The Latest Provider Relief Fund Updates from HHS

Members & Publications

May 8, 2020

The Department of Health and Human Services (HHS) continues to release updates regarding the CARES Act Provider Relief Fund allocations released over the past month. Providers who received a payment through this program and intend to keep the money are required to complete an attestation through the HHS attestation portal, which includes verification of the amount(s) received and an agreement to abide by the Terms and Conditions. HHS has also provided FAQ resources. We note that both the Terms and Conditions and the FAQ resources have changed over time and could do so again in the future.

Earlier this week, HHS announced:

  • A refined formula HHS is using to calculate total allocations for all providers. This formula may result in some providers having received funds in excess of the amount HHS calculates as due to them under the new formula, while other providers may now be eligible for additional allocation.
  • A public release of the names of providers who have received allocations through the program and have attested to the terms and conditions. This public release includes the name, city, state, and amount of allocation for each provider.

AAPM&R offers the following considerations as providers are reviewing the program and determining next steps:

  • With the release of new information about the Provider Relief Program, some providers may be considering whether or not to return these funds and not participate in the program. If you have already signed the attestation, it is our understanding that you do still have the option to return funds and withdraw your attestation. This can be achieved by asking your bank to remit the full amount of the allocation and by contacting the CARES Provider Relief Hotline at (866) 569-3522.
  • Under the updated formula, a provider’s total Provider Relief Fund allocation can be estimated by dividing your “gross receipt sales” or “program service revenue” by 2.5 trillion and then multiplying by 50 billion – ((gross receipts or sales) / 2,500,000,000,000) * 50,000,000,000. This estimate may result in an amount lower than the amount the provider already received (we anticipate this may be the case for providers for whom Medicare fee-for-service revenues are between 32-33% or higher of total revenues). HHS FAQs have indicated that HHS will not seek to recoup funds for overpayments made from the Provider Relief Fund; however, the FAQs are subject to change, and this statement is not formalized as a promulgated regulation.
  • In addition to completing the attestation, HHS is also asking those who have received funds to submit revenue information through a general distribution portal. Submission of revenue data would provide HHS with the information they need to make further allocations if additional funds are available.

We recognize that there is continued confusion around this program. As we understand it, HHS has pushed to get funds out to providers as quickly as possible, making it challenging to keep HHS’ informational resources and communications up-to-date. We continue to urge caution with respect to accepting the allocated funds and advise a detailed review of the terms and conditions with a legal, financial, and/or tax professional. In addition, we recommend maintenance of detailed documentation of decision-making related to the allocations received, and if the money is spent, a detailed accounting of how the money was utilized given the HHS statements that recipients will be subject to future reporting requirements and audits.   


Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.