September 20, 2020

Volume X, Number 264

September 18, 2020

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COVID-19: Take Two (for some) on Additional DHHS Provider Relief Funding

The Department of Health & Human Services (DHHS) announced some Medicare providers who experienced challenges in the Phase 1 general distribution application period will get a second chance to apply for funds. This limited group of providers will have until August 28, 2020 to exercise this second chance to apply for funds. These applications will be processed alongside the Phase 2 general distributions for Medicaid, Medicaid managed care, CHIP, and dental providers, who now also have until August 28, 2020 to file their applications. Like the Phase 1 funding, the maximum total payment amount, inclusive of any Phase 1 payments, is 2 percent of the applicant’s annual patient revenue. 

In addition to the other eligible Phase 2 provider types (e.g., Medicaid, CHIP, and dentists) this second chance is intended to be used by: (1) Medicare providers who received funds in Phase 1 of less than 2 percent of their annual revenues but did not meet the filing deadline earlier this year for reporting additional revenue information; (2) Medicare providers who received funds but decided to decline them and now wish to accept funds; and (3) Medicare providers who underwent a change of ownership in 2019 or 2020 and were as a result required to return funds received by prior owners. 

To apply for the Phase 2 funding, a Provider must meet one of the following 6 requirements:

  • Billed Medicare fee-for-service during the period of Jan.1, 2019-Dec. 31, 2019; or

  • Be a Medicare Part A provider that experienced a change in ownership and billed Medicare fee-for-service in 2019 or 2020 that prevented the otherwise eligible provider from receiving Phase 1 General Distribution payment; or

  • Billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan.1, 2018-Dec.31, 2019; or

  • Billed a health insurance company for oral health care-related services as a dental service provider; or

  • Be a licensed dental service provider who does not accept insurance and has billed patients for oral health care-related services.

Additionally, to be eligible to apply, the applicant must meet all of the following requirements, as applicable:

  • Filed a federal income tax return for fiscal years 2017, 2018, 2019; or be exempt from filing a return;

  • Provided patient care after January 31, 2020 (patient care is now being defined to include health care, services and support, as provided in a medical setting, at home, or in the community);

  • Actively provides patient care directly or indirectly;

  • Has not received a previous General Distribution payment totaling approximately 2 percent of annual patient revenue; and

  • For individuals, reported on Form 1040 (or other tax form) gross receipts or sales from providing patient care.

Applicants will be required to complete an application and submit documentation including tax returns, and FTE and revenue worksheets through the provider relief application and attestation portal. DHHS indicates that payments will take between five and seven weeks to process and will be paid on a rolling basis as information is validated. These funds will be subject to the same attestation and reporting requirements as all other provider relief funds. 

This second chance is not available to all providers, including those that are newly formed in 2020. DHHS has indicated it is still working to address payments to providers that opened in 2020 and providers that do not bill Medicare and, as such, have not received funds. More information should be forthcoming for these providers. 

DHHS will host a webinar on August 13 to provide additional detail on the application process. 

© 2020 Foley & Lardner LLPNational Law Review, Volume X, Number 225

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About this Author

Alexis Bortniker, Health Care Attorney, Foley Lardner Law Firm
Partner

Alexis Bortniker is a senior counsel and health care lawyer with Foley & Lardner LLP. Her practice focuses on transactional and regulatory matters with an emphasis on counseling health systems, hospitals, and other providers in managed care and physician contracting. Ms. Bortniker is a member of the firm’s Health Care Industry Team.

Previously, Ms. Bortniker was an associate with Choate Hall & Stewart LLP where she gained experience working directly with health care organizations on regulatory and corporate compliance issues, including...

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Anil Shankar, Foley Lardner, Health Care Lawyer, Attorney, Legislation
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