HHS Begins Distribution of Payments to Hospitals with High COVID-19 Admissions, Rural Providers

The Department of Health and Human Services is processing payments from the Provider Relief Fund to hospitals with large numbers of COVID-19 inpatient admissions through April 10, 2020, and to rural providers in support of the national response to COVID-19.

“These new payments are being distributed to health care providers who have been hardest hit by the virus: $12 billion to facilities admitting large numbers of COVID-19 patients and $10 billion to providers in rural areas, who are already working on narrow margins,” said HHS Secretary Alex Azar. “HHS has put these funds out as quickly as possible, after gathering data to ensure that they are going to the providers who need them the most”


COVID-19 High-Impact Distribution:

Recognizing the particular impact the COVID-19 pandemic has had on hospitals in certain parts of the nation, and that inpatient admissions are a primary driver of costs to hospitals related to COVID-19, HHS is distributing $12 billion to 395 hospitals who provided inpatient care for 100 or more COVID-19 patients through April 10, 2020, $2 billion of which will be distributed to these hospitals based on their Medicare and Medicaid disproportionate share and uncompensated care payments.

These 395 hospitals accounted for 71 percent of COVID-19 inpatient admissions reported to HHS from nearly 6,000 hospitals around the country. The distribution uses a simple formula to determine what each hospital receives: hospitals are paid a fixed amount per COVID-19 inpatient admission, with an additional amount taking into account their Medicare and Medicaid disproportionate share and uncompensated care payments.

These hospitals will begin receiving funds via direct deposit in the coming days.


Rural Distribution:

Rural hospitals, many of whom were operating on thin margins prior to COVID-19, have been particularly devastated by this pandemic. As healthy patients delay care and cancel elective services, rural hospitals are struggling to keep their doors open.

Recipients of the $10 billion rural distribution will include, rural acute care general hospitals and Critical Access Hospitals, Rural Health Clinics, and Community Health Centers located in rural areas.

Hospitals and RHCs will each receive a minimum base payment plus a percent of their annual expenses. This expense-based method accounts for operating cost and lost revenue incurred by rural hospitals for both inpatient and outpatient services. The base payment will account for RHCs with no reported Medicare claims, such as pediatric RHCs, and CHCs lacking expense data, by ensuring that all clinical, non-hospital sites receive a minimum level of support no less than $100,000, with additional payment based on operating expenses. Rural acute care general hospitals and CAHs will receive a minimum level of support of no less than $1,000,000, with additional payment based on operating expenses.

Eligible providers will begin receiving funds in the coming days via direct deposit, based on the physical address of the facilities as reported to the Centers for Medicare and Medicaid Services and the Health Resources and Services Administration, regardless of their affiliation with organizations based in urban areas.

HHS and the Administration are continuing to work rapidly on additional targeted distributions to some providers including skilled nursing facilities, dentists, and providers that solely take Medicaid.

Visit hhs.gov/providerrelief for additional information.


CMS announces independent nursing home commission

The Centers for Medicare & Medicaid Services announced a new independent Commission that will conduct a comprehensive assessment of the nursing home response to the 2019 Novel Coronavirus (COVID-19) pandemic. The Commission will provide independent recommendations to the contractor to review and report to CMS to help inform immediate and future responses to COVID-19 in nursing homes. This unprecedented effort builds upon the agency’s five-part plan unveiled last April to ensure safety and quality in America’s nursing homes, as well as recent CMS efforts to combat the spread of COVID-19 within these facilities.

Press release


CDC issues PPE burn rate calculator

The CDC has a PPE Burn Rate Calculator tool that is intended to help healthcare facilities plan and optimize their use of PPE.



CMS increases payments for audio-only telephone visits

In response to efforts by organized medicine, the Centers for Medicare & Medicaid Services announced they are increasing payments for audio-only telephone visits between Medicare beneficiaries and their physicians to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110, and the payments are retroactive to March 1, 2020.

This is a major victory for medicine enabling physicians to care for their patients, especially their elderly patients with chronic conditions who may not have access to audio-visual technology or high speed Internet.

Organized medicine worked with Senators Shelley Moore Capito and Joe Manchin to spearhead a letter to HHS Secretary Azar and CMS Administrator Verma. The letter sent on April 29 had 37 signers and included the following requests:

  1. Increase Medicare payment rates for telephone-based evaluation and management codes (99441-99443) to bring payments for these codes equal to Medicare’s established in person visit codes (99212-99214) that will ensure that patients without advanced video-sharing capabilities are able to get care virtually, while helping to sustain physician practices.
  2. Immediately provide guidance to Medicare Administrative Contractors to ensure that recent CMS guidance and rules are followed appropriately to enable the payment of telephone E/M claims.
  3. Provide members of Congress with a briefing on CMS efforts to address this issue by May 8, 2020.


CMS reopens comment period for Coordinating Care for out-of-state providers

The Centers for Medicare & Medicaid Services has reopened the public comment period for the Coordinating Care from Out-of-State Providers for Medicaid-Eligible Children with Medically Complex Conditions, Request for Information, by 30 additional days. The new comment period deadline is 5 p.m. EDT on June 3, 2020.

This change was formally announced as a Notice in the Federal Register. Please submit any comment that CMS should consider in this RFI process through the Federal Register.


HRSA issues guidance for uninsured COVID testing

The Health Resources and Services Administration recently launched a COVID-19 Uninsured Program Portal where health care providers who have conducted COVID-19 testing of uninsured individuals for COVID-19 or provided treatment to uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020 can request claims for reimbursement.

Providers will be reimbursed, generally at Medicare rates, subject to available funding. Steps will involve:

–         Enrolling as a provider participant

–         Checking patient eligibility

–         Submitting patient information

–         Submitting claims

–         Receiving payment via direct deposit.

To learn more about the program, including the registration and claim submission process, go to COVIDUninsuredClaim.HRSA.gov. HRSA also developed a video overview of the program. In addition, providers can access real-time technical support, as well as service and payment support, by calling the Provider Support Line at 866-569-3522. The hours of operation are 8 a.m. to 8 p.m. Monday through Friday in your local time zone.

Please do not hesitate to reach out to HRSA’s Office of Regional Operations with questions, concerns, or requests for support and engagement.