HHS Releases First $30 Billion of Stimulus Funds, SNFs Included
Patrick Connole
5/1/2020
The Department of Health and Human Services (HHS) has announced the distribution of the first $30 billion of the $100 billion stimulus fund, which skilled nursing facilities (SNFs) are in line to receive, according to a statement by Mark Parkinson, president and chief executive officer of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL).
He noted that reporting that this stimulus fund was only for hospitals was incorrect, as SNFs are included.
Other highlights are the following:
■ All Medicare providers will receive payments based on their 2019 Part A and Part B billings.
■ AHCA/NCAL will provide a more detailed analysis in later days, but a quick back of the envelope analysis indicates that providers will receive roughly 6.2 percent of their 2019 billings.
■ HHS intends to get the money to providers directly. It may have hit some provider accounts as early as April 10.
■ This is a grant. It is not a loan.
Parkinson said this stimulus funding program is in addition to the Accelerated Payment Program. Providers can participate in both.
More details on the stimulus funding include that HHS is partnering with UnitedHealth Group to deliver the initial $30 billion distribution to Medicare providers. Providers will be paid electronically where possible.
AHCA/NCAL said providers that normally receive a paper check for reimbursement from the Centers for Medicare & Medicaid Services (CMS) will receive a paper check in the mail for this payment as well.
All facilities and providers that received Medicare fee-for-service (FFS) reimbursement in 2019 are eligible for this initial rapid distribution.
Payments to practices that are part of larger medical groups will be sent to the group’s central billing office. All relief payments are made to the billing organization according to its Taxpayer Identification Number.
AHCA/NCAL said as a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.
This dispersal of funds is intended to provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers that are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services. This provision will aid providers with declining occupancy rates.
Providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursement in 2019. This means that CMS, as with calculating the Accelerated and Advance Payments, has used net reimbursement based on claims to calculate the award amounts.
Total FFS payments were approximately $484 billion in 2019. A provider can estimate its payment by dividing the 2019 Medicare FFS (not including Medicare Advantage) payments it received by $484,000,000,000, and multiplying that ratio by $30,000,000,000.
Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system. Providers should work with their financial management, revenue cycle divisions, or third-party billing contractors to arrive at their own estimates.
AHCA/NCAL provided this calculation example. A provider billed Medicare FFS $121 million in 2019. To determine how much it would receive, use this equation: $121,000,000 / $484,000,000,000 x $30,000,000,000 = $7,500,000
Also, in coming weeks, funds will be released for providers in areas particularly impacted by the COVID-19 outbreak, rural providers, low-volume Medicare providers of services, providers who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans.
The terms and conditions are within 30 days of receiving the payment, and providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment.
The portal for signing the attestation was to open the week of April 13, 2020.
Visit HHS’ FAQ for additional information on eligibility and process.