• News New Blog Banner

  • CARES Act Provider Relief: Sorting Out the Details

    HHS continues to shed light on how providers can know if they're receiving money as it eases concerns about who qualifies.

    The $30 billion in COVID-19 funds being sent directly to health care providers has sparked questions among providers about whether they qualify for the funds, how they'll receive them, and what kinds of restrictions might apply.

    Fortunately, there are answers out there. In addition to its initial story on release of the funds, PT in Motion News published a subsequent piece on how to find out if you're receiving any of the money. Here's more of what we know about the program.

    You don't have to be "currently taking patients" as long as you were still seeing patients after January 31 — and HHS is taking a broad view of patients with "possible" COVID-19.
    The basic requirement for the funds, according to HHS, is that you billed Medicare in 2019 and provided "diagnoses, testing, or care for individuals with possible or actual cases of COVID-19." As far as HHS is concerned, that includes everyone you treated: "HHS broadly views every patient as a possible case of COVID-19," HHS states.

    You can still qualify for the money if you stopped operations due to the pandemic.
    Again, from HHS: "If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19."

    Payment is tied to your Taxpayer Identification Number.
    Whether you're looking for funds for a large health system or as a solo practitioner, the relief payments are made to the billing organization according to its Taxpayer Identification Number, either via direct deposit or paper check. Here's how HHS breaks it down on its provider relief fund webpage:

    • Large Organizations and Health Systems. Large organizations will receive relief payments for each of their billing TINs that bill Medicare. Each organization should look to the part of their organization that bills Medicare to identify details on Medicare payments for 2019 or to identify the accounts where they should expect relief payments.
    • Employed Physicians. Employed physicians should not expect to receive an individual payment directly. The employer organization will receive the relief payment as the billing organization.
    • Physicians in a Group Practice. Individual physicians and providers in a group practice are unlikely to receive individual payments directly, because, as the billing organization, the group practice will receive the relief fund payment. Providers should look to the part of their organization that bills Medicare to identify details on Medicare payments for 2019 or to identify the accounts where they should expect relief payments.
    • Solo Practitioners. Solo practitioners who bill Medicare will receive a payment under the TIN used to bill Medicare.

    You have to be in good standing with Medicare and other federal health programs.
    Not surprisingly, providers can receive the money only if they aren't currently terminated from Medicare; aren’t excluded from participation in Medicare, Medicaid, or other federal health programs; or haven’t had their Medicare billing privileges revoked.

    You have to attest to receiving the funds — and agree to the terms and conditions — within 30 days of receiving the payment.
    Providers who received payment are required to attest that they've received the funds and agree to the program's terms and conditions within 30 days of receipt. You can do that by visiting the CARES Act Provider Relief Fund Payment Attestation Portal.

    Documentation will be important.
    Recipients of payment will be required to submit reports to HHS as needed to ensure compliance with the terms and conditions. HHS hasn't yet shared instructions about the form and content of the reports.

    Not sure if you're receiving funds? Call 866-569-3522.
    UnitedHealth Group is handling the stimulus payments for HHS — call their provider relations department to find out the status of a payment or whether you qualify. If you haven't set up direct deposit through CMS or UHG, you'll receive a paper check within the next week or two. Although CMS is not administering the program, if you are a Medicare provider and have questions that UHG can't answer, email COVID-19@cms.hhs.gov.

    Additional money may be coming to other types of providers.
    The administration is working on targeted distributions focused on providers in areas particularly impacted by the COVID-19 outbreak, including 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. APTA sent a letter to HHS several weeks ago urging HHS to provide immediate assistance to physical therapy specialists, including pediatric physical therapy providers, that are dependent on Medicaid and have few or no patients with Medicare.

    APTA can't provide legal advice or answer questions about individual cases.
    Please note that APTA cannot provide legal advice, meaning that we are unable to provide clarification beyond what HHS has provided thus far. If you have questions beyond what has been provided, please consider consulting with a local attorney.

    Comments

    • Our company received an electronic deposit from the HHS fund. I went to the website to review the terms and conditions and entered the information as requested to identify our company, bank account and amount of deposit received. I received an error message of (Data Mismatch-One or more of the TIN's you have submitted does not match our records, please try again). I tried again and received the same message. I called 866-569-3522 speaking with a representative on a recorded line and received a reference number for the call. He stated they had been having some difficulties with some entries. Stated if the recipient did not respond within 30 days the HRSA would automatically determine this was acceptance of the terms and conditions and list this Tax ID as accepted. He reviewed my Tax ID and company information in their system and it was correct. He stated he made notes under the call reference number of this conversation. Also stated there was nothing else for me to do at this time. Since then I have tried to complete this process to accept the terms and conditions, but received the same message. I have sent an email to COVID-19@cms.hhs.gov outlining the conversation and requesting some documented instructions on this issue and the resolution. Has this situation come up with other providers?

      Posted by Pam S Reed on 4/23/2020 8:39 AM

    • Yes, I am having the same issue.

      Posted by Markus Munger -> >FRc>O on 4/24/2020 8:00 AM

    • There is no mention of pediatric practices receiving any of the allocated money form this fund.! Why are pediatric practices sidelined? Dr. Prapti Kanani

      Posted by Prapti Kanani on 4/24/2020 9:28 AM

    • When trying to attest, this question is asked: Are you a billing entity that received Medicare fee-for-service (FFS) payments from the Centers for Medicare and Medicaid Services (CMS) in 2019? WE ARE NON-PAR WITH MDC, & THEREFORE RECEIVED NO PAYMENTS, AS PATIENTS RECEIVE REIMBURSEMENT PAYMENTS AFTER PAYING US. DO WE QUALIFY? WE GOT A CHECK FROM THEM..

      Posted by David Adam Shapiro on 4/24/2020 11:13 AM

    • It's the "Documentation will be important" part that concerns me with keeping the HHS funds that were deposited to our company bank account. Without knowing what reports HHS will be looking for, I'm very uncomfortable testifying to the terms and conditions. We billed Medicare in 2019, we have been seeing patients after 1/31/20, but there are other stipulations in the terms and conditions that indicate the funds must be used in certain ways and for certain purposes. Until they are more specific on that, how can we know to keep or return the funds?

      Posted by Tony Friedrichs on 4/25/2020 6:47 AM

    • I'm having the same/similar issue, I know I'm eligible for CARES act-provider relief but they dont recognize my TIN, which I have been working under this TIN for more than 10 years(including 2019). when I called UHG they just telling me the same story without any solution to fix this problem. i'm so frustrated that I'm even willing to hire a professional to help me in this confusion.

      Posted by Andrew Kim on 4/26/2020 10:54 AM

    • We are in cash practice however we build Medicare directly for the patient as required by law The patient is then reimbursed directly from Medicare the terms and conditions Regarding Medicare advantage plans we’re still unclear

      Posted by Michael Darrow on 4/26/2020 2:11 PM

    • I owe personal taxes, but am in good standing with medicare. On a payment plan. Will this prevents me from keeping the finding to keep my clinic going ?

      Posted by nicole on 4/27/2020 9:05 AM

    • I share Tony Friedrichs concerns about the provisions. I am a psychologist, not a physical therapist, but I have been trying to get feedback from my own professional organizations and any others regarding these concerns. There are unclear documentation requirements, the possibility of audits, possible obligation to return the funds or face charges, and the opening paragraph states that the 10 page document is not an exhaustive list of provisions which is scares me. Bluntly speaking I don't trust the government or insurance companies that much and unless I hear some legal 'thumbs up' from a professional organization that had their lawyers review it, I'm leaning towards returning the money (something I always hate to do). If you actually read the provisions that are listed all the way through however, you will find that you cannot use the money to traffic in chimpanzees caught in the wild or for sex trafficking; those are not the provisions that concern me.

      Posted by David Lipton on 4/27/2020 9:16 AM

    • I am wondering if discussion/permission was given to PTs to perform SOCs if RN is also in a case during this pandemic? This would really help support our nursing staff.

      Posted by barbara nicholson on 4/27/2020 9:23 AM

    • • @David: To be eligible for the general distribution, a provider must have billed Medicare in 2019 and provide or provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19. $50 billion will be disbursed in the General Distribution. For additional information, see: https://www.hhs.gov/sites/default/files/20200425-general-distribution-portal-faqs.pdf

      Posted by APTA staff on 4/28/2020 6:43 AM

    • • @Tony: While APTA cannot provide legal advice and is unable to provide clarification beyond what HHS has provided thus far, as discussed in the Terms and Conditions, you’ll need to maintain appropriate records and cost documentation and be prepared to submit copies of such records and documentation upon request of the Secretary. Further, as noted in the Terms and Conditions, you’ll be required to fully cooperate in any audits that the federal government does to ensure compliance with the Terms and Conditions. If you have additional questions, please consider consulting with a local attorney.

      Posted by APTA staff on 4/28/2020 6:43 AM

    • @Andrew: Please contact your Members of Congress and also email COVID-19@cms.hhs.gov to bring this issue to their attention. Please also contact us directly at advocacy@apta.org.

      Posted by APTA staff on 4/28/2020 6:44 AM

    • @Michael: Eligibility for the “General” distribution is limited to providers who “billed Medicare in 2019 and provide or provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19.” Providers who are eligible for the additional $20 billion is limited to providers who received money in the first round; allocation is based off of 2018 net patient revenue. Providers who have NOT yet received any payments from the Provider Relief Fund may still receive funds in other distributions. For additional information: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html and https://www.hhs.gov/sites/default/files/20200425-general-distribution-portal-faqs.pdf

      Posted by APTA staff on 4/28/2020 6:44 AM

    • @Nicole: APTA is not able to comment on your unique situation. Please review the HHS provider relief funds webpage: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html and accompanying Terms and Conditions. https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/terms-conditions/index.html

      Posted by APTA staff on 4/28/2020 7:52 AM

    • @Barbara: For a summary of the blanket waivers CMS has issued for health care providers, please see: https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf

      Posted by APTA staff on 4/28/2020 7:53 AM

    • Are rural outpatient clinics eligible? Is there a baseline of fee-for service that must be met? Any information on sole proprietors with staff PT's that assign their benefits? I have been unable to determine any reason for ineligibility with UHG, because they only have information supplied by HHS without explanations. Only those eligible and accepting for this 1st grant will be permitted to apply for follow up funding which will likely include Medicare Advantage plans and Medicaid.

      Posted by Betty Fackler on 4/28/2020 8:45 PM

    • @Betty: Medicare providers who have already received a payment from the Provider Relief Fund are now eligible to apply for additional funds by submitting data about their annual revenues and estimated COVID-related losses via the Provider Relief Fund Application Portal. Providers who have not yet received any payment from the Provider Relief Fund should not use the General Distribution Portal. However, providers who have not yet received any payments from the Provider Relief Fund may still receive funds in other distributions. For additional information: https://www.hhs.gov/sites/default/files/20200425-general-distribution-portal-faqs.pdf and https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

      Posted by APTA staff on 4/29/2020 7:00 AM

    • I just tried to Attest and my data is a mismatch also. Same comments as Pam Reed

      Posted by PAUL A FRANCISCO on 4/29/2020 1:40 PM

    • We received the money but had sold our practice at the end of the year. We feel we should not be receiving the money and uncomfortable with the attestation. We have 20 emails form the bank and have spent over 1.5 hours on the phone with HHS to find out procedure to return. GOOD LUCK. Bank doesn't know and although the care relief people tried to be helpful know ones seems to know how to give it back. Please let me know if anyone has had success. I only have 10 days left!!

      Posted by Gillian B on 4/29/2020 5:56 PM

    • • @Paul: Please call UnitedHealth Group (UHG), as UHG is administering the program at the direction of HHS. You may reach UHG at: 866-569-3522. If UHG is not able to provide assistance, you may also email COVID-19@cms.hhs.gov. Explain the issue and ask that the email be forwarded to the appropriate HHS staff. Finally, you may wish to consider reaching out to your Members of Congress to bring this to their attention.

      Posted by APTA staff on 4/30/2020 9:49 AM

    • @Gillian: The CARES Act Provider Relief Fund Payment Attestation Portal is open. It's at https://covid19.linkhealth.com/#/step/1 Should you choose to reject the funds, you must complete the attestation to indicate this. This Payment Portal will guide you through the attestation process to accept or reject the funds.

      Posted by APTA staff on 4/30/2020 9:51 AM

    • We have received the funds. We are an outpatient PT/OT clinic. We are testing any COVID-19 patients. We are seeing patients like we always do (though a reduced number). Since it includes care for individuals with possible or actual COVID-19, and we aren't for sure, it sounds as though we can use the funds. Are we to just assume that we continue to operate as normal, and hope the "records" we are to keep will be able to be accommodated by our normal eval/daily notes etc? It seems many have the similar questions but the answer is kind of skirted. Rephrasing: If we treat as normal (COVID-19 precautions, social distancing) we can receive the funds and would be then following the terms and conditions? Who then wouldn't be, who is still treating and in good standing?

      Posted by Amy on 4/30/2020 11:42 AM

    • Does anyone know if the Provider Relief Funds deposited by the government into our accounts are taxable as income?

      Posted by Anne Elkin on 4/30/2020 2:27 PM

    • I am a Medicare provider. I have grave concerns about the terms and conditions associated with cares act funding relief Apparently, I am deemed to have accepted the terms and conditions if I do not return the money within 30 days. At this point, I simply wish to return the money, and not participate. But I don’t find anywhere a a method or link to do that? Am I missing something? How does one decline the program?

      Posted by David M White on 5/1/2020 1:50 AM

    • @Amy: While APTA cannot provide legal advice and is unable to provide clarification beyond what HHS has provided thus far, as discussed in the Terms and Conditions, you’ll need to maintain appropriate records and cost documentation and be prepared to submit copies of such records and documentation upon request of the Secretary. Further, as noted in the Terms and Conditions, you’ll be required to fully cooperate in any audits that the federal government does to ensure compliance with the Terms and Conditions. If you have additional questions, please consider consulting with a local attorney.

      Posted by APTA staff on 5/1/2020 10:33 AM

    • @Anne: The Treasury Department has not yet made a determination on the tax status of funds from the provider relief fund.

      Posted by APTA staff on 5/1/2020 10:33 AM

    • @David: The CARES Act Provider Relief Fund Payment Attestation Portal is open at https://covid19.linkhealth.com/#/step/1 Should you choose to reject the funds, you must complete the attestation to indicate this. This Payment Portal will guide you through the attestation process to accept or reject the funds.

      Posted by APTA staff on 5/1/2020 10:34 AM

    • I have followed the attestation process. I am at step 4 where it shows my TIN number, last 6 of my bank account, and the amount I received. The button to click says "review and accept". No where in the steps leading up to this did it ask if you wanted to accept or decline the money. I'm not sure if I select "review and accept" if that means I'm accepting it or if the last page will give me the option to decline (which I want to do). Do you know if that is where it asks about declining because there is nothing anywhere else that gives you that option.

      Posted by Elizabeth on 5/3/2020 5:26 PM

    • @Elizabeth: Please call UHG at 866-569-3522 to confirm.

      Posted by APTA staff on 5/4/2020 8:24 AM

    • I read that reporting is not required on payments less than $150,000.

      Posted by James Weaver on 5/4/2020 9:56 PM

    • @James: All providers should closely read the terms and conditions associated with the relief fund from which they are accepting funds. Providers should account for the uses of the funds in accordance with the Terms and be prepared to submit reports in accordance with the Terms. To view the Terms and Conditions for the different funds, see: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/terms-conditions/index.html

      Posted by APTA staff on 5/5/2020 7:48 AM

    • I attested/accepted to receiving the funds but I no longer want the funds. How do I return it to HHS?

      Posted by Julia Mason on 5/7/2020 12:01 AM

    • @Julia: Please contact the CARES Provider relief fund hotline at 866-569-3522.

      Posted by APTA staff on 5/7/2020 8:04 AM

    • WIll mental health providers be receiving any of the allocated monies, particularly those who primarily see medicaid clients?

      Posted by Paul Johnson on 5/7/2020 2:33 PM

    • I am eligible for the funds, but have not received anything. I have been billing Medicare for the past 11 years under the same TIN and it is the bulk of my practice. We have a small two practitioner office. I have tried the 866.569.3522 number which is no help, HHS help hotline, CMS, Noridian, and even my state representative and no one has any answers or a clue where I can get assistance. Any suggestions are welcome!

      Posted by Ryan Meyers on 5/7/2020 5:24 PM

    • • @Paul: Please stay tuned. It is our understanding that the Administration is collecting information from states that could be used to distribute COVID-19 provider relief grant funds to providers that serve Medicaid enrollees. HHS has $28 billion remaining in Congress' initial $100 billion in provider grants set aside in the CARES Act. HHS has said those will go to "skilled nursing facilities, dentists, and providers that solely take Medicaid," as well as reimbursing providers for COVID-19 care for the uninsured. Congress also refilled the fund with an additional $75 billion, and HHS has not yet said how it will distribute those funds.

      Posted by APTA staff on 5/8/2020 8:22 AM

    • @Ryan: Please email COVID-19@cms.hhs.gov with information about your business, the TIN, and your contact information, and ask that your email be forwarded to the appropriate HHS staff to investigate why you did not receive any funds. Please also contact your Members of Congress with the same information and ask that they investigate. Additionally, please email advocacy@apta.org so we can further discuss.

      Posted by APTA staff on 5/8/2020 8:23 AM

    • Does this stimulation from their Terms and Conditions mean that if you have received a PPP loan you can not use the money to reimburse lost payroll due to COVID19? "The Recipient certifies that it will not use the Payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse."

      Posted by Anne Haile on 5/8/2020 10:54 AM

    • @Anne: You want to be careful of not using the provider relief funds to pay for expenses that another assistance program covers (you want to avoid “double-dipping”). Please also see the updated HHS FAQ, which states: Does HHS intend to recoup any payments made to providers not tied to specific claims for reimbursement, such as the General Distribution payments? (Added 5/6/2020) The Provider Relief Fund and the Terms and Conditions require that recipients be able to demonstrate that lost revenues and increased expenses attributable to COVID-19, excluding expenses and losses that have been reimbursed from other sources or that other sources are obligated to reimburse, exceed total payments from the Relief Fund. Generally, HHS does not intend to recoup funds as long as a provider’s lost revenue and increased expenses exceed the amount of Provider Relief funding a provider has received. HHS reserves the right to audit Relief Fund recipients in the future to ensure that this requirement is met and collect any Relief Fund amounts that were made in error or exceed lost revenue or increased expenses due to COVID-19. Failure to comply with other Terms and Conditions may also be grounds for recoupment. https://www.hhs.gov/sites/default/files/provider-relief-fund-general-distribution-faqs.pdf

      Posted by APTA staff on 5/11/2020 8:09 AM

    • We Finally resolved returning the money. When you get to the attestation page 3. It says review and accept. We never hit that accept button for fear we were keeping the money. BUT... after getting help from a supervisor...7.5 hours of calls later. If you hit the accept button it takes you to page 4 where you can reject the funds! Copy the rejection for records. Money is still in our account but I am sure they will suck it out soon!

      Posted by Gillian B on 5/11/2020 10:32 AM

    • I have a provider who has not received any money from this program. I called the UHC number with no resolution. They can find the provider and tax id but can only confirm no payment issued. No one to call and the answers from the reps at UHC are different each time Is their anyone who can explain why the doctor has not received payment? He has billed Medicare for years. He has had no COVID patients, but I have other clients who did receive money who have not treated COVID patients either, I tried the COVID email mentioned in other comments. They told me they are unable to help ANy information would be appreciated.

      Posted by Rose Mendoza on 5/12/2020 3:51 PM

    • Our practice did not receive a payment. We are in good standing - we are still gettign medicare payments over $15k per month. UHC reps could not provide information. Is there anyway to appeal?

      Posted by Bill on 5/13/2020 12:35 PM

    • Still have not received a distribution from CARES provider relief. So this is just an update. UHG has not been able to do much if they were not given TIN with banking info by HHS. UHG immediately you must be ineligible. HHS help line no help. Emails to HHS Covid19 were not answered. APTA advocacy Kara very supportive. Noridian jurisdiction "E" has been helpful using 1099 and EFTtracing with Credit Union. Discovered account number from13 years ago had changed slightly 2 times without interrupting existing EFT. Apparently a new EFT from an unrecognized source could not be established. Fixed EFTwith Noridian and PECOS Monday/Tuesday, made a few more phone calls. Today had an actual phone call from HHS telling me they are escalating my case to tier 2 expedited level - good news I hope. "And yet she persisted"

      Posted by Betty Fackler on 5/15/2020 1:36 AM

    • @Rose: All facilities and providers that received Medicare fee-for-service (FFS) reimbursements 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 (TIN). If a provider did not receive any of the initial $30 billion distribution and thus is not eligible to apply for the additional $20 billion distribution, the provider should contact their Members of Congress and also email COVID-19@cms.hhs.gov, and ask CMS to forward the email to the appropriate HHS staff managing the program. When they reach out to Congress and also CMS, they should provide their business name, address, TIN, and contact information, explain the issue and how they have been a Medicare provider for years, etc.

      Posted by APTA staff on 5/16/2020 7:21 AM

    • @Bill: Please email COVID-19@cms.hhs.gov with information about your business, the TIN, and your contact information, and ask that your email be forwarded to the appropriate HHS staff to investigate why you did not receive any funds. Please also contact your Members of Congress with the same information and ask that they investigate. Additionally, please email advocacy@apta.org so we can further discuss.

      Posted by APTA staff on 5/16/2020 7:22 AM

    • @Gillian B - They will not "suck out" the payment just by you rejecting it. You must return the funds yourself. There should have been a box that popped up when you chose to reject the funds that tells you how to return the money.

      Posted by Elisabeth Ridley on 5/26/2020 10:28 AM

    Leave a comment
    Name *
    Email *
    Homepage
    Comment