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Due to the financial impact of COVID-19, Congress allocated $175 billion in federal relief funds for physician practices and health care facilities. This guide outlines the eligibility and application requirements that women’s health practices must follow to access federal relief funds. These funds are not loans and will not need to be repaid.

Medicaid & CHIP Allocation

HHS is launching a new Provider Relief Payment Portal on June 10, 2020 for practices that take Medicaid and CHIP payments but have been previously excluded from relief funds. The deadline for eligible practices to submit an application for relief funds is July 20, 2020

Eligibility

Practices that have not previously received relief funds from the General Allocation and billed their state Medicaid or CHIP programs and/or Medicaid and CHIP managed care organizations between January 1, 2018 and May 31, 2020. Note: If your practice is eligible, complete the Requirements ASAP to be sure you are allocated relief funds before money runs out.

Requirements

  • Read the Instructions for the Medicaid Provider Distribution for more information on eligibility, required materials for application, and directions for filling out the portal
  • Download the Medicaid Provider Distribution Application Form
  • Gather the following materials to submit to the portal:
    • Your practice’s Taxpayer Identification Number (TIN)
    • The National Provider Identifier (NPI) for each clinician in your practice
    • Your practice’s “Gross Receipts or Sales” or “Program Service Revenue” that was submitted on your last federal income tax return
    • Estimated practice revenue losses
    • A copy of your practice’s most recently filed federal income tax return for 2017, 2018, or 2019
    • Your most recent Employer’s Quaterly Federal Tax Return on IRS Form 941 or your Employer’s Annual Federal Unemployment Tax Return on IRS Form 940
    • Information regarding the amount of loan funds you have received from the US Treasury, Small Business Administration, or FEMA
    • This FTE worksheet 
    • This Gross Revenue Worksheet 
    • Your banking information

Payments

Applications will be processed by HHS as they are submitted. HHS aims to provide each eligible practice with relief funds that are equal to 2% of their total net revenue.

General Allocation

HHS distributed additional funds to practices that filed Medicare claims in 2019. HHS plans to use these additional funds to make up for revenue losses across payers, not just Medicare-fee-for service claims. 

Eligibility

The deadline to apply for additional relief was June 3rd. Practices that received relief funds from HHS before 5pm on April 24, 2020 were eligible to apply for additional funding. If you applied before the deadline your practice will still receive additional funds. 

Requirements

  1. Complete the Provider Attestation Portal to confirm that you received funds previously and you agree to the Terms and Conditions for your first distribution of funds. This must be completed within 45 days of payment allocation. 
  2. Gather the following materials to submit in the General Distribution Portal:
    1. Your practice’s Taxpayer Identification Number (TIN)
    2. Your practice’s “Gross Receipts or Sales” or “Program Service Revenue” that was submitted on your federal income tax return
    3. Estimated practice revenue losses in March and April 2020 due to COVID
    4. A copy of your practice’s most recently filed federal income tax return
    5. A listing of the TINs of any subsidiary practices that have received federal relief funds but do not file separate tax returns
  3. Complete the General Distribution Portal (Note: the deadline to apply for funds has passed and the portal is currently closed)
    1. You will be required to agree to these new Terms and Conditions for additional funding

Payments

Payments will be provided on a rolling, weekly basis beginning at the end of April.

HHS aims to provide each eligible practice with relief funds that are equal to 2% of their 2018 total net revenue. Relief funds received during both allocations should add to equal this amount. To calculate the total relief funds you should expect to receive, use this formula:

(Individual Provider Revenues/$2.5 Trillion) X $50 Billion = Expected Combined General Distribution.

To estimate your payment, you may need to use “Gross Receipts or Sales” or “Program Service Revenue.” For more detailed information, see the General Distribution FAQs.

For more information: Visit the HHS Federal Relief webpage and the HHS General Distribution Portal FAQs.

Reimbursement for COVID-19 Care Provided to Uninsured Patients

Physicians and practices can be reimbursed for COVID-19 testing and treatment that was provided to uninsured patients. Reimbursements will be based on current Medicare rates for eligible services.

Eligibility

Patients must have COVID-19 as their primary diagnosis, except in the case of pregnancy, where it may be listed secondarily, to qualify for coverage. Reimbursements will cover the following services if they were provided after February 4, 2020:

  • Specimen collection, antibody and other diagnostic testing
  • Inpatient, outpatient, emergency room, and telehealth visits related to testing and for treatment after diagnosis.

Requirements

  1. Register as a provider participant. Registration is now open at this link. You will need to create or sign in to an Optum ID account.
  2. Validate your TIN
  3. Set up Optum Pay Automated Clearing House
  4. Add a Provider Roster
  5. Add and Attest to Patient Roster
  6. Submit patient claims electronically.
  7. You will be required to agree to the Terms and Conditions for COVID-19 Testing and Treatment

Payments

The Health Resources and Services Administration (HRSA) began sending reimbursements in mid-May 2020.

For more information: Visit the HRSA webpage and FAQ.

Targeted Allocation

For more information, visit the HHS website.

  • Rural providers – Rural health clinics and hospitals can receive additional funds, which will be distributed on the basis of operating expenses.
  • High-impact areas – Hospitals in significantly impacted areas were contacted to apply for extra funds.
  • Indian Health Services – Additional funds are being distributed to Indian Health Services facilities based on operating expenses.
  • Skilled Nursing Facilities

ACOG Advocacy

If your practice is not eligible for any of the relief funds detailed above, ACOG is working diligently to secure the financial support you need. Read our statement regarding the methodology HHS is using to distribute relief funds, as well as the letters ACOG has sent to HHS urging them to prioritize women’s health practices that have been excluded from relief efforts.


Information on practice management during Coronavirus is developing rapidly and ACOG will release updates to policy and funding opportunities as they arise. ACOG continues to support its members during this time. If you have any further question or concerns, please reach out to us and submit your questions at acogcoding.freshdesk.com or covid@acog.org.