The $484 billion spending package: 10 top questions answered
Also known as “Cares Act 3.5,” the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA), signed into law April 24, aims to replenish small business relief, support healthcare providers, and expand testing for COVID-19.
What does the $484 billion spending package mean for practices like yours? How can you access the funds? We tackled these and related questions on a recent webinar.
In case you missed the webinar, here are answers to the top questions we received from attendees.
Q: Providers must sign an attestation to receive funds. Where can we access the attestation statement?
A: You can access the attestation statement on the Provider Attestation Portal. To file for reimbursement for claims for providing uninsured patients COVID-19 testing or care, please go here.
Q: What type of revenue information will we need to submit?
A: The U.S. Department of Health and Human Services (HHS) uses TIN numbers to determine calculation. To calculate your estimated total allocation, divide your "gross receipts or sales" or "program service revenue" by 2.5 trillion and then multiply by 50 billion. ((Gross Receipts or Sales) / 2,500,000,000,000) * 50,000,000,000.
Q: Is balance billing only for non-insured due to COVID-19 diagnosis? What if the insurance states the patient has a copay or deductible? Should we still bill according to what the insurance states in the EOB?
A: You can still bill insurance as usual for patients being tested or treated for COVID-19. However, if patients have an insurance plan that is out of network with your provider, they cannot pay more than they would if they were in network.
Q: With the CARES Act relief fund, do we have to bill a possible COVID-19 diagnosis?
A: No, not for funds coming to you directly via the Centers for Medicare & Medicaid Services (CMS) and based on your prior year’s revenue or cost reports. That money comes in the form of a direct payment, not a loan, and isn’t based on whether you’re treating COVID-19 patients. It’s meant to provide relief — even to offices that have had to close or furlough staff because of the pandemic.
Q: Can you still apply for the U.S.Small Business Administration (SBA) Disaster Loan that was available at 3.75% for a 30-year fixed rate? If so, what is the link?
A: For the Express loan, yes. The Express loan program provides loans up to $350,000 for no more than seven years with an option to revolve, according to the SBA website. It states, “There is a turnaround time of 36 hours for approval or denial of a completed application. The uses of proceeds are the same as the standard 7(a) loan.” The SBA offers guidance on finding lenders here.
Q: Do you have to rehire with the Paycheck Protection Program (PPP) even if you don’t need workers due to a slowdown?
A: Ask your lender, if you have already applied, or make sure to get that clarification in writing from your lender if you are still thinking of applying. The PPP language in the CARES Act and subsequent SBA guidance has made certain provisions ambiguous and individual lenders have different standards as far as loan forgiveness.
Q: Can pediatricians apply for financial support, and what programs are available to private practice pediatricians besides PPP?
A: Unfortunately, there are not a lot of options for pediatricians or providers who do not have Medicare patient populations. Much of the money is going toward hospitals and provider offices based on their Medicare reimbursement. If you happen to be treating an uninsured patient for COVID-19, regardless of what type of patient it is (Medicare, Medicaid, private insurance, etc.), you can apply for claim forgiveness here. There are other SBA loans available besides the PPP, and these come with less stringent requirements for how the money is used. Click here for more information.
Q: The CARES Act designated $100 billion to reimburse eligible providers’ expenses or lost revenues directly attributed to COVID-19. Is the $100 billion only for Medicare adult or pediatrics Medicaid also?
A: Providers who do not have Medicare patient populations have fewer options, as mentioned. If you treat an uninsured patient for COVID-19, you can apply for claim forgiveness here. You may also click here for more information on SBA loans available besides the PPP.
Q: Can you use stimulus relief funds to buy an EHR if you now use paper?
A: Based on the terms and conditions, this does not appear to be the case. According to the terms and conditions, “Payment will only be used to prevent, prepare for, and respond to coronavirus” and “Payment shall reimburse the Recipient only for health care related expenses or lost revenues that are attributable to coronavirus.”
Q: Do we have a chance of being approved for the second wave of stimulus if we did not have a negative loss of revenue in March, but we did have a significant loss in April, and expect a greater loss in May?
A: The Provider Relief Fund is being distributed regardless of lost revenue this year and is solely based on past years’ Medicare reimbursements or cost reports. However, you can demonstrate the lost revenue in April and May as justification for receiving those funds, based on the terms and conditions.
For the Provider Relief Fund based on 2019 Medicare reimbursements, click here.
For the Provider Relief Fund based on 2018 net patient revenue, click here.
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