Congress created the Provider Relief Fund in the Coronavirus Aid, Relief, and Economic Security (CARES Act) in late March and has appropriated $175 billion to cover physician and hospital lost revenue and additional unreimbursed expenses related to the COVID-19 pandemic. The fund also covers care provided to uninsured COVID-19 patients.   

On April 10, 2020, the U.S. Department of Health and Human Services (HHS) began automatically distributing $30 billion directly to physicians, hospitals and other health care providers based on historical fee-for-service Medicare payments.  

On April 24, 2020, HHS announced a second phase of $20 billion in funding for a total of $50 billion. Hospitals directly received payments in the second phase, and physicians who received some of the first $30 billion in payments are eligible but must apply for this additional funding.

This week HHS clarified the Provider Relief Fund payment allocation methodology and eligibility. A provider’s estimated total allocation (from both the $30 billion tranche and the $20 billion tranche) should be approximately 2% of their 2018 gross patient revenue. 

Providers should not apply for the second tranche of funding if the payments they have already received exceed their estimated total allocation. Providers who believe they have received an overpayment should contact the HHS provider relief hotline at (866) 569-3522.

Funding is also set aside to reimburse providers for care provided to uninsured COVID-19 patients.

According to HHS, half of the second $20 billion tranche has already been distributed and that numerous providers have applied for the uninsured funding. Eligible physicians are encouraged to apply to both funds immediately. See the CMA Financial Toolkit for Medical Practices for more information on how to apply and how to estimate your total allocation

HHS continues to report that it intends for funding to be distributed to Medicaid providers in the near future.