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CARES Act Provider Relief Fund: FAQs


Trending Questions

What action does a provider need to take after receiving a Provider Relief Fund payment? (Modified 5/26/亿乐彩彩票)

The CARES Act requires that providers meet certain terms and conditions if a provider retains a Provider Relief Fund payment. If a provider chooses to retain the funds, it must attest that it meet these terms and conditions of the payment. The  will guide you through the attestation process to accept or reject the funds. Not returning the payment within 90 days of receipt will be viewed as acceptance of the Terms and Conditions. A provider must attest for each of the Provider Relief Fund distributions received.

How can I return a payment I received under the Provider Relief Fund? (Modified 5/26/亿乐彩彩票)

Providers may return a payment by going into the attestation portal within 90 days of receiving payment and indicating they are rejecting the funds. The  will guide providers through the attestation process to reject the funds.


To return the money, the provider needs to contact their financial institution and ask the institution to refuse the received Automated Clearinghouse (ACH) credit by initiating an ACH return using the ACH return code of "R23 - Credit Entry Refused by Receiver." If a provider received the money via ACH they must return the money via ACH. If a provider was paid via paper check, after rejecting the payment in the attestation portal, the provider should destroy the check if not deposited or mail a paper check to UnitedHealth Group with notification of their request to return the funds.

What documents do I need to begin entering in the payment portal?
  1. TIN that received prior Provider Relief Fund payments
  2. TIN(s) of subsidiary organizations that received prior Provider Relief Funds but do not file separate tax forms (i.e., subsidiary organizations that are accounted for in the parent organization’s tax filing)
  3. Amount of payments received
  4. Relief Fund payment transaction numbers / check numbers
  5. A copy of your most recently filed tax forms
Why does the website say my TIN is not eligible?

HHS is collecting tax and financial loss data from providers who have already received payments under the General Distribution. If you have not already received a Provider Relief Fund payment you are not eligible to submit your tax and financial loss information to the Provider Relief Fund Payment Portal. However, this does not mean that you are ineligible for forthcoming Provider Relief funds.


If you received a General Distribution payment by 5:00 pm EST, Friday April 24, 亿乐彩彩票 and are being told that your TIN is ineligible, please check to see if you entered your TIN correctly and check to see that the TIN matches the TIN for the organization that received a Provider Relief Fund payment.

Is there a publicly available list of providers and the payments they received through the Provider Relief Fund? (Modified 5/26/亿乐彩彩票)

HHS has posted once they attest to receiving the money and agree to the Terms and Conditions. All providers that received a payment from the Provider Relief Fund and retain that payment for at least 90 days without rejecting the funds are deemed to have accepted the Terms and Conditions. Providers that affirmatively attest through the provider portal or that retain the funds past 90 days, but do not attest, will be included in the public release of providers and payments. The list includes current total amounts attested to by providers from each of the Provider Relief Fund distributions, including the General Distribution, Rural Distribution, and High-Impact Areas Distribution.

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Provider Relief Fund General Information


Overview

Provider Relief Funds are being disbursed via both “General” and “Targeted” Distributions.

General Distribution

To be eligible for the General Distribution, a provider must have billed Medicare in 2019 and provide or provided after January 31, 亿乐彩彩票 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of   COVID-19. $50 billion will be disbursed in the General Distribution.

All providers retaining funds must sign an attestation and accept the terms and conditions associated with payment. Providers must also submit tax documents and financial loss estimates if they wish to be eligible for additional funds.

Targeted Distributions

U.S. healthcare providers may be eligible for payments from the remaining funds through Targeted Distributions. Information on future distributions will be shared when publicly available.

No, HHS will not issue a new payment to a provider that received and then subsequently rejected and returned the original payment. The provider may be considered for future distributions if it meets the eligibility criteria for that distribution.

Retention and use of these funds are subject to certain terms and conditions. If these terms and conditions are met, payments do not need to be repaid at a later date. These terms and conditions can be found here.

Providers that did not receive funding under the General Distribution may be included in future allocations under the Provider Relief Fund.

A description of additional disbursements can be found on the General Information page.

Attestation

The CARES Act requires that providers meet certain terms and conditions if a provider retains a Provider Relief Fund payment. If a provider chooses to retain the funds, it must attest that it meet these terms and conditions of the payment. The will guide you through the attestation process to accept or reject the funds. Not returning the payment within 90 days of receipt will be viewed as acceptance of the Terms and Conditions. A provider must attest for each of the Provider Relief Fund distributions received.

Yes. The requires payment recipients to (1) confirm they received a payment and the specific payment amount that was received; and (2) agree to the Terms and Conditions of the payment.

Yes. If a provider would like to reject one payment, the provider may still accept future distribution payments. The provider must use the to accept or reject payments.

Rejecting Payments

Providers may return a payment by going into the attestation portal within 90 days of receiving payment and indicating they are rejecting the funds. The will guide providers through the attestation process to reject the funds.

To return the money, the provider needs to contact their financial institution and ask the institution to refuse the received Automated Clearinghouse (ACH) credit by initiating an ACH return using the ACH return code of “R23 - Credit Entry Refused by Receiver." If a provider received the money via ACH they must return the money via ACH. If a provider was paid via paper check, after rejecting the payment in the attestation portal, the provider should destroy the check if not deposited or mail a paper check to UnitedHealth Group with notification of their request to return the funds.

If the provider received a payment via check and has not yet deposited it, destroy, shred, or securely dispose of it. If the provider has already deposited the check, mail a refund check for the full amount, payable to “UnitedHealth Group” to the address below. Please list the check number from the original Provider Relief Fund ACH payment or check in the memo.

UnitedHealth Group
Attention: CARES Act Provider Relief Fund
PO Box 31376
Salt Lake City, UT 84131-0376

Terms and Conditions

Unless the payment is associated with specific claims for reimbursement for COVID-19 testing or treatment provided on or after February 4, 亿乐彩彩票 to uninsured patients, under the Terms and Conditions associated with payment, providers are eligible only if they provide or provided after January 31, 亿乐彩彩票, diagnoses, testing or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19.

Not every possible case of COVID-19 is a presumptive case of COVID 19. For clarification as it relates to presumptive COVID 19 cases, refer to the Frequently Asked Question that defines a presumptive case of COVID-19.
 

Failure by a provider that received a payment from the Provider Relief Fund to comply with any term or condition can subject the provider to recoupment of some or all of the payment. Per the Terms and Conditions, all recipients will be required to submit documents to substantiate that these funds were used for increased healthcare-related expenses or lost revenue attributable to coronavirus, and that those expenses or losses were not reimbursed from other sources and other sources were not obligated to reimburse them. HHS will have significant anti-fraud monitoring of the funds distributed, and the Office of Inspector General will provide oversight as required in the CARES ACT to ensure that Federal dollars are used appropriately.

The Terms and Conditions state that none of the funds appropriated in this title shall be used to pay the salary of an individual, through a grant or other mechanism, at a rate in excess of Executive Level II. The salary limitation is based upon the Executive Level II of the Federal Executive Pay Scale. Effective January 5, 亿乐彩彩票, the Executive Level II salary is $197,300. For the purposes of the salary limitation, the direct salary is exclusive of fringe benefits and indirect costs. The limitation only applies to the rate of pay charged to Provider Relief Fund payments and other HHS awards. An organization receiving Provider Relief Funds may pay an individual’s salary amount in excess of the salary cap with non-federal funds.

If a provider ceased operation as a result of the COVID-19 pandemic, they are still eligible to receive Provider Relief funds so long as they provided on or after January 31, 亿乐彩彩票, diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19, therefore, care does not have to be specific to treating COVID-19.  Recipients of funding must still comply with the Terms and Conditions related to permissible uses of Provider Relief Fund payments.

There is no direct ban under the CARES Act on accepting a payment from the Provider Relief Fund and other sources, so long as the payment from the Provider Relief Fund is used only for permissible purposes and the recipient complies with the Terms and Conditions. By attesting to the Terms and Conditions, the recipient certifies that 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.

HHS has not yet detailed how recoupment or repayment will work. However, the Terms and Conditions associated with payment require that the Recipient be able to certify, among other requirements, that it was eligible to receive the funds (e.g., provides or provided after January 31, 亿乐彩彩票, diagnoses, testing, or care for individuals with possible or actual cases of COVID-19) and that the funds were used in accordance with allowable purposes (e.g., to prevent, prepare for, and respond to coronavirus). Additionally, recipients must submit all required reports as determined by the Secretary. Non-compliance with any Term or Condition is grounds for the Secretary to direct recoupment of some or all of the payments made. HHS will have significant anti-fraud monitoring of the funds distributed, and the Office of Inspector General will provide oversight as required in the CARES Act to ensure that Federal dollars are used appropriately.

The term “health care related expenses attributable to coronavirus” is a broad term that may cover a range of items and services purchased to prevent, prepare for, and respond to coronavirus, including:

  • supplies used to provide healthcare services for possible or actual COVID-19 patients;
  • equipment used to provide healthcare services for possible or actual COVID-19 patients;
  • workforce training;
  • developing and staffing emergency operation centers;
  • reporting COVID-19 test results to federal, state, or local governments;
  • building or constructing temporary structures to expand capacity for COVID-19 patient care or to provide healthcare services to non-COVID-19 patients in a separate area from where COVID-19 patients are being treated; and
  • acquiring additional resources, including facilities, equipment, supplies, healthcare practices, staffing, and technology to expand or preserve care delivery.

Providers may have incurred eligible health care related expenses attributable to coronavirus prior to the date on which they received their payment.  Providers can use their Provider Relief Fund payment for such expenses incurred on any date, so long as those expenses were attributable to coronavirus and were used to prevent, prepare for, and respond to coronavirus.  HHS expects that it would be highly unusual for providers to have incurred eligible expenses prior to January 1, 亿乐彩彩票.

The term “lost revenues that are attributable to coronavirus” means any revenue that you as a healthcare provider lost due to coronavirus.  This may include revenue losses associated with fewer outpatient visits, canceled elective procedures or services, or increased uncompensated care.  Providers can use Provider Relief Fund payments to cover any cost that the lost revenue otherwise would have covered, so long as that cost prevents, prepares for, or responds to coronavirus.  Thus, these costs do not need to be specific to providing care for possible or actual coronavirus patients, but the lost revenue that the Provider Relief Fund payment covers must have been lost due to coronavirus.  HHS encourages the use of funds to cover lost revenue so that providers can respond to the coronavirus public health emergency by maintaining healthcare delivery capacity, such as using Provider Relief Fund payments to cover:

  • Employee or contractor payroll
  • Employee health insurance
  • Rent or mortgage payments
  • 亿乐彩彩票 lease payments
  • Electronic health record licensing fees
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.  HHS will provide guidance in the future about the type of documentation we expect recipients to submit on the CARES Act Provider Relief page.
 

Reporting Requirements

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. The specific reporting obligations imposed on providers receiving $150,000 or more from any Act primarily making appropriations for the coronavirus response and related activities, which is a statutory requirement, begins for the calendar quarter ending June 30. The Secretary may request additional reports prior to that date. HHS will provide guidance in the future about the type of documentation we expect recipients to submit.

Balance Billing

The Terms and Conditions do not impose any limitations on the ability of a provider to submit a claim for payment to the patient’s insurance company. However, an out-of-network provider delivering COVID-19-related care to an insured patient may not seek to collect from the patient out-of-pocket expenses, including deductibles, copayments, or balance billing, 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.

Providers accepting the Provider Relief Fund payment should submit a claim to the patient’s health insurer for their services. Most health insurers have publicly stated their commitment to reimbursing out-of-network providers that treat health plan members for COVID-19-related care at the insurer’s prevailing in-network rate. If the health insurer is not willing to do so, the out-of-network provider may seek to collect from the patient out-of-pocket expenses, including deductibles, copayments, or balance billing, in an amount that is no greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.

Appeals

HHS will apportion relief funds to US healthcare providers with the intention of optimizing the beneficial impact of the funds.

HHS is not taking direct inquiries from providers, and no remedy or appeals process will be available. For additional information, please call the provider support line at (866) 569-3522.

There is no appeals or dispute process.

Publication of Payment Data

HHS has posted once they attest to receiving the money and agree to the Terms and Conditions. All providers that received a payment from the Provider Relief Fund and retain that payment for at least 90 days without rejecting the funds are deemed to have accepted the Terms and Conditions. Providers that affirmatively attest through the provider portal or that retain the funds past 90 days, but do not attest, will be included in the public release of providers and payments. The list includes current total amounts attested to by providers from each of the Provider Relief Fund distributions, including the General Distribution, Rural Distribution, and High-Impact Areas Distribution.

The represent the list of providers that received one or more payments from the Provider Relief Fund and that have attested to receiving at least one payment and agreed to the associated Terms and Conditions. If a provider has received more than one payment but has not accepted all of the payments (by attesting and agreeing to the Terms and Conditions), only the dollar amount associated with the accepted payment or payments will appear. These data displayed on the website will be updated biweekly.

Provider Relief Fund payments are being made to providers or groups of providers that are organized within a Tax Identification Number (TIN). The information displayed is of providers by billing TIN that have received at least one payment, which they have attested to, and the address associated with that billing TIN. Providers will not be listed if they have not yet attested to the payment terms and conditions or if they are within a larger billing entity that received payment. In addition, the address listed for the billing TIN often corresponds with the billing location (based on CMS’s Provider Enrollment, Chain, and Ownership System (PECOS)), and may not align with the physical location of a health care practice site. Updated data will be made available on the CDC’s .

No. To ensure transparency, HHS will publish the names of payment recipients and the amounts accepted and attested to by the payment recipient.

This approach may not be accurate. Each row in the public use file (PUF) is associated with an individual billing TIN, which is the unique identifier that received and attested to one or more payments. If an organization name is listed more than once, it may be because the organization has more than one billing TIN that received a payment, or it may be because multiple providers have the same name.

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General Distribution


Overview and Eligibility

To be eligible for a General Distribution payment, providers must have billed Medicare on a fee-for- service basis (Parts A or B) in Calendar Year 2019. Additionally, under the Terms and Conditions associated with payment, these providers are eligible only if they provide or provided after January 31, 亿乐彩彩票, diagnoses, testing or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19.

All providers retaining funds must sign an attestation and accept the terms and conditions associated with payment. Providers must also submit tax documents and financial loss estimates if they wish to be eligible for additional funds.

HHS is distributing an additional $20 billion of the General Distribution to providers to augment their initial allocation so that $50 billion is allocated proportional to providers' share of 2018 net patient revenue. The allocation methodology is designed to provide relief to providers, who bill Medicare fee-for-service, with at least 2% of that provider’s net patient revenue regardless of the provider’s payer mix. Payments are determined based on the lesser of 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April. If the initial General Distribution payment you received between April 10 and April 17 was determined to be at least 2% of your annual patient revenue, you may not receive additional General Distribution payments.

In general, providers can estimate payments from the General Distribution of approximately 2% of 2018 (or most recent complete tax year) patient revenue. To estimate your payment, use this equation:

(Individual Provider Revenues/$2.5 Trillion) X $50 Billion = Expected Combined General Distribution.
To estimate your payment, you may need to use “Gross Receipts or Sales” or “Program Service Revenue.” Providers should work with a tax professional for accurate submission.

This includes any payments under the first $30 billion general distribution as well as under the $20 billion general distribution allocations. Providers may not receive a second distribution payment if the provider received a first distribution payment of equal to or more than 2% of patient revenue.

HHS is distributing an additional $20 billion of the General Distribution to providers to augment their initial allocation so that $50 billion is allocated proportional to providers' share of 2018 net patient revenue. Payments are determined based on the lesser of 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April. If the initial General Distribution payment you received between April 10 and April 17 was determined to be at least 2% of your annual patient revenue, you may not receive additional General Distribution payments. There may be additional distributions in the future for which providers are eligible.

HHS is reviewing providers’ uploaded financial information. Payments will go out weekly, on a rolling basis, as information is validated. HHS may seek additional information from providers as necessary to complete its review.

No, only providers that received a previous payment under the General Distribution are eligible to receive funding through this additional distribution.

Yes, you may receive additional funding through Targeted Distribution payments related to COVID-19. Additional allocations will be made separately from General Distribution payments. You may also file claims for testing and treatment of uninsured COVID-19 patients in the .

Yes, providers can resubmit a General Distribution application. HHS will review the most recent request.

Providers that have been allocated a payment must sign an attestation confirming receipt of the funds and agree to the Terms and Conditions within 90 days of payment. If a provider believes it was overpaid or may have received a payment in error, it should reject the entire General Distribution payment and submit the appropriate revenue documents through the General Distribution portal to facilitate HHS determining their correct payment. If a provider believes they are underpaid, they should accept the payment and submit their revenues in the provider portal to determine their correct payment.

The Provider Relief Fund and the Terms and Conditions require that recipients be able to demonstrate that lost revenues and increased expenses attributable to COVID-19, excluding expenses and losses that have been reimbursed from other sources or that other sources are obligated to reimburse, exceed total payments from the Relief Fund. Generally, HHS does not intend to recoup funds as long as a provider’s lost revenue and increased expenses exceed the amount of Provider Relief funding a provider has received. HHS reserves the right to audit Relief Fund recipients in the future to ensure that this requirement is met and collect any Relief Fund amounts that were made in error or exceed lost revenue or increased expenses due to COVID-19. Failure to comply with the Terms and Conditions may be grounds for recoupment.

Yes. If, as a result of the sale of a practice/hospital, the TIN that received a General Distribution payment did not provide diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 亿乐彩彩票, the provider must reject the payment. The will guide you through the attestation process to reject the payment.

An organization’s adjusted gross receipts should be calculated as gross receipts as shown on the organization’s most recent tax return plus gross receipts of the practice acquired not reflected in the organization’s tax return minus gross receipts of providers sold not reflected in the organization’s tax return. If an organization’s adjusted gross receipts exceed the gross receipts shown in the tax return by more than 20%, the organization is eligible to enter the adjusted gross receipts figure in the . Otherwise, the organization should enter the gross receipts figure as shown on the tax return. Organizations that have already submitted an application in the Payment Portal can resubmit a revised application using the adjusted gross receipts number accounting for acquisitions, if the adjusted gross receipts exceeds the gross receipts shown in the tax return by more than 20%. Gross receipts of acquired entities that provide care as of January 31, 亿乐彩彩票 and file their own tax returns cannot be included in such adjusted gross receipts figure, because they should submit their own application as tax return filers.

No. A provider that sold its only practice or facility must reject the Provider Relief Fund payment because it cannot attest that it was providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 亿乐彩彩票, as required by the Terms and Conditions. Seller organizations should not transfer a payment received from HHS to another entity. If the current TIN owner has not yet received any payment from the Provider Relief Fund, it may still receive funds in other distributions.

No. The new TIN owner cannot accept the payment from another entity nor attest to the Terms and Conditions on behalf of the previous owner in order to retain the Provider Relief Fund payment. If the new TIN owner did not receive a direct payment under the General Distribution, it is not eligible to receive a payment under the General Distribution. However, the new TIN owner may still receive funds in other distributions.

If the non-surviving entity (billing TIN) received a General Distribution payment but was not providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 亿乐彩彩票, that provider must reject the General Distribution payment. If the surviving entity (billing TIN) received a General Distribution payment, it should accept the payment and submit its adjusted gross receipts if its adjusted gross receipts exceed the gross receipts shown in the tax return by more than 20% in the to be considered for additional Provider Relief Fund payments.

Until the purchase is complete, the organization should only report current gross receipts in its application and should exclude the practice it is intending to purchase. Any changes in ownership that have not occurred should not be included in your revenue submission. Submissions must be based on the organization that exists at the time of application, not a projection of expected lost revenue from the practice that is being acquired.

No. A provider may not return a portion of a Provider Relief Fund payment. If a provider that sold a practice that was included in its most recent tax return gross receipts or sales (or program services revenue) figure, can attest to meeting the Terms and Conditions, it may accept the funds. The Terms and Conditions place restrictions on how the funds can be used. In particular, all recipients will be required to substantiate that these funds were used for increased healthcare-related expenses or lost revenue attributable to coronavirus, and that those expenses or losses were not reimbursed from other sources and other sources were not obligated to reimburse them. Generally, if a provider anticipates that its COVID-related lost revenues or increased expenses will be materially less than the value of the Provider Relief Fund payment received, the provider should reject the entire General Distribution payment and submit the appropriate revenue documents through the to facilitate HHS determining their correct payment.

If a provider that purchased a practice or facility in 2019 or January 亿乐彩彩票 did not bill Medicare fee-for-service in 2019 and did not receive any Provider Relief Fund payment, it is not eligible for payments under the General Distribution and may not submit its gross revenue receipts in . However, the provider may still receive funds in future distributions.

The parent entity should attach and submit a statement as the first page of the uploaded tax return file indicating any additional billing TINs not previously entered into the application forms as well as the Provider Relief Fund payments that these billing TINs received.

If an organization that sold, terminated, transferred, or otherwise disposed of a provider that was included in its most recent tax return gross receipts or sales (or program services revenue) figure can attest to meeting the Terms and Conditions, it may accept the funds. The Terms and Conditions place restrictions on how the funds can be used.  In particular, all recipients will be required to substantiate that these funds were used for increased healthcare-related expenses or lost revenue attributable to coronavirus, and that those expenses or losses were not reimbursed from other sources and other sources were not obligated to reimburse them.  Generally, if a provider anticipates that its COVID-related lost revenues or increased expenses will be materially less than the value of the General Distribution payments received, the provider should reject the payment and submit its adjusted gross receipts in .

The parent entity should complete an application by listing the Billing TINs of the respective subsidiaries without entering its own Filing TIN. In the application, the parent entity should enter the sum of all “gross sales or receipts” or “program service revenue” of all subsidiary entities with Billing TINs in the applicable field in the application form. Further, the parent entity should submit a statement on the first page of the uploaded tax return file stating (i) the parent entity’s Filing TIN and that it does not bill Medicare and (ii) a schedule of the billing subsidiaries, their Billing TINs, and gross sales or receipts.

Yes, a parent organization can accept and allocate funds at its discretion to its subsidiaries. The Terms and Conditions place restrictions on how the funds can be used.  In particular, the parent organization will be required to substantiate that these funds were used for increased healthcare-related expenses or lost revenue attributable to COVID-19, and that those expenses or losses were not reimbursed from other sources and other sources were not obligated to reimburse them.

Yes, the parent organization with subsidiary billing TINs that received payments may attest and keep the payments as long as providers associated with the parent organization were providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 亿乐彩彩票 and can otherwise attest to the Terms and Conditions. The parent organization can allocate funds at its discretion to its subsidiaries. If the parent organization would like to control and allocate Provider Relief Fund payments to its subsidiaries, the parent organization must attest to accepting its subsidiaries’ payments and agreeing to the Terms and Conditions.

The applying organization should complete an application by listing the Billing TINs of the eligible subsidiaries that provide or provided after January 31, 亿乐彩彩票, diagnoses, testing or care for individuals with possible or actual cases of COVID-19. In the application, the parent entity should enter the sum of all “gross sales or receipts” or “program service revenue” of all eligible subsidiary entities that provide or provided after January 31, 亿乐彩彩票, diagnoses, testing or care for individuals with possible or actual cases of COVID-19 and enter the subsidiaries’ Billing TINs in the applicable fields in the application form. Further, the parent entity should submit a statement on the first page of the uploaded tax return file stating (i) the parent entity’s Filing TIN and (ii) a schedule of the eligible subsidiaries, their Billing TINs, and gross sales or receipts. Any revenues from subsidiaries that are not directly providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 may not be included.

HRSA distributed the initial $30 billion in Provider Relief funds in proportion to a provider’s 2019 Medicare Fee for Service billings. Read more about the allocation methodologies.

The Provider Relief Fund payment recipient has discretion in allocating the Provider Relief funds to support health care related expenses or lost revenue attributable to COVID-19, so long as they are not reimbursed from other sources and other sources were not obligated to reimburse them.

Payment Portal

The CARES Act requires that providers meet certain terms and conditions to receive Provider Relief Funds. In order to keep the initial General Distribution payment, and in order to be eligible to receive additional General Distribution funds, you must attest that you meet these terms and conditions and you must submit your financial and tax information.

The $50 billion general allocation is apportioned based on provider revenue. Tax forms are needed to ascertain and confirm provider revenue.

  1. TIN that received prior Provider Relief Fund payments
  2. TIN(s) of subsidiary organizations that received prior Provider Relief Funds but do not file separate tax forms (i.e., subsidiary organizations that are accounted for in the parent organization’s tax filing)
  3. Amount of payments received
  4. Relief Fund payment transaction numbers / check numbers
  5. A copy of your most recently filed tax forms

Any provider who received a payment from the Provider Relief Fund as of 5:00 pm EST Friday, April 24, 亿乐彩彩票 can apply for additional funding via the .

Providers who have not received funding as of 5:00 pm EST Friday April 24, 亿乐彩彩票 are not eligible to use the . However these providers may still be eligible for payments from the Provider Relief Fund through other mechanisms, including the Targeted Distributions.

The has been deployed to collect information from providers who received General Distribution payments prior to April 24, 亿乐彩彩票 at 5:00 pm EST.

The collects four pieces of information to allocate remaining General Distribution funds:

  1. a provider’s “Gross Receipts or Sales” or “Program Service Revenue” as submitted on its federal income tax return;
  2. the provider’s estimated revenue losses in March 亿乐彩彩票 and April 亿乐彩彩票 due to COVID;
  3. a copy of the provider’s most recently filed federal income tax return;
  4. a listing of the TINs for any of the provider’s subsidiary organizations that received relief funds but DO NOT file separate tax returns.

This information may also be used to allocate other Provider Relief Fund distributions.

HHS is collecting: the “gross receipt or sales” or “program service revenue” data to have an understanding of a provider’s usual operations; the revenue loss information to have an understanding of COVID impact; and, tax forms to verify the self- reported information. HHS is collecting information about organizational structure and subsidiary TINs so that we do not overpay or underpay providers who file tax returns covering multiple legal entities (e.g. consolidated tax returns).

Providers meeting the following criteria are required to submit a separate portal application:

  1. Provider has received Provider Relief Fund payments as of 5:00pm EST Friday April 24, 亿乐彩彩票 AND
  2. Provider has filed a federal income tax return for 2017, 2018, or 2019.

As such, each entity that files a federal income tax return is required to file an application even if it is part of a provider group. However, a group of corporations that files one consolidated return will have only the tax return filer apply.

Each provider submitting an application is required to list the TINs of each subsidiary that (a) has received Provider Relief Fund payments as of 5:00 EST Friday April 24, 亿乐彩彩票 AND (b) has not filed federal income tax returns for 2017, 2018, or 2019.

Do not list any subsidiary’s TIN that has filed a federal income tax return, because such subsidiary is required to submit a separate application.

For example:

  1. A parent entity and two subsidiaries received Provider Relief Fund payments. The parent filed a federal income tax return, but the two subsidiaries did not as they are consolidated with the parent.

The parent should submit an application and list the subsidiary TINs therein. The subsidiaries cannot submit an application as they did not file a tax return.

  1. A parent entity and two subsidiaries A and B received Provider Relief Fund payments. The parent and subsidiary A filed a federal income tax return, but the subsidiary B did not as it is consolidated with the parent.

The parent and subsidiary A should submit separate applications. The parent would list the TIN subsidiary B in its application.

Eligibility
To enter the you must meet two criteria:

  1. You must have already received a Provider Relief Fund Payment by 5:00 pm EST, Friday April 24, 亿乐彩彩票
  2. You must attest to having received the payment via the , and you must agree to the Terms and Conditions on the attestation portal.

Data
Before you initiate your application via the , please collect the following data

  1. The Taxpayer Identification Number for the organization applying for Provider Relief funds. (“Application TIN”)
  2. The Taxpayer Identification Number(s) of any subsidiary organizations if and only if those organizations do not file separate tax returns, but rather consolidate into the returns of the “Application TIN”. If your organization has subsidiaries that file separate tax returns, a separate application must be made for each subsidiary that files a separate return.
  3. An estimate of the organization’s lost revenue for March 亿乐彩彩票 and April 亿乐彩彩票. Lost revenue can be estimated by comparing year-over-year revenue, or by comparing budgeted revenue to actual revenue. For April 亿乐彩彩票, an estimate of the total monthly loss based on data from the first few weeks in April or by extrapolation from March data is acceptable.
  4. A copy of the most recent tax form filed by the organization associated with the Application TIN.

Any person authorized by the provider organization may complete this form. We recommend it be completed by an organization’s corporate office, specifically, the CFO or other accounting professional.

No. HHS will be processing applications in batches every week. Funds will not be disbursed on a first-come-first-served basis, which is to say, an applicant will be given equal consideration regardless of when they apply.

HHS is collecting tax and financial loss data from providers who have already received payments under the General Distribution. If you have not already received a Provider Relief Fund payment you are not eligible to submit your tax and financial loss information to the . However, this does not mean that you are ineligible for forthcoming Provider Relief funds.

If you received a General Distribution payment by 5:00 pm EST, Friday April 24, 亿乐彩彩票 and are being told that your TIN is ineligible, please check to see if you entered your TIN correctly and check to see that the TIN matches the TIN for the organization that received a Provider Relief Fund payment.

Organizations that have not received any General Distribution payments as of April 24, 亿乐彩彩票 may be eligible for relief funds in future distributions. The is only collecting tax IDs from providers who have received a General Distribution payment.

The Federal Tax Classification describes the type of tax filer that the applicant is for purposes of the applicant’s federal income tax return with the IRS, for example Partnership or S Corporation.

The answer is determined by the type of the applicant’s entity and any tax elections the applicant has made.

  • Form 1040      The applicant is a sole proprietor or provides services as the sole member of an LLC.
  • Form 1065      The applicant is a partnership.
  • Form 1120      The applicant is a C corporation.
  • Form 1120-S   The applicant is an S corporation.
  • Form 990        The applicant is a tax-exempt organization.
  • Form 1041      The applicant is a trust.

All providers that have filed tax returns in 2019 or 2018 should submit the filings as supporting documentation. If a particular healthcare provider has a legitimate reason (e.g. tax exempt) for not having IRS filings, then alternative financial statements are acceptable. If the entity is tax exempt, the entity should use Net Patient Revenues from its most recent audited annual financial statements as a substitute for “Program 亿乐彩彩票 Revenue” when prompted. Further, the entity should submit its most recent audited financial statements as a substitute for the federal income tax return Form 990 requested.

  • Form 1040      Box 1 of Schedule C
  • Form 1065      Box 1a
  • Form 1120      Box 1a
  • Form 1120-S   Box 1a
  • Form 990        Use Part I, 9 “Program 亿乐彩彩票 revenue”
  • Form 1041      Box 1 of Form 1040 Schedule C

[Note: you use a Form 1040 Schedule C also for Form 1041]

The applying state entity should select “Tax-Exempt Organization” in the dropdown menu for “Federal Tax Classification.” The state entity should use Net Patient Revenues from its most recent audited annual financial statements as a substitute for “Program 亿乐彩彩票 Revenue”. Further, the state entity should submit its most recent audited financial statements as a substitute for the federal income tax return Form 990.

You may use a reasonable method of estimating the revenue during March and April compared to the same period had COVID-19 not appeared. For example, if you have a budget prepared without taking into account the impact of COVID-19, the estimated lost revenue could be the difference between your budgeted revenue and actual revenue. It would also be reasonable to compare the revenues to the same period last year.

HHS is asking for Gross Receipts because it is a measure of revenues you received during the applicable filing period.

HHS realizes that a final revenue number may not be available until a certain time after the end of April. As the program seeks to provide liquidity support to the healthcare system in a timely manner we are using estimated revenues.

Submit the most recent form that you have filed with the IRS (typically 2017, 2018 or 2019).

If you are required to, but have not filed a tax return in 2017 or 2018, you are ineligible to apply. You should file the applicable tax return and then re-apply.

You must attest for all payments received to be eligible for additional General Distribution funding. You are only eligible to apply for additional funding through the if you have TINs that have received prior relief fund payments. Fill out one application for each eligible TIN that has received a Provider Relief Fund payment and for which there is a corresponding tax filing. If you are a subsidiary of a tax filing organization, and do not file a separate tax return, you are ineligible to apply for additional funds.

Providers may find their Medicare ID number by logging into the Medicare Provider Enrollment, Chain, and Ownership System (PECOS).

Council for Affordable Quality Healthcare (CAQH) Provider ID number is the unique identifier assigned to each CAQH ProView user at the time of registration. If you have been invited to join CAQH ProView by a health plan, hospital or other participating organization, you may have received a welcome letter with your CAQH Provider ID Number. New users also have the option to self-register through the . Upon completion of the self-registration process, users will receive a welcome email with their unique CAQH Provider ID Number.

You may make one request for each TIN that has received prior Provider Relief Fund payments.

During the HHS review of the data submitted through the Provider Payment Portal, a number of healthcare providers that submitted their information for payments from the General Distribution were flagged for data verification, and may require additional follow-up and communication prior to receiving funds.  Common issues that prompted a submission to be flagged for further review include information entered not matching tax documentation, providers with significantly lower than expected Medicare revenue, and apparent data entry errors. 

Please resubmit your revenue information on the  for HHS verification.  Resubmissions have the same instructions and requirements as the original DocuSign submission.  Please review to ensure that you are submitting the correct information.

No. Potential payment is not affected by a requirement to resubmit additional information. HHS is working to process all providers’ submissions as quickly as possible. HHS is distributing an additional $20 billion of the General Distribution to providers to augment their initial allocation so that $50 billion is allocated proportional to providers' share of 2018 net patient revenue. Payments are determined based on the lesser of 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April 亿乐彩彩票. If after further review of your resubmitted revenue information, the initial General Distribution payment you received between April 10 and April 17 was determined to be at least 2% of your annual net patient revenue, you may not receive additional General Distribution payments. 

No. HHS reached out directly to those providers who need to resubmit their revenue information. If you did not receive an email from HHS requesting resubmission, you do not need to take any action at this time. 

Determining Additional Payments

In general, providers can estimate payments from the General Distribution of approximately 2% of 2018 (or most recent complete tax year) patient revenue.  To estimate your payment, use this equation:

(Individual Provider Revenues/$2.5 Trillion) X $50 Billion = Expected Combined General Distribution.

To estimate your payment, you may need to use “Gross Receipts or Sales” or “Program Service Revenue.”  Providers should work with a tax professional for accurate submission.

This includes any payments under the first $30 billion general distribution as well as under the $20 billion general distribution allocations. Providers may not receive a second distribution payment if the provider received a first distribution payment of equal to or more than 2% of patient revenue.

HHS is working to process all providers’ submissions as quickly as possible. HHS is distributing an additional $20 billion of the General Distribution to providers to augment their initial allocation so that $50 billion is allocated proportional to providers' share of 2018 net patient revenue. Payments are determined based on the lesser of 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April. If after further review of your resubmitted revenue information, the initial General Distribution payment you received between April 10 and April 17 was determined to be at least 2% of your annual patient revenue, you may not receive additional General Distribution payments. It is the Department’s intention to distribute relief funds as quickly as possible.

You will receive an email when your application is completed. You will receive a notification from HHS as to the final status of your application. HHS is distributing an additional $20 billion of the General Distribution to providers to augment their initial allocation so that $50 billion is allocated proportional to providers' share of 2018 net patient revenue. Payments are determined based on the lesser of 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April. If after further review of your resubmitted revenue information, the initial General Distribution payment you received between April 10 and April 17 was determined to be at least 2% of your annual patient revenue, you may not receive additional General Distribution payments.

Data Sharing

HHS is using DocuSign to securely pass encrypted data to HHS. Neither DocuSign nor UnitedHealth Group will have access to your data.

DocuSign is securely passing your data to HHS in encrypted files. Neither DocuSign nor UnitedHealth Group will have access to your data.

UnitedHealth Group and its subsidiaries will not have access to any information collected from providers, nor do they participate in determining the methodology used to allocate Provider Relief Fund payments.  UnitedHealth Group will know the amounts of relief funding paid to providers, as UnitedHealth Group is processing the payments.

HHS will have access to your revenue data to optimally allocate Provider Relief Funds. HHS will not share your revenue data with any other entities, in or outside of government, except as prescribed by law.

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Targeted Distribution

Rural Distribution

Rural Distribution payments were made to rural acute care general hospitals and Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs), and Community Health Centers located in rural areas. Hospitals and RHCs will each receive a minimum base payment plus a percent of their annual expenses. This method accounts for operating cost and lost revenue incurred by rural hospitals for both inpatient and outpatient services. The base payment will account for RHCs with no reported Medicare claims, such as pediatric RHCs, and CHCs lacking expense data, by ensuring that all clinical, non-hospital sites receive a minimum level of support no less than $100,000, with additional payment based on operating expenses. Rural acute care general hospitals and CAHs will receive a minimum level of support of no less than $1,000,000, with additional payment based on operating expenses.

Rural hospitals received a graduated base payment plus approximately 2% of total operating expenses reported on their most recent, publicly available cost reports. The base payment gradually increases from $1 to $3 million depending on hospital operating expenses and establishes a floor for rural hospitals to support their financial stability during the COVID-19-pandemic. The additional amount is a percentage of each individual hospital’s total operating expenses so that payments are related to the actual operating expenses that rural hospitals are incurring. Worksheet G-3, Line 4 of the Medicare hospital cost report was used for total operating expenses. If cost reports were more or less than a year in length, then total operating expenses were adjusted to reflect a full year.

No. Eligibility for Rural Distribution payments is limited to rural acute care general hospitals, Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs), and Community Health Centers that are located in a rural area as defined by HHS’s Federal Office of Rural Health Policy. The exception hospitals include a significant number of very large urban facilities. The Rural Distribution payments focused on smaller rural hospitals that are struggling to remain financially viable.

Rural facilities were identified based on their provider type and the physical addresses of the hospital or clinic site as reported to CMS for rural acute care general hospitals, critical access hospitals (CAHs), and independent rural health clinics (RHCs), and to HRSA for Community Health Centers, regardless of affiliation with organizations based in urban areas. HHS used the December 2019 file to identify hospitals, CAHs, and RHCs. Due to data constraints, facilities that were not included in the December 2019 Provider of 亿乐彩彩票 file were not included in the Rural Distribution.

For the Rural Distribution, HHS used the Federal Office of Rural Health Policy’s definition of rural, which includes: 

  1. All non-Metro counties.
  2. All Census Tracts within a Metropolitan county that have a Rural-Urban Commuting Area (RUCA) code of 4-10. The RUCA codes allow the identification of rural Census Tracts in Metropolitan counties.
  3. 132 large area census tracts with RUCA codes 2 or 3. These tracts are at least 400 square miles in area with a population density of no more than 35 people per square mile.

If the RHC is owned by a rural hospital or CAH, the hospital received the payment. Rural hospitals that own RHCs (also known as provider-based RHCs) report their RHCs’ operating expenses as part of the hospital cost report. Since provider-based clinics operate under the ownership and administrative and financial control of the hospital, the RHC expenses are included in the base payments and additional payments calculated for the rural hospital. These provider-based RHCs did not receive separate payments. Urban hospitals did not receive Rural Distribution payments and neither did provider-based RHCs. If the RHC is a freestanding, independent facility, then it received the payment directly.

Rural Distribution funding is targeted at organizations that provide acute and primary care in rural areas. Acute care hospitals in rural areas and Critical Access Hospitals (CAHs) in rural areas and non-rural areas are eligible for Rural Provider Relief funding. CAHs outside of rural areas are included in the rural provider distribution because CAHs have a unique safety net role and statutory charge. That statute also initially gave state governors the authority to designate necessary provider CAHs, a number of which did not make a distinction between rural and urban designations.

In addition to hospitals, the following types of organizations received payments: freestanding (not provider-based) Rural Health Clinics (RHCs) and Community Health Centers. For provider-based RHCs, RHC funds were distributed through the rural hospital and CAH allocation.

HHS analyzed the following files to identify facility locations and operating costs:

  • ,
  • , contains the most recent cost report data available. For most hospitals, this is the 2018 fiscal year. We used hospital data from 2016 to replace missing data for two hospitals and 2017 data for 16 hospitals.
  • The HRSA Bureau of Primary Health Care extracted data from the most recent Uniform Data System (UDS) to identify rural Community Health Center sites.

No. Rural provider allocations are based on historical operating expense data to enable rapid distribution of funds to meet immediate rural needs.

Facilities were identified from the December 2019 file. Due to data constraints, facilities that were not included in the December 2019 Provider of 亿乐彩彩票 file were not included in this rural allocation.

High Impact Area Targeted Distribution

In allocating the funds, the Administration is working to address both the economic harm across the entire healthcare system due to COVID-19 and the economic impact on providers directly treating patients with COVID-19. The distribution takes into consideration the challenges faced by facilities serving a significantly disproportionate number of low-income patients and that inpatient admissions are a primary driver of costs to hospitals related to COVID-19.

Of the $12 billion distribution, $10 billion was allocated based on a fixed amount per COVID-19 inpatient admission. The remaining $2 billion of the $12 billion was distributed based off each hospital’s portion of Medicare Disproportionate Share Hospital (DSH) payments and Medicare Uncompensated Care Payments (UCP).

HHS made 336 COVID-19 High Impact Area Distribution payments to 395 hospitals and health systems that provided inpatient care for 100 or more COVID-19 patients through April 10, 亿乐彩彩票. Some payments were made to hospitals and health systems that operate more than one hospital.

Providers should update their capacity and COVID-19 census data to ensure that HHS can make timely payments in the event that the provider becomes a high-impact provider. Providers can continue to update their information through the same method they used previously.

HHS partnered with UnitedHealth Group to deliver funds. Payment were sent via Automated Clearing House (ACH). The automatic payments were sent via Optum Bank with “CARES Act HighImpactAreaPmt*” in the payment description. Payments were sent to the group’s central billing office. All relief payments were made to provider billing organizations based on their TINs.

In order to allow HHS to calculate and make payments in a fair, transparent, and timely manner based on submitted COVID-19 admissions data, the Department selected April 10 as the cut-off for the COVID-19 High Impact Area distribution.

HHS may make additional COVID-19 High Impact Area distributions. If HHS decides to make an additional distribution, the Department will announce any additional COVID-19 High Impact Area distributions in advance and give a deadline and method for providing updated data.

HHS used COVID-19 admissions as a proxy for the extent to which each facility experienced lost revenue and increased expenses associated with directly treating a substantial number of COVID-19 inpatient admissions. The hospitals that received COVID-19 High-Impact Area distributions encountered, in the aggregate, 129,911 admissions, or over 70% of the total number of COVID-19 inpatient admissions reported by April 10, 亿乐彩彩票.

Skilled Nursing Facilities Distribution

HHS will distribute $4.9 billion in additional funding (over and above General Distributions received) to more than 13,000 skilled nursing facilities. Eligible facilities range in size of between six and 1,389 beds. This represents a range of distributions between $65,000 and $3,255,500 and a national average distribution of ~$315,600 per facility. Each Skilled Nursing Facility received a fixed distribution per facility of $50,000 plus distribution of $2,500 per bed.

HHS allocated funding for certified Skilled Nursing Facilities with a capacity between six and 1,389 beds.

Most SNF fund payments will be dispersed electronically based upon banking account information associated with the organization’s billing TIN. If the organization’s billing TIN does not have a bank routing number associated with it, the organization will most likely receive a paper check.

Indian Health Service Distribution

HHS allocated funding for IHS, Tribal, and Urban Indian Health programs. This includes IHS and Tribal hospitals.

HHS allocated $500 million to IHS, Tribal, and Urban Indian Health programs.  Approximately 4% of the $500 million in available funding was allocated for Urban Indian Health programs, consistent with the percent of patients served by Urban Indian Organizations (UIOs) in relation to the total IHS active user population, as well as prior allocations of IHS COVID-19 funding.  IHS divided remaining funding equally between hospitals (48%) and clinics (48%).
HHS used different formulas for each of the different facility types.

  • IHS Hospitals and Tribal Hospitals
    • Per hospital allocation = $2. 815 million base + (Total Operating expenses * 3%)
  • IHS and Tribal Clinics/Programs
    • Per IHS clinic allocation = Base amount of $187,000 + 5% of (estimated service population * average cost per user)
  • IHS Urban Programs
    • Per IHS Urban Indian health allocation = Base amount of $181,250 + 6% of (estimated service population * average cost per user)

HHS analyzed the following files to determine the allocation for IHS Distribution to IHS and tribal hospitals:

  • , December 2019 update.
  • (HCRIS), 1/17/亿乐彩彩票 update, contains the most recent cost report data available. For most hospitals, this is the 2018 fiscal year.
  • Total operating expenses are reflected in Worksheet B PART I COL 26 of the cost report.

HHS identified the service population for most service units, and estimated an operating cost of $3,943 per person per year based on actual IHS spending per user from a 2019 IHS Expenditures Per Capita and Other Federal Health Care Expenditures Per Capita.

HHS is partnering with UnitedHealth Group to deliver funds. Each organization’s payment will be sent via Automated Clearing House (ACH). The automatic payments are sent via Optum Bank with “CARES Act Tribal&IndianHlthPmt*” in the payment description. Payments are sent to the group’s central billing office. All relief payments are made to provider billing organizations based on their Taxpayer Identification Numbers (TINs).

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Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on June 3, 亿乐彩彩票