What financial assistance is available for hospitals, health systems, and health care providers?

The American Rescue Plan Act included $8.5 billion for rural health providers via the Provider Relief Fund. Additionally, coronavirus relief legislation in December included $9 billion in new funding for health care providers, including $3 billion for the Provider Relief Fund, which covers non-reimbursable expenses attributable to COVID-19. The Provider Relief Fund received $175 billion in previous legislation and is run through the Public Health and Social Services Emergency Fund (PHSSEF). All health care entities that provide health care, diagnoses, or testing are eligible for funding.

What is the process for hospitals, health systems, and health care providers to receive the PHSSEF funding?

The PHSSEF fund is designed to respond immediately to needs. HHS reviews applications and makes payments on a rolling basis in order to get money into the health system as quickly as possible. HHS is given significant flexibility in determining how the funds are allocated. This is to ensure that the fund disperses money fast enough to help struggling entities. You can view additional information about the Provider Relief Fund here.

 

What expenses qualify for funding?

All non-reimbursable expenses attributable to COVID-19 qualify for funding. Examples include building or retrofitting new ICUs, increased staffing or training, personal protective equipment, the building of temporary structures and more. Lost revenue from cancelled procedures, which has put significant strain on the health care system, is also a qualified expense. Any expenses reimbursed or obligated to be reimbursed by insurance or other mechanisms are not eligible. Payments will have to be returned to the fund if other sources provide reimbursement for expenses.

 

Can health care entities access funds under the PHSSEF if they are also eligible for funding from another government program?

Yes. The funds may not be used for expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse. Even if qualified expenses are eligible for reimbursement from another mechanism, an entity may still apply for funding from the PHSSEF fund while simultaneously applying for funding from other sources. However, should the entity subsequently receive reimbursement for expenses from any other source after receiving funding for the same expenses from the PHSSEF fund, the entity will be required to re-pay the funding it received from the PHSSEF fund. This same rule also applies to the new SBA7(a) loans Paycheck Protection Program forgivable loans, the SBA’s Economic Injury Disaster Loan (EIDL) Program, and the new EIDL Emergency Grant Program.

 

Hospitals are facing cash flow challenges due to canceling elective services. Is there anything in this bill to help hospitals stay afloat, even temporarily? 

The CARES Act created the opportunity for hospitals to receive accelerated payments. Specifically, acute care hospitals, critical access hospitals (CAHs), children’s hospitals, and prospective payment system-exempt cancer hospitals (PCHs) will be able to request accelerated Medicare payments for inpatient hospital services.

Medicare will work with qualified hospitals to estimate their upcoming payments and give that money to hospitals in advance. Qualified facilities can request a lump sum or periodic payment reflecting up to six months of Medicare services. Accelerated payments must be repaid to Medicare.

Government funding legislation in October 2020 included changes to the repayment policies for these loans and extended the timeline for repayment for providers. Repayment will begin one year after the payment(s) were issued; recipients have a total of 29 months to repay Medicare. You can view additional information on repayment terms from CMS here.

 

Treating patients with COVID-19 is very resource-intensive for hospitals. How will Medicare ensure that hospitals are adequately reimbursed for treating COVID-19 patients?

The CARES Act increases Medicare reimbursement to care for a COVID-19 patient by 20 percent. This add-on payment for inpatient hospital services will be applied for the duration of the COVID-19 emergency.

 

What support is included for community health centers?

The American Rescue Plan Act included $7.6 billion in additional emergency funding for community health centers. This funding is in addition to the $1.32 billion in supplemental funding for community health centers (CHCs) in the CARES Act and $100 million distributed in March. Health centers are on the front lines in addressing COVID-19 in underserved communities across the country. Community Health Centers can also access the PHSEFF fund. Recent government funding legislation also funded CHCs through FY 2023.