The Trump administration has laid out a plan for how to disperse the remaining $70 billion to providers struggling financially due to the COVID-19 outbreak.
The U.S. Department of Health and Human Services (HHS) allocated $30 billion to providers out of a $100 billion pot passed in an economic stimulus package by Congress a few weeks ago.
Here is how the remainder will be allocated in the coming weeks:
- $20 billion to providers that will build on the general $30 billion and will be based on net patient revenues from 2018. The initial $30 billion was allocated based on historical Medicare spending, but the $20 billion will be based on all sources;
- $10 billion to hospitals in areas hit hard by the COVID-19 outbreak such as New York;
- $10 billion to rural hospitals, many of which are already in financial distress; and
- $400 million to Indian Health Service facilities.
The remaining money will be allocated in several different ways.
HHS Secretary Alex Azar said on a call with reporters on Wednesday the agency will distribute money for skilled nursing facilities and providers that rely primarily on Medicaid.
Azar added the rest will be reserved for a second tranche of COVID-19 hotspot funding and to cover the uninsured claims at Medicare rates for any providers.
The timing for when providers will get the money will depend.
How to get the money
HHS will launch a portal next week at hhs.gov/providerrelief where providers can submit revenue information for the $20 billion in general funds.
“Payments will go out weekly on a rolling basis,” Azar said on the call.
Some providers won’t have to submit any revenue information because CMS already has cost reports. Those providers could get money as soon as this Friday.
The $10 billion allocated for rural hospitals and health centers will be distributed next week based on operating expenses, HHS officials said.
To qualify for the COVID-19 hotspot funding, a hospital must submit apply by Thursday at midnight Pacific time by giving HHS several pieces of information.
A hospital must give their tax identification number, national provider identifier, total number of intensive care unit beds as of April 10 and the total number of COVID-19 admissions dating back to Jan. 1.
HHS will develop and disclose a formula based on that data to determine how much money each hospital would get.
Azar couldn’t give any more details on the makeup of the funding formula as “we want to see that data first to make sure we don’t have any gaps in our approaches,” he said. “Once we finalize that we will get that money out and will receive that by the middle of next week.”
But it remains unclear how much exactly is reserved to cover the uninsured claims. The Trump administration a few weeks ago promised to reimburse providers via Medicare rates for any COVID-19 treatment for uninsured individuals.
Azar was confident there will be enough money leftover in the $100 billion fund to cover any uninsured claims, especially based on the agency’s understanding of “uninsured utilization and COVID utilization.”
He also mentioned that Congress is expected to pass another $75 billion to providers.
But an estimate from the Kaiser Family Foundation said that covering uninsured COVID-19 treatment costs could range from nearly $14 billion to as much as $41 billion.
A provider can register to get Medicare reimbursement for uninsured treatments starting on April 27 via a website that will soon be launched called coviduninsuredclaim.hrsa.gov.
Providers who sign up will have to submit claims as they would to an insurer or Medicare. The claims can date back as far as Feb. 4 when the Centers for Medicare & Medicaid Services created a billing code for COVID-19.
Providers can expect payments as soon as mid-May, HHS said.
The announcement comes as HHS has faced criticism from providers and hospital groups on how it dispersed the initial $30 billion round of funding.
The safety-net hospital association America's Essential Hospitals slammed HHS for using Medicare spending as the means for allocation, even though some facilities don't primarily rely on Medicare revenue.
Azar defended the decision on the call, saying that the goal was to get out the money as fast as possible and using Medicare was the quickest way because payment data was already available.
America's Essential Hospitals praised the additional funding, but had some concerns about how exactly HHS will target hard-hit COVID-19 areas for the $10 billion.
"Targeting will require complete and accurate data, and we have concerns about technical problems providers now face as they try to comply with the department’s request for targeting data," said AEH CEO and President Bruce Siegel. "We call on the department to extend its data submission deadline until it has resolved these technical issues and clearly and publicly communicated how it will use this information."