ACCT COVID-19 Resources

28-August-2020 COVID-19 Resource

Good evening, please see below regarding an extension to apply for the Medicaid provider relief fund distribution as well as a second opportunity for certain Medicare providers through August 28th.Warm Regards,
– Miranda
Miranda Franco | Holland & Knight
Senior Policy Advisor
Holland & Knight LLP

View Original Document on CMS Website


As part of its ongoing efforts to provide financial relief to healthcare providers impacted by the coronavirus disease 2019 (COVID-19), today the Department of Health and Human Services (HHS) is announcing an application deadline extension for the Phase 2 general distribution to Medicaid, Medicaid managed care, Children’s Health Insurance Program (CHIP) and dental providers. HHS also plans to allow certain Medicare providers who experienced challenges in the Phase 1 Medicare General Distribution application period a second opportunity to receive funding. Both groups will have until Friday, August 28, 2020 to apply.

“From the start, HHS’s administration of the Provider Relief Fund has been focused on distributing funding in a way that is fast, fair and transparent,” said HHS Secretary Alex Azar. “Extending the deadline for Medicaid providers and giving certain Medicare providers another shot at funding is another example of our work with providers to ensure as many as possible receive the support they need.”

Medicaid, CHIP, & Dental (Phase 2 General Distribution) Deadline Extension

In June, HHS announced the opening of Phase 2 of the General Distribution – a $15 billion allocation – wherein eligible Medicaid, Medicaid managed care, CHIP and dental providers could begin applying for funding of up to 2 percent of reported revenue from patient care. The goal for this opportunity was to reach the remaining providers participating in state Medicaid and CHIP programs that did not receive funding in the Phase 1, Medicare General Distribution, as well as certain dental providers. Since the announcement, HHS has posted resources and hosted a number of webinars targeted at providers and provider organizations to answer questions and assist eligible providers with the application process. The initial deadline of July 20, 2020, was extended to August 3, 2020, based on provider feedback that they learned about the program too close to the deadline and needed more time to complete their application. HHS continues to keep an open line of communication with provider organizations, congressional, state and local leaders, in a collective effort to get the word out about this program, and HHS has learned that a second extension would be beneficial to those providers. By giving providers until August 28, 2020 to apply, HHS is hopeful it has struck the right balance in terms of providing as much flexibility as possible, recognizing the constraints on smaller practices already operating on thin margins with limited administrative staff. HHS will also soon be providing a more simplified application form in response to ongoing dialogue focused on improving the provider experience.

Second Chance for Certain Medicare Providers
Starting the week of August 10, HHS will allow Medicare providers who missed the opportunity to apply for additional funding from the $20 billion portion of the $50 billion Phase 1 Medicare General Distribution. In April, to expedite providers getting money as quickly as possible, as they faced the financial hardships stemming from suspended elective procedures and other COVID-19 related impacts, HHS, utilizing the Centers for Medicare and Medicare Services (CMS) payment information, distributed $30 billion directly to Medicare providers proportionate to their share of 2019 Medicare fee-for-service reimbursements. This was part one of the $50 billion Phase 1 Medicare General Distribution which sought to offer providers financial relief equal to 2 percent of their annual revenues. Providers that do not submit comprehensive cost reports with CMS were asked to submit revenue information to a portal to receive the balance of their 2 percent payment of General Distribution funds. Some providers, including many Medicaid, CHIP, and dental providers with low Medicare revenues, did not complete an application by the deadline for this additional $20 billion round of funding. HHS, in its principle of ensuring fairness in the administration of the Provider Relief Fund program, is now giving those eligible providers another opportunity to apply for additional funding. They will have until August 28, 2020, to complete an application to be considered for the balance of their additional funding up to 2 percent of their annual patient revenues.

Payments for Providers Who Had a Change in Ownership
As previously noted, HHS relied on 2019 CMS payment data on file to determine automatic payments for $30 billion of the $50 billion Phase 1 Medicare General Distribution. Accordingly, some providers or provider practices that experienced a change in ownership in 2020 missed out on payments as the payments were distributed to the previous owners. Prior owners are required to return the payments to HHS, if they cannot attest to providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31, 2020. For program integrity considerations, previous owners are precluded from transferring funds to new owners who may qualify and can attest to providing care for possible or actual COVID 19 cases. HHS did not reissue returned payments to the new owners and instead promised to give new owners a separate opportunity to apply for provider relief funding. That opportunity is now here. Starting the week of August 10, providers who experienced change in ownership challenges may submit their revenue information, along with documentation proving a change in ownership, by August 28 for consideration for Provider Relief Fund payment.

HHS is currently working to address relief payments to new providers in 2020 along with those that have yet to receive any funding for a variety of reasons, including the fact that they may only bill commercially, or do not directly bill for the services they provide under the Medicare and Medicaid programs and thus did not receive any funding yet. Future announcements will be provided.

For updated information and data on the Provider Relief Fund, visit:

14-May-2020 COVID-19 Resource Updates

Subject: House Democrats unveil the HEROES Act

Major healthcare takeaways:

Medicare Accelerated Payment Program: Section 30206 would lower the interest rate to one percent for loans to Medicare providers made under the Accelerated and Advance Payment Program. Also, at a hospital’s request, the Secretary shall provide one year before claims are offset to recoup such payment; reduce the per-claim recoupment percentage not to exceed 25 percent, and allow no less than two years from the date of the first accelerated payment before requiring that the outstanding balance be paid in full.

The bill also would require an HHS report to House and Senate committees of jurisdiction on the total payments from the Medicare loan programs and the number of providers receiving the payments every two weeks during the public health emergency. After the emergency, HHS would be required to inform the lawmakers about recoupments of the loans and the outstanding program balances, as well as accrued interest every six months until all the loans are repaid.

Notably, CMS recently paused the Part A program for review and suspended the Part B loan program. The agency said that more than $92 billion had been provided in Part A loans, while more than $8 billion was released in Part B loans.

Provider Relief Fund: The legislation includes an additional $100 billion for the fund. The bill does not include great specificity regarding how the money should be allocated. The authorizers created rules and processes for distribution, including limitations regarding utilizing the funds for lost revenue. Appropriators could still address this in a more detailed fashion should they so choose. Note the original CARES Act created the $100 billion fund while the most recent coronavirus stimulus package infused an additional $75 billion into the fund. If passed as currently written, this provision would bring the fund to $275 billion. The Senate will likely be reluctant to add this volume of funding as they want greater transparency around where the most recent $75 billion will be directed before dolling out more money.

Medicaid: The bill would increase the Federal Matching Assistance Percentage (FMAP) by 14 percentage points through June 30, 2021. The legislation would also increase the FMAP by ten percentage points for state Medicaid services for patients in home and community-based care. Also, as drafted, the HHS secretary also cannot take any action to finalize or implement the Medicaid Fiscal Accountability Rule (MFAR) during the federal government’s COVID-19 emergency; it also cannot implement any rule similar to those provisions related to the Medicaid program or the State Children’s Health Insurance Program (CHIP) during the same time period. The bill also temporarily increases Medicaid disproportionate share hospital (DSH) allotments by 2.5 percent.

Medicare: The bill would provide an outlier payment for inpatient claims for any amount over the traditional Medicare payment to cover excess costs hospitals incur for more expensive COVID19 patients until January 31, 2021.

Testing: The Heroes Act would require an updated strategic testing plan with certain benchmarks and timelines. It would give $75 billion in grants to public health departments to support testing, surveillance, contact tracing, and containment activities. Public health departments would be required to use culturally competent and multilingual approaches to contact tracing and public awareness campaigns. The bill also revives a previously proposed mandate that all insurers cover treatment for the coronavirus without cost-sharing.

Telehealth: The bill would provide additional funding to the Indian Health Service for telehealth services. Otherwise, other provisions are largely focused on one-time emergency funding of $5.25 billion to the Federal Communications Commission (FCC) for an “E-rate to the Home” initiative. It ensures that all broadband providers are eligible to participate (provider-neutral). Many stakeholders continue to push for permanent changes for telehealth in future relief packages.

Miranda Franco | Holland & Knight
Senior Policy Advisor
Holland & Knight LLP



Heroes Act Summary.pdf

Heroes Act Health Summary.pdf

Phase 4 summary Approps.pdf