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Due to the financial impact of COVID-19, Congress allocated $100 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

HHS is allocating 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. The deadline to complete these steps is June 3. Practices must submit their attestation and revenue data by June 3 in order to receive additional funds.

Eligibility

Practices that received relief funds from HHS before 5:00 p.m. on April 24, 2020 are eligible to apply for additional funding.

Note: If your practice is eligible, complete the Requirements ASAP to be sure you are allocated additional funds before money runs out.

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
    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 (Available soon)
  5. Add and Attest to Patient Roster (Available May 6th)
  6. Submit patient claims electronically. (Available May 6th)
  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) will begin sending reimbursements in mid-May 2020.

For more information: Two informational webinars have also been scheduled on April 29th and 30th from 2–3 p.m. EST to provide further information on the package. You can also 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.

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.