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News & Press: Government Affairs News

HHS Provides Additional Guidance on Provider Relief Payments

Tuesday, May 12, 2020   (0 Comments)
Posted by: Bradley Coffey, MA, AAOE Government Affairs
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Washington, DC - The Department of Health and Human Services (HHS) has updated its FAQs on the agency's provider relief funding provided in the CARES Act. Of note, HHS writes that it views every patient treated since January 31, 2020 as a possible case of COVID-19 making it easier for orthopedic surgeons to agree to the terms and conditions of payment which require that providers receiving funds must have diagnosed, tested, or cared for individuals with possible or actual cases of COVID-19.

Additionally, HHS provides greater clarity on how to decline payment should a provider not wish to accept the funding. If declining payment, the provider, or their representative, must contact their financial institution and ask the institution to refuse the automated clearinghouse (ACH) payment by initiating an ACH return using the return code "R23 - Credit Entry Refused by Receiver". If payment was initially received by ACH, the money must be returned via ACH. If payment was received by a paper check, the provider must destroy the check after rejecting the payment in the attestation portal or mail the paper check to UnitedHealth Group with notification of their request to return the funds.

$50 billion of the $100 billion appropriated in the CARES Act are allocated to "general distribution" payments with $30 billion of these payments having already been distributed in April 2020. Many orthopedic surgeons that have applied for the additional $20 billion in general distribution funding are still waiting for word from HHS on approval of additional funding. This may take some time according to HHS. The agency will be processing applications in batches every Wednesday at 12:00 pm EST and funding will not be distributed on a first-come-first-serve basis. HHS indicated that it intended to distribute the additional funding within 10 business days of the submission however, the likely volume of applications is likely extending this goal.

The additional $50 billion in CARES Act funding will be distributed via targeted distributions to providers in areas hit hard by COVID-19, providing COVID-19 care to uninsured Americans, rural providers, and the Indian Health Service.

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