PAYER PROGRAMS

CARES Act Provider Relief Fund

Overview

While not administered by Medicare, providers that have billed Medicare claims in 2019 are eligible for the CARES Act Provider Relief Fund. $50 billion of the $100 billion CARES Act will be distributed to providers in order to provide immediate funding to support healthcare-related expenses or lost revenue attributable to COVID-19.

These are payments, not loans, to healthcare providers, and will not need to be repaid.

First Phase: On April 10, 2020, the U.S. Department of Health and Human Services (HHS) began automatically distributing $30 billion directly to physicians, hospitals, and other health care providers based on historical fee-for-service Medicare payments from 2019.

Second Phase: On April 24, 2020, HHS released an additional $20 billion in funding.

 

What to do if you are an Eligible Provider

First Phase: Payment to providers were paid based on the information on file with UnitedHealth Group (UHG) or the Centers for Medicare & Medicaid Services (CMS):

  • ACH payments have “HHSPAYMENT” as the payment description from Optum Bank
  • Paper checks were mailed to providers who normally receive paper check reimbursement from CMS

Second Phase: Direct payments were distributed to hospitals; however, physicians who received payments in the first phase must actively apply for this second phase of funding. HHS guidance to providers is that the estimated total allocation (across both phases of payments) be approximately 2% of 2018 gross patient revenue.

Providers should not apply for the second tranche of funding if the payments they have already received exceed their estimated allocation.

Providers must fill out an attestation confirming receipt of the funds and agreeing to the Terms and Conditions of payment within 45 days (increased from 30 days) of receiving payment. Providers who believe they have received an overpayment should contact the HHS provider relief hotline at (866) 569-3522.

External Resources

Medicare Advanced Payment Request – Suspended

In light of the $175 billion recently appropriated for healthcare provider relief payments through the CARES Provider Relief Fund and additional funding injected into the Paycheck Protection Program, CMS suspended its Advance Payment Program as of April 26, 2020.

External Resources

Blue Shield of California

Overview

Blue Shield of California is working with financial service partners to support health professionals dealing with the pressures of the COVID-19 pandemic. Four programs have recently been announced and will be available to qualifying network providers:

Advance Payments:

Blue Shield has begun directly providing advancements for future fee-for-service payments and capitation payments under current contracts with practices. The maximum dollar amount for these advancements will be the lesser of 25% of total 2019 capitation/claims payments or $5M.

No repayments are required during a six-month grace period, after which repayment amounts will be offset from claims payments. In order to keep these funds, a provider cannot be participating in the concurrent loan guarantee program or the Value-Based contracting initiative below.

Loan Guarantees:
Blue Shield intends to guarantee loans issued by American Express’ Direct Merchant Lending arm to providers. American Express is requiring an existing relationship with the provider. The loans will be capped at $2 million with flexible repayment terms and an interest rate of 3 ½ – 4%.

OODA​Health:
OODA Health is working with Blue Shield to expand its service offering that pays Blue Shield members’ liability to providers more quickly.

Value-Based Agreements:​
Blue Shield will work with select providers to convert their existing fee-for-service agreements to a value-based contract that provides a monthly base revenue stream.

For more information and to receive an application for the programs, providers are asked to send an email to Financecommunication@blueshieldca.com. Completed applications can be sent back to that same email address.

Applications are evaluated every Monday and Thursday by the Program Review Committee. Once a request is approved, the provider must sign applicable paperwork. Funds are typically released within 2 days after signed documents are returned.

External Resources

  • Blue Shield of California – News Center link

Hello Alice COVID-19 Business for All Grant

Founded in 2017, Hello Alice believes in business for all and exists to serve every American with an entrepreneurial spirit. Hello Alice with the support of Verizon, Silicon Valley Bank, Ebay, and others is offering $10,000 emergency grants, being distributed immediately to small business owners impacted by this pandemic.

If your business has been severely impacted by COVID-19, please complete the full COVID19 Business for All Grant application to apply for immediate support in the form of $10,000 grants. The $10,000 COVID-19 Business for All Grants will be awarded on a rolling basis.

External Resources

  • Hello Alice COVID-19 Business for All Grant link

TELEHEALTH PROGRAMS

FCC COVID-19 Telehealth Program

Overview

The COVID-19 Telehealth Program will provide funding to help healthcare providers purchase telecommunications services, information services, and devices necessary to provide critical connected care services.

Prior to Applying

  • Register for Commission Registration System (CORES)
    • Obtain an FCC Registration Number (FRN) – needed for application
  • File an FCC Form 460 through My Portal
    • The rural healthcare provider requirement is exempt for purposes of applying for the
      COVID-19 Telehealth Program
    • Choose Register an ineligible site for the Applying to field
  • Register with the federal System for Award Management (SAM)
    • This will allow for funds from this program to be deposited into your bank account

How to Apply

Use the login you created for CORES to sign-on and access the program application on FCC’s
online portal.

Information needed:

  • Data Universal Numbering System (DUNS) Number
    • You can look up your DUNS Number here
  • DATA Act Business Type – default to R – Small Business
  • Total number of patients serviced (annually)
  • Documentation to support the amount of funding requested
    • (i.e. itemized list of services/devices required to conduct telehealth with quotes on price)

External Resources

Our team is here to help you through this transition, so don’t hesitate to let us know how we can help you deliver quality care to your patients.