Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund
Helping Uninsured Americans Access COVID-19 Testing and/or Treatment
Posted on Monday, August 17, 2020
Updated Friday, August 28, 2020: The deadline to apply for Phase 2 General Distribution Funding has been extended to September 13, 2020.
Providers still have time to apply for aid through the CARES Act Provider Relief Fund. Below you’ll find important information about this program that can help providers recover revenue lost to the COVID-19 crisis and help uninsured patients avoid unexpected medical bills related to coronavirus testing and treatment.
Information for Providers
The federal government has allocated $175 billion to the Provider Relief Fund (PRF) to be distributed to qualified health care service and support providers for:
- Appropriate expenses
- Lost revenue due to COVID-19
- Helping uninsured Americans access COVID-19 testing and/or treatment
The Coronavirus Aid, Relief, and Economic Security (CARES) Act appropriated $100 billion, and the Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA) appropriated $75 billion, to this program. The program is administered by UnitedHealth Group through a contract with the Health Resources & Services Administration (HRSA).
Payments from the Provider Relief Fund do not need to be repaid by providers who comply with the program’s terms and conditions.
Information for Uninsured Patients
According to HHS.gov: “Providers who participate in and are reimbursed from the HRSA COVID-19 Uninsured Program are not allowed to “balance bill” individuals who do not have health care coverage (uninsured).”
If you are an uninsured patient and you receive a bill for COVID-19 testing and/or treatment services which shows that a portion of the bill was paid for by the Health Resources & Services Administration (HRSA), you should contact your healthcare provider as you may not be responsible for the balance.
However, if your provider did not participate in the HRSA COVID-19 Uninsured Program or the care you received was not eligible for reimbursement from the program’s funds, you may be responsible for payment.
Applying for Reimbursement Through the CARES Act Provider Relief Fund
The deadline to apply for Phase 2 General Distribution funding has been extended to September 13, 2020. Providers should check the HHS.gov website for the latest updates on deadlines and requirements.
Key conditions for reimbursement from the Provider Relief Fund include:
- Screening patients for health coverage to ensure they are uninsured.
- Accepting the payment provided from the fund and refraining from further billing the patient.
- Submitting to a post-payment audit.
- Confirming that COVID-19 is the primary diagnosis (except in the case of pregnancy).
Additional points to keep in mind:
- Reimbursement is generally at Medicare rates and payment is dependent upon available funding.
- Qualifying health costs and services such as COVID-19 testing, office visits, telehealth, non-emergency transportation, and more, with dates of service/admittance on or after February 4, 2020, are eligible for reimbursement.
- Claims cannot be repealed or reprocessed after submission.
- To submit claims electronically, providers need a clearinghouse or similar relationship.
- Providers must attest that the information submitted is correct (billing companies/revenue cycle vendors can attest to the accuracy of the information for the provider).
EligibilityAdvocates can help providers apply for reimbursement from the CARES Act Provider Relief Fund, navigate regulatory flexibilities related to COVID-19, and screen patients for insurance coverage.
Contact us for more information on the CARES Act Provider Relief Fund or to get started on the application process before the deadline.