Medicare Compliance & Reimbursement

If your practice is in need of financial assistance and weighing its COVID-19 funding options, read on for a breakdown of what’s available — and what’s no longer on the table.

1. CARES Act Provider Relief Fund

Good news: The Department of Health and Human Services (HHS) is releasing $20 billion more in CARES Act Provider Relief Fund money to assist providers in combatting the pandemic. That’s on top of the $30 billion it automatically released last month. Payments began April 24.

Bad news: The new formula HHS has stipulated for calculating the further payments may mean some organizations won't receive any additional Provider Relief Fund payments — or may even have a portion of their previous funding taken back.

More information: www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

2. Accelerated Payments

Good news: The Centers for Medicare & Medicaid Services (CMS) has approved more than 21,000 accelerated payment applications totaling $59.6 billion in payments to Part A providers, it says in a release. For Part B suppliers, CMS has approved almost 24,000 applications advancing $40.4 billion in payments.

Bad news: CMS is putting the brakes on the program — including for applications that are still pending. CMS “is reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment Program to Part B suppliers effective immediately,” it said in the April 26 release. The availability of CARES Act funding seems to be driving the agency’s decision.

“CMS will not be accepting any new applications for the Advance Payment Program, and CMS will be reevaluating all pending and new applications for Accelerated Payments in light of historical direct payments made available through the [HHS] Provider Relief Fund,” the agency said.

More information: www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf.

3. CARES Act Paycheck Protection Program (PPP).

Good news: The Paycheck Protection Program and Health Care Enhancement Act enacted on April 24 has provided an additional $310 billion for the Small Business Administration (SBA) to resume the Paycheck Protection Program. SBA maxed out its previous $349 billion PPP funding on April 16.

Good news/Bad news: “To further ensure PPP loans are limited to eligible borrowers, the SBA has decided, in consultation with the Department of the Treasury, that it will review all loans in excess of $2 million, in addition to other loans as appropriate, following the lender’s submission of the borrower’s loan forgiveness application,” Treasury Secretary Steve Mnuchin and SBA Administrator Jovita Carranza said in an April 28 release. “Regulatory guidance implementing this procedure will be forthcoming.” The move could be good, in that it will free up more funds for small businesses that actually need the help, observers note. But it will place additional burdens on companies that legitimately qualify for the funds.

More information: www.sba.gov/funding-programs/loans/coronavirus-relief-options/paycheck-protection-program.