Home Health & Hospice Week

Many home health and hospice agencies discovered significant chunks of cash mysteriously deposited in their bank accounts when Medicare abruptly launched its CARES Act Provider Relief Fund program.

Confusion about the program abounds, maintains Tom Boyd with Simione Healthcare Consultants in Rohnert Park, California.“Many getting money did not know it was coming, and others not having the money want to know where it is and when is it coming,” Boyd tells Eli.“Some want to know how to apply.”

Read on for how the payments work, according to materials the Department of Health and Human Services has issued.

HHS calculates providers’ relief fund payment amounts based on their portion of Medicare fee-for-service revenues in 2019. Total FFS expenditures were $484 billion in 2019, HHS says in a fact sheet about the program. So your payment should be the amount of your 2019 FFS payments divided by $484 billion and multiplied by the pool of relief funds, $30 billion.

Tip: Another way to calculate your payment is by multiplying your 2019 revenues by 6.1983 percent, offers finance expert Dave Macke with VonLehman & Co.

For example: An agency with $3 million in 2019 Medicare revenues would see a nearly $186,000 relief payment.

Don’t be surprised if your payment doesn’t match your calculations exactly. The feds used your 2019 revenues based on payment dates, not on dates of service, Macke advises. And the figure includes FFS payments only, not reimbursement for Medicare Advantage patients.

All three HHH Medicare Administrative Contractors issued this statement about the program on April 13: “Recognizing the importance of delivering funds in a fast and transparent manner, $30 billion is being distributed immediately through a program administered by the Department of Health and Human Services — with payments arriving via direct deposit beginning April 10, 2020 — to eligible providers throughout the American health care system. These payments are unrelated to the Accelerated and Advanced Payments you may have requested from Medicare. The automatic payments will come from Optum Bank with ‘HHSPAYMENT’ as the payment description.”

Note that there is “no relationship between the monies and the virus,” Boyd points out. Instead, they are “grants” determined based on the historical Medicare revenues of the provider, he says.

Agencies have been asking if they can dispute the amount given if it’s insufficient or incorrectly determined, Boyd adds. At this time, it doesn’t appear so, experts agree.

While many providers were mystified when the money showed up in their accounts, others are wondering where their payout is.

One possibility is a scenario experienced by Macke’s client, who doesn’t already have direct deposit set up with Optum Bank. Upon inquiry, HHS told Macke the client would receive a paper check in about two weeks, instead.

How to know: MAC Palmetto GBA pro-vides the HHS CARES Provider Relief phone number, 866-569-3522, in its announcement. Call that number to check on your relief payment status, Macke recommends. Have both your Tax ID and PTAN numbers ready.

Where’s The Other $70 Million?

CMS distributed about $26 billion of the $30 billion in funding on April 10, HHS Secretary Alex Azar said in a tweet that day. But even once CMS tops out the $30 billion, it has $70 billion more appropriated for provider funding relief.