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HHS is urging all eligible providers to apply early; do not wait until the last day or week of the application period.

ACOG continues to advocate with Congress for continued financial relief for obstetrician-gynecologists. As information becomes available, this page will be updated. Subscribe to ACOG Rounds emails, ACOG Advocacy News emails, or follow us at @acogaction on social media for details.

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.

General Allocation: Phase 3

HHS has created a new portal of federal relief funds for providers that have already received Provider Relief Fund payments in addition to previously ineligible providers. For eligible providers, the new Phase 3 General Distribution is designed to balance an equitable payment of 2 percent of annual revenue from patient care for all applicants plus an add-on payment to account for revenue losses and expenses attributable to COVID-19.

Eligibility

The following practice types are eligible to apply for funds now through November 6, 2020:

  • Providers who previously received, rejected or accepted a General Distribution Provider Relief Fund payment. Providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment.
  • Behavioral Health providers, including those that previously received funding and new providers.
  • Healthcare providers that began practicing January 1, 2020 through March 31, 2020. This includes Medicare, Medicaid, CHIP, dentists, assisted living facilities and behavioral health providers.

Requirements

  1. Required documentation:
    1. Most recent federal income tax return for 2017, 2018, or 2019, unless exempt
    2. Revenue worksheet (if required by Field 15)
    3. Operating revenues and expenses from patient care
  2. All applicants must submit their TIN and financial information to the Provider Relief Fund Application and Attestation Portal and agree to the Terms and Conditions for your first distribution of funds.
    1. You will be required to agree to these new Terms and Conditions for additional funding

Payments

Phase 3 General Distribution supports providers who have been most significantly impacted by COVID-19, as measured by changes in their revenues and expenses from patient care. If a provider did not previously receive approximately 2% of annual revenues from patient care, they will receive this amount consistent with prior general distributions, plus their Phase 3 allocation. Payments received in prior PRF distributions will be considered when calculating a provider's Phase 3 payment. All PRF distributions will be paid to the Filing or Organizational TIN, and not directly to subsidiary TINs. Providers receiving >$100,000 must sign up for Optum Pay in order to support program integrity.

For more information: Visit the HHS Federal Relief webpage and the press release for New Phase 3 Provider Relief Funding. For more detailed information on receiving payment, please see Provider Relief Fund FAQs.

General Allocation: Phase 2

The Phase 2 deadline was September 13, 2020

Following ACOG’s advocacy efforts, HHS has reopened the General Distribution portal for all practices who have not yet received relief funds equal to 2% of your 2018 total practice revenue. Practices that missed the previous deadline to apply for funds and those that were not previously eligible can apply now.

Eligibility

The following practice types are eligible to apply for funds now through September 13:

  • Practices that received a small amount of funds based on their Medicare revenue but missed the June 3rd deadline to apply for additional funds. 
  • Those that see Medicaid patients and were previously excluded from receiving federal relief funds. 
  • Providers who previously received Phase 1 General Distribution payment(s), but rejected and returned the funds and are now interested in reapplying.

Requirements

  1. If you previously received a direct deposit from HHS, complete the Provider Attestation Portal to confirm that you received funds and you agree to the Terms and Conditions for your first distribution of funds. 
  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
    1. You will be required to agree to these new Terms and Conditions for additional funding

Payments

Practices should receive relief funds that are equal to 2% of their 2018 total net patient revenue. Relief funds received during both allocations should add to equal this amount. 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 linked below.

For more information: Visit the HHS Federal Relief webpage and the Instructions for Applying to Phase 2 of the General Distribution 

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.