The Department of Health and Human Services (HHS) Provides an Update on the Provider Emergency Relief Fund

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On May 15, 2020, HHS posted revised FAQs on the Provider Relief Fund General Distribution Portal in response to many questions from physicians and medical societies related to the CARES Act Provider Relief Fund.

Certain formulas that were previously on the HHS were used by physicians to calculate what they thought HHS intended for them to receive from the fund. Based on their calculations, many physicians though they received too much and that those funds would later be recouped by HHS.

To allay these concerns, HHS removed the formula and overpayments language from the portal last week. Unfortunately, in some cases, the appearing and disappearing of the formulas from the website heightened rather than allayed concerns.

Currently, HHS has asked for people to provide documentation of certain revenue information so that it can make the calculations specific to each TIN (Taxpayer Identification Number).

Several of the FAQs are dated May 14, and they seek to clarify some of the recent confusion, particularly these two questions:

How did HHS determine the additional payments under the General Distribution? (Added 5/14/2020)

HHS is distributing an additional $20 billion of the General Distribution to providers to augment their initial allocation so that $50 billion is allocated proportional to providers’ share of 2018 net patient revenue. The allocation methodology is designed to provide relief to providers, who bill Medicare fee-for-service, with at least 2% of that provider’s net patient revenue regardless of the provider’s payer mix. Payments are determined based on the lesser of 2% of a provider’s 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April. If the initial General Distribution payment you received between April 10 and April 17 was determined to be at least 2% of your annual patient revenue, you will not receive additional General Distribution payments.

How can I estimate 2% of patient revenue to determine my approximate General Distribution payment? (Added 5/14/2020)

In general, providers can estimate payments from the General Distribution of approximately 2% of 2018 (or most recent complete tax year) patient revenue. To estimate your payment, use this equation:

(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.” Providers should work with a tax professional for accurate submission.

This includes any payments under the first $30 billion general distribution as well as under the $20 billion general distribution allocations. Providers may not receive a second distribution payment if the provider received a first distribution payment of equal to or more than 2% of patient revenue.

Additional information that has recently been added notes that HHS is making a list publicly available of the providers who have received and accepted money from the Provider Relief Fund here: https://data.cdc.gov/Administrative/HHS-Provider-Relief-Fund/kh8y-3es6

Read the updated FAQs here: [https://www.hhs.gov/sites/default/files/provider-relief-fund-general-distribution-faqs.pdf}