The deadline has been extended to Aug. 3 for eligible physicians to apply for a special distribution of about $15 billion that will be targeted to doctors who care for patients enrolled in Medicaid and CHIP but have not yet received payments from the federal Health Care Provider Relief Fund.
The Provider Relief Fund, created by the Coronavirus Aid, Relief and Economic Security (CARES) Act, has assisted physician practices and health care facilities facing severe expenses and revenue losses caused by the public health emergency.
The AMA has been advocating for additional funds with a wider distribution because initial distribution only supported Medicare-enrolled physicians and facilities. Pediatric and OB-GYN practices and others with no Medicare patients still need help.
Initial distribution of payments covered about 62% of health care providers who participate in state Medicaid and CHIP programs, HHS reported. The remaining 38% of Medicaid and CHIP providers and will be the focus of the special distribution.
HHS has noted that many of these practices are safety net providers operating on thin margins.
Payment amounts will be at least 2% of reported gross revenue from patient care, and the final amount will be determined based on submitted data, according to an HHS fact sheet.
The Provider Relief Funds may be used to cover lost revenue attributable to COVID-19 or health-related expenses purchased to prevent, prepare for, and respond to coronavirus, the fact sheet states.
Requirements for eligibility
HHS lists the following requirements to be eligible for the distribution:
- Must not have received payment from the $50 billion distributed so far to Medicare providers.
- Must have billed Medicaid or CHIP programs or Medicaid managed care plans for health care-related services between Jan. 1, 2018 and Dec. 31, 2019.
- Must have filed a federal income tax return for fiscal years 2017, 2018 or 2019; or be exempt from filing a return.
- Must have provided patient care after Jan. 31.
- Must not have permanently ceased providing patient care.
- Must have reported on Form 1040 (or other tax form) gross receipts or sales from providing patient care.
Instructions and an application form can be downloaded from hhs.gov/providerrelief and physicians can use the CARES Act Provider Relief Fund Payment Attestation Portal to report expenses or lost revenue due to COVID-19.
Remedy sought for ineligible providers
The AMA has made HHS aware of a particular issue involving physicians who primarily care for patients with Medicaid or CHIP coverage but received a small sum from the automatic Medicare allotment in April because they may have treated patients with Medicare coverage.
Currently, those physicians are ineligible for this round of funding—even if they rejected or returned the money. HHS has indicated that they are working on a policy solution for this issue, and the AMA has pledged to remain engaged with HHS in finding a remedy.
In addition to advocating for physicians with HHS, the AMA has also lobbied Congress to provide relief to physician practices facing hardships due to COVID-19.
Learn more about the AMA’s COVID-19 advocacy efforts and track the pandemic with the AMA's COVID-19 resource center, which offers resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.