FAQ: Public Health and Social Service Emergency Fund
ACA
How is the first $30 billion tranche of CURES’ $100
billion investment in the Public Health and Social Service
Emergency Fund for health care providers being
allocated?
The first $30 billion of the $100 billion fund will be
distributed through the Health Resources and Services
Administration (HRSA) to health care providers proportionally,
based on the providers’ share of total Medicare payments in 2019.
For example, if total Medicare fee-for-service payments in 2019 were $100 and one physician received $2 in payments from Medicare fee-for-service in 2019, then that physician accounted for 2 percent of total Medicare fee-for-service payments in 2019. According to this formula, that physician would receive 2 percent of this $30 billion.
Who qualifies for this first round of
funding?
All facilities and providers that received Medicare
fee-for-service (FFS) reimbursements in 2019 are eligible for
this initial rapid distribution.
What are the restrictions on how grant recipients spend
this round of funding?
Providers that accept this funding must protect patients and are
banned from sending “surprise” balanced bills to those they treat
for the coronavirus. Moreover, providers that accept this money
to cover costs for treating the uninsured must accept Medicare
rates.
How quickly will the money hit the provider’s bank
account?
Grants were electronically distributed this morning (April 10th)
with the majority of funds expected to be deposited in providers’
bank accounts that day.
What do providers need to do after receiving
funds?
In order to officially accept these funds, providers must sign an
attestation confirming receipt of funds and agree to the terms
and conditions of payment within 30 days. They can do this
through a provider portal that will open up the week of April
13th.
What if a provider doesn’t qualify for this round of
grants?
The objective with this first funding round is immediate relief,
and CMS based this distribution formula on data they already
had. CMS has indicated that future rounds of funding from
the $100 billion fund will have a more formal application
process, and that some portion of future allocations could be
targeted towards providers that do not typically bill Medicare,
such as pediatricians or children’s hospitals.
What about providers who do qualify for this round, but
generally don’t have a large traditional Medicare
population?
There will be some providers that receive money in this first
allocation, but receive a smaller sum based on their patient
population. For example, providers who see a
disproportionately high amount of Medicare Advantage payments
will see a lower payment in this funding round since MA payments
are not counted with traditional Medicare payments. CMS has
acknowledged this short-coming and has been clear that these
providers will be still be eligible for future grant allocations
from the Public Health and Social Service Emergency Fund.
White House Fact Sheet on the program here: https://gop-waysandmeans.house.gov/wp-content/uploads/2020/04/CARES-Act-Provider-Relief-Fund-Fact-Sheet_WAMR_4.10.20-1.pdf
More resources for providers here: https://waysandmeansforms.house.gov/UploadedFiles/CARES_Support_for_Providers.pdf
Source: House Ways and Means Committee, April 10, 2020