On Friday, April 10, the Department of Health and Human Services (HHS) distributed $30 billion of the $100 billion CARES Act funding to Medicare “providers” (physicians, hospitals, and other facilities and health professionals that bill Medicare). The amount was distributed in direct proportion to providers’ total 2019 Medicare fee-for-service reimbursement. As an example, if a large hospital system’s total Medicare spending in 2019 represented 1 percent of the total Medicare FFS spending across the country, that hospital system would receive 1 percent of the $30 billion. HHS distributed the funds electronically, and some ACEP members have already reported receiving the funds. We recognize that this way of distributing funding is not entirely fair. Some of you, depending on where you practice and your patient mix, will receive more or less than others, since again, the amount you receive is simply based on your Medicare payments from last year.
There is also a catch that goes along with the funding. Within 30 days, you must agree to certain terms and conditions. These terms and conditions include the following statement:
“The Secretary has concluded that the COVID-19 public health emergency has caused many healthcare providers to have capacity constraints. As a result, patients that would ordinarily be able to choose to receive all care from in-network healthcare providers may no longer be able to receive such care in-network. Accordingly, for all care for a possible or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses 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 Recipient.”
ACEP is seeking clarification on exactly what this condition means and how this may impact you and your patients. If you do not agree to all the terms listed, you are required to contact HHS within 30 days of receipt and return the funds. HHS has opened the CARES Act Provider Relief Fund Payment Attestation Portal where providers are required to go and attest to the terms and conditions.
On April 14, we sent a letter to the HHS Secretary that listed all of our questions and concerns about the $30 billion distribution and the associated terms and conditions. We asked for HHS to respond to our questions as soon as possible, so that we can update you and give you or your group enough time to consider whether to accept the terms and conditions or return the funding before the 30-day time period ends. We will keep you updated on any responses we hear from HHS.
It is important to note that this is just the first wave of the $100 billion. $70 billion still remains, and HHS has stated publicly that the remaining funding will go toward “providers in areas particularly impacted by the COVID-19 outbreak, rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans.”
All in all, ACEP doesn’t feel what you may receive from the $30 billion first wave of funding is enough. We have actively advocated on your behalf from the moment the CARES Act was passed to push HHS to distribute funding directly to you-- emergency physicians who are risking your lives combating the virus and have the greatest risk of missing work because of being exposed to COVID-19. On March 27, ACEP sent a letter to the HHS Secretary asking that HHS prioritize funding for emergency physicians—and on April 3, we sent a follow-up letter specifically requesting that HHS distribute $3.6 billion to emergency physician practices. We know we have our work cut out for us, but please know ACEP will continue to fight for you and work as hard as we can to ensure that you have the resources you need to do your jobs.
Read additional details about the $100 billion fund.