On April 10, the Centers for Medicare & Medicaid Services (CMS) directly deposited grants to Medicare providers and suppliers, including O&P practices. The funds are part of the stimulus funding enacted under the COVID-19 legislation passed March 27, known as the CARES Act. The legislation created a $100 billion fund to assist healthcare providers weather the pandemic. The grants, which totaled $30 billion, do not need to be paid back. The amount of each O&P practice’s payment is determined automatically, based on the portion that the Medicare program paid each provider or supplier the last calendar year.
The payments are separate from Medicare advance payments and any small business loans/forgivable loans for which O&P practices may have applied.
This was the first round of payments from the US Department of Health and Human Services (HHS) Provider Relief Fund. Providers have 30 days to accept the funds and agree to the terms and conditions associated with the payment via the HHS online portal at https://covid19.linkhealth.com/#/step/1.
BMD, a law firm with offices in Ohio and Florida, clarified the HHS requirements for the deposits in a question and answer format, as follows:
I am a provider that received payment (or I expect to receive a paper check), should I attest and agree to the terms and conditions?
On April 16, 2020, HHS updated its guidance regarding the Terms and Conditions for acceptance of the payment and use of the funds. CMS made it clear that if a provider ceased operations as a result of the COVID-19 pandemic, the provider is still eligible to receive funds so long as the provider provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS clarified that care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19. This clarification will make it much easier for providers to attest to the Terms and Conditions. See our April 10 alert for more details on Terms and Conditions.
Providers must attest via HHS’s online portal within 30 days of receipt of the payment, which in most instances will be May 10, 2020. Providers that do not desire to keep the payment must contact HHS within 30 days of receipt of payment and remit the payment to HHS in accordance with HHS’s instructions. If a provider fails to attest to the Terms and Conditions and does not remit payment back to HHS, the provider will be deemed to accept the Terms and Conditions and must still comply with those terms.
Providers that accept the payments and attest to the Terms and Conditions must establish a policy and plan for record-keeping evidencing compliance with the Terms and Conditions. We anticipate that HHS will conduct audits to ensure providers’ compliance.
What if I did not receive a payment?
Some providers did not receive an electronic payment on April 10, 2020, but still received Medicare fee-for-service payments in 2019. If you did not receive an electronic payment, but believe you are entitled to payment through the Provider Relief Fund, you may be receiving a paper check over the next few weeks. HHS partnered with UnitedHealth Group and Optum to make the payments. Therefore, providers that are out-of-network with UHC or do not receive electronic payments from UHC may likely receive paper checks.
Also, individual providers who billed through a group practice entity, either as an employee or independent contractor will not receive a payment. In such an instance, HHS will make payment to the billing provider, which is the billing entity.
To read more about the grants, including What if I also received payments under the CMS Accelerated/Advance Payment Program? and What about the remaining $70 billion?, visit BMD’s blog.