April 23, 2020

Here's how HHS will distribute $70B for providers affected by Covid-19

Daily Briefing

    HHS on Wednesday announced that it will use a new formula to distribute a portion of the $70 billion remaining in a fund intended to support providers combating the new coronavirus, after providers and lawmakers raised concerns that the previous formula disadvantaged rural hospitals and providers in Covid-19 hotspots.

    Covid-19 weekly webinar: What you need to know in 45 minutes

    US Covid-19 cases surpass 834K, death toll tops 42K

    The announcement came as the number of cases of Covid-19, the disease caused by the new coronavirus, and deaths related to the virus continued to grow in the United States. As of Thursday morning, U.S. officials had reported 834,340 cases of Covid-19 in the country—up from 805,772 cases as of Wednesday morning.



    Officials as of Thursday morning also had reported 42,501 U.S. deaths linked to the new coronavirus—up from 40,316 deaths reported as of Wednesday morning.

    HHS releases plan to distribute $70B in Covid-19 funds to providers

    As hospitals and providers continue to treat growing numbers of Covid-19 patients, HHS on Wednesday released a plan to distribute the remaining $70 billion in the Public Health and Social Services Emergency Fund that Congress had allocated under an economic stimulus package enacted late last month to support providers combating Covid-19. The package included a total of $100 billion for the fund, and HHS earlier this month distributed $30 billion of the funding to providers.

    To allocate the first round of funding, HHS calculated the amounts providers would receive using a formula based on their 2019 Medicare fee-for-service revenues. Lawmakers and providers have since raised concerns about the formula, which they said disadvantaged rural hospitals and some providers in Covid-19 hotspots.

    On Wednesday, HHS said it is updating the formula it will use to distribute a portion of the remaining $70 billion. The department said it will use the new formula, which will be based on providers' net patient revenues in 2018 from all sources, to calculate a total of $20 billion in payments to providers from the fund. HHS said it will begin distributing the payments on April 24. Some providers will automatically receive their payments based on revenue data they've previously submitted to CMS, but others will need to submit their revenue information through an online portal that HHS plans to launch this week, the department said.

    HHS under the new plan also will distribute $10 billion to hospitals in areas hit hardest by the United States' Covid-19 epidemic. Providers by April 23 must use an online portal to apply to receive that funding. HHS said providers will need to submit information on the number of patients they admitted between Jan. 1 and April 10, and the department will then determine whether providers qualify for the funds based on their submission and Medicare Disproportionate-Share Hospital data.

    In addition, HHS under the plan will distribute $10 billion to rural health clinics and hospitals. HHS said it will distribute those funds as soon as next week, "using a methodology that distributes payments proportionately to each facility and clinic."

    Further, HHS under the plan will distribute $400 million to Indian Health Service facilities based on their operating expenses. HHS said it will distribute those funds as soon as next week.

    HHS also said providers can submit claims to HHS for reimbursement for Covid-19 services provided to uninsured patients. HHS said it will use a portion of the remaining funds to pay providers at Medicare reimbursement rates for such care provided on or after Feb. 4, subject to funding availability. In order to receive the reimbursements, providers will have to be enrolled as a Medicare provider, check patients' benefits and eligibility, submit patients' information and related claims, and receive the payment via direct deposit. Providers can begin enrolling in the reimbursement program on April 27 and start submitting claims in early May by visiting coviduninsuredclaim.hrsa.gov.

    Separately, HHS' Health Resources and Services Administration (HRSA) on Wednesday awarded nearly $165 million that was allocated under the stimulus package to rural hospitals and telehealth resource centers to help them purchase personal protective equipment, increase testing for the new coronavirus, bolster telehealth services, and take other steps to respond to the country's Covid-19 epidemic.

    CMS launches toolkit to help local health care officials use Covid-19 workforce flexibilities

    Also on Wednesday, CMS launched a toolkit intended to help local health care officials take advantage of new workforce flexibilities the Trump administration is allowing during the Covid-19 epidemic.

    The virtual COVID-19 Healthcare Workforce Toolkit provides state and local regulators with information on new flexibilities regarding funding options, liability protections, and workforce training. The toolkit also provides examples of how regulators across the United States have used the flexibilities and will track whether those efforts are successful. 

    CMS Administrator Seema Verma said, "The administration has taken swift and unprecedented emergency action to lift regulatory constraints, ease federal rules, and approve waivers that help local hospitals, clinics, and other health care facilities boost their frontline medical staffs and increase their ability to care [for] patients in the face of crisis. This new resource will help states apply all of these important changes on the ground in order to maximize their workforce to ensure care for patients."

    Trump orders 60-day pause on issuing green cards, but exempts health workers

    Meanwhile, President Trump on Wednesday signed an executive order that experts say will delay the issuance of green cards to immigrants seeking residency in the United States, but only for a relatively small share of applicants.

    Earlier this week, Trump said he would sign an executive order to temporarily suspend certain types of immigration to the United States in an effort to curb the new coronavirus' spread and reduce job competition in the U.S. economy. Under the order Trump signed Wednesday, the federal government for 60 days will suspend the issuance of green cards to a number of immigrants, but the order includes various exceptions. For example, the order exempts physicians, nurses, and other health care professionals from the restrictions, as well as professionals who perform "essential" work to fight the new coronavirus, as determined by federal agencies.

    After the initial 60-day pause, the Trump administration could choose to renew and extend the executive order.

    According to Reuters, the administration likely will face lawsuits challenging the policy (King, FierceHealthcare, 4/22; Romoser, Inside Health Policy, 4/22 [subscription required]; Armour, Wall Street Journal, 4/22; Cirruzzo, Inside Health Policy, 4/22 [subscription required]; Brady, Modern Healthcare, 4/22; Haseley, Inside Health Policy, 4/22 [subscription required]; CMS release, 4/22; Colvin/Spagat, Associated Press, 4/23; Hesson et al., Reuters, 4/22; Executive order, 4/22; New York Times, 4/22; HHS release, 4/22).
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