President Donald Trump signed legislation for a fourth round of COVID-19 stimulus funding into law this afternoon. The Paycheck Protection Program and Health Care Enhancement Act (COVID 3.5) allocates additional funds to sustain health care businesses during the COVID-19 public health emergency. In addition, the Department of Health and Human Services (HHS) is set to begin distribution of $20 billion from the CARES Act Provider Relief Fund based on 2018 patient net revenue.

Additional relief fund distributions begin
The federal CARES Act included a $100 billion Provider Relief Fund to support hospitals and physicians impacted by COVID-19. On April 10, an initial $30 billion was allocated to clinicians and facilities based on their 2019 Medicare payments. However, these advance payments did little for providers who see few or no Medicare patients. Starting today, HHS will begin rolling distribution of the remaining $20 billion as a “general allocation” based on 2018 net patient revenue, not just Medicare fee-for-service.

A portion of the distribution will be based on hospital and facility cost reports, which are filed with HHS. For those without adequate cost reports on file, HHS has opened a portal for providers to attest to their net 2018 revenue for purposes of determining allocation. More information and a link to attestation portal can be found here.

Of the remaining $50 billion in the Provider Relief Fund, $10 billion will be allocated for a targeted distribution to hospitals in areas that have been particularly impacted by the COVID-19 outbreak based on information they provide on the number of ICU beds and admissions for patients with a COVID-19 diagnosis. An additional $10 billion is being allocated to rural hospitals and rural health clinics based on their operating expenses, and $400 million is being directed to Indian Health Service facilities. An unspecified portion of the remaining funding will be used for clinicians and facilities that rely more on Medicaid than Medicare revenues.

Some portion of the remaining funds is being used to cover the costs of caring for uninsured patients with COVID-19. These funds may be claimed beginning Monday (April 27) at hrsa.gov/coviduninsuredclaim, and the reimbursement for the uninsured will be based on Medicare payment rates. Physician services provided to uninsured patients, such as office and emergency visits, including those provided via telehealth, may be reimbursed in this manner.

COVID 3.5 funds target medical care, testing
The Paycheck Protection Program and Health Care Enhancement Act (COVID 3.5) was authored to infuse more money into the Paycheck Protection Program and enhance support of health care businesses. Key provisions include $310 billion in new funds for the PPP, $60 billion for Small Business Administration disaster assistance loans and grants, an additional $75 billion to the Public Health and Social Services Emergency Fund to support the need for COVID-19 related expenses and lost revenue due to coronavirus, and $25 billion to bolster coronavirus testing.

A COVID 3.5 summary prepared by the AMA has additional details.