a payment from the Rural Distribution, part of the targeted allocations.|
|Rural Health Clinic (RHC) Testing Payment Terms and Conditions||The recipient has received payment from funds appropriated in the Public Health and Social Services Emergency Fund for COVID-19 testing and related expenses.|
|Skilled Nursing Facility Relief Fund Payment Terms and Conditions||The recipient has received payment from funds appropriated as part of the targeted allocations.|
|Indian Health Service Relief Fund Payment Terms and Conditions||The recipient has received a payment from the Tribal Distribution, part of the targeted allocations.|
|Safety Net Provider Relief Fund Payment Terms and Conditions||The recipient has received a payment appropriated as part of the safety net targeted distribution.|
COVID-19 Uninsured Program Portal
Providers requesting reimbursement for COVID-19 testing or provided treatment for uninsured COVID-19 individuals on or after February 4, 2020 may use this portal to submit claims.
|Terms and Conditions||Description|
The recipient plans to submit claims for reimbursement for COVID-19 testing and/or testing related items and services provided to FFCRA (Families First Coronavirus Response Act) Uninsured Individuals.
The recipient plans to submit claims for reimbursement for care or treatment related to positive diagnoses of COVID-19 provided to individuals who do not have any health care coverage at the time the services were provided.
Reporting Requirements & Auditing
All providers receiving Provider Relief Fund payments will be required to comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the Secretary.
General and Targeted Distribution Post-Payment Notice of Reporting Requirement
The purpose of this notice is to inform Provider Relief Fund (PRF) recipients that received one or more payments exceeding $10,000 in the aggregate from the PRF of the timing of future reporting requirements. Detailed instructions regarding these reports will be released by August 17, 2020.
The Recipients of provider relief fund payments may be subject to auditing to ensure the accuracy of the data submitted to HHS for payment. Any Recipients identified as having provided inaccurate information to HHS will be subject to payment recoupment and other legal action. Further, all recipients of provider relief payments shall maintain appropriate records and cost documentation including, as applicable, documentation described in 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 that providers used all Provider Relief Fund payments appropriately. Upon the request of the Secretary, the Recipient shall promptly submit copies of such records and cost documentation and Recipient must fully cooperate in all audits the Secretary, Inspector General, or Pandemic Response Accountability Committee conducts to ensure compliance with applicable Terms and Conditions. Deliberate omission, misrepresentation, or falsification of any information contained in payment applications or future reports may be punishable by criminal, civil, or administrative penalties, including but not limited to revocation of Medicare billing privileges, exclusion from federal health care programs, and/or the imposition of fines, civil damages, and/or imprisonment. (For more details, please refer to the Terms and Conditions associated with each payment distribution and the HHS FAQs).
For additional assistance applying, please call the provider support line at (866) 569-3522; for TTY dial 711. Hours of operation are 7 a.m. to 10 p.m. Central Time, Monday through Friday.
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