Topics: Medical Billing
The Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law in March of 2020 in an effort to reduce the economic impact of the COVID-19 pandemic. Passed with bipartisan support in Congress, the legislation delivered more than $2 trillion in aid through a variety of programs. While most people are familiar with programs like the boost to unemployment insurance benefits or the Paycheck Protection Program (PPP) that helped many small businesses stay afloat in the early days of the crisis, healthcare practices have remained focused on the phased rollout of the Provider Relief Fund.
What is the Provider Relief Fund?
The Provider Relief Fund is a $175 billion program designed to deliver direct-to-provider funding for authorized healthcare practices. Rather than issuing the money in a lump sum to all providers, the Department of Health and Human Services (HHS) broke the distribution into three distinct phases, each of which featured different requirements and targeted different recipients. HHS also released some funds through targeted distributions.
Phase 1 Distribution
Available to providers who billed Medicare fee-for-service, the first wave of funds amounted to about $50 billion. Issued in two rounds over the course of April, Phase I distributions were based on a proportion of eligible providers’ 2019 MFFS payments, revenues from CMS cost reports, or revenue submissions to the relief fund’s provider portal. The maximum amount of relief funds was set at two percent of the provider’s total 2018 patient revenue.
Phase 2 Distribution
Launched in July of 2020, the second phase of general distribution consisted of $18 billion in funds. A bit broader in its scope, eligible providers included practices participating in their state’s Medicaid/CHIP programs or Medicaid managed plans. Dental practices, assisted living facilities, and Medicare providers who missed the first phase of funding or had a change of ownership in 2019.
HHS issued additional payments through targeted distributions focusing on rural healthcare providers, safety-net hospitals, tribal hospitals, urban health centers, and hospitals hit hardest by COVID-19 outbreaks. These distributions have totaled more than $55 billion so far.
Provider Relief Fund Phase 3 Distribution
On October 1, HHS announced that practices could apply to receive funds to cover revenue loss and expenses resulting from the COVID-19 pandemic. Phase 3 is scheduled to distribute up to $20 billion. Unlike previous phases, distributions will be totally application-based rather than automatic, so healthcare providers need to be aware of who is eligible and when they must apply to receive funding.
Who is Eligible?
All providers who were eligible to receive a previous PRF distribution may apply for funding, regardless of whether they previously participated in the program. Practices that began offering services in 2020 are also eligible to apply. Any practice that has suffered financial losses due to COVID-19 should apply for funding, especially if those losses have not been reimbursed by other sources.
Even if a practice received distributions during previous phases, they may still be eligible to receive up to two percent of annual revenue if they have not already done so. All submissions will be reviewed by HHS to verify that they have not yet met this threshold.
When and How to Apply
Given the expected high volume of applications, HHS recommends that providers submit their claims as quickly as possible to ensure timely distribution and avoid missing out on funds. The department has set up a special webpage to provide updates regarding wait times and guidelines for the PRF.
Applications must be submitted to the Provider Relief Fund Application and Attestation Portal between October 5 and November 6 to be eligible for Phase 3 distributions.
It’s important to note that the Phase 3 application differs slightly from the Phase 2 form. Additional information is required regarding revenue and expenses in order to calculate the financial impact of COVID-19 accurately. Healthcare practices that have already submitted an application must re-submit a new form to be considered for Phase 3 distributions.
NCG Medical Can Help
As an experienced medical billing provider, we’ve been following the latest developments with the Provider Relief Fund very closely to make sure practices like yours aren’t missing out on funds that can help shore up revenue losses caused by the pandemic. Our team of billing and coding experts can walk you through the process of applying for Phase 3 distributions quickly and easily. Contact us today to find out how a medical billing provider can transform your practice and help you keep your focus on growing your loyal patient base.