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Tag: CARES Act

CARES Act Funding Update

HHS allocates $14 billion in targeted “Round Two” payments.
Toyon’s August Series of CARES Updates

Toyon is pleased to provide this update on the CARES Act Public Health and Social Services Emergency Fund (PHSSEF). Toyon’s updates on the PHSSEF will be issued as a series this August. The first update applies to “Round Two” of CARES relief funding from July 2020. During the rest of August, Toyon will be providing these other important updates:

  • Toyon’s Take on HHS Reports due February 14, 2021 – HHS is releasing funding and documentation reporting instructions by August 17. Recipients have 45 days from the end of 2020 (Sunday, February 14, 2021) to report COVID-19 related expenditures through December 31, 2020.
  • Toyon’s Take on PHSSEF and Cost Reporting – Key takeaways on the importance of filed cost reports and the PHSSEF.

 

In July, HHS announced a second round of $14 billion related to three targeted distributions from the PHSSEF.

  • $10 billion High Impact Payments

  • $3 billion Safety Net Payments

  • $1 billion Rural Payments

 

 

 

 


Toyon is preparing estimates on PHSSEF qualification and funding for hospitals nationally. Please contact Fred Fisher if you would like an evaluation for your hospital(s).

Fred Fisher — fred.fisher@toyonassociates.com
888.514.9312
Toyon’s Covid-19 Funding Resources


HHS Releases $14 billion of “Round Two” Funds
Listed below is further insight on HHS’s Round Two targeted funding distributions totaling $14 billion. Based on a current tally of the PHSSEF, HHS committed to spend $116.4 billion of the $175 billion, leaving $58.6 billion remaining in the fund (not accounting for the HRSA COVID-19 Uninsured Program).

$10 Billion Round Two High Impact Payments
On July 17, HHS announced distribution of High Impact payments eligible to more than 1,000 providers
reporting any of the following (based on data submitted June 15):

  • Over 161 COVID-19 admissions between January 1 and June 10, 2020.
  • One COVID-19 admission per day.
  • A disproportionate intensity of COVID admissions that exceeds the average ratio of COVID
    admissions per bed. Responding to an FAQ dated July 22, HHS states the average
    admissions per bed ratio (threshold) is 0.54864.

Eligible hospitals are paid $50,000 per COVID-19 admission. In Round One, payment per admission
was $76,975, and included a DSH add-on. High Impact payments received from Round One were
considered in the second distribution.
As of August 3,HHS distributed $9.1 billion of the 10 billion, leaving $900 million HHS will likely be
paying hospitals over the coming weeks.

$3 Billion Round Two Safety Net Payments
On July 10, HHS announced $3 billion in Round Two distribution of Safety Net payments. In this
Second Round, HHS acknowledged shortcomings of qualifying hospitals for safety net payments in
Round One. HHS accounts for recognizing an additional 215 hospitals as safety nets in Round Two by
expanding safety net criteria as follows:

  • Like Round One, providers must have an Uncompensated Care Cost per Bed measurement at
    or over $25,000. In Round Two, HHS corrected this measurement, “annualizing” this data, so
    hospitals with short cost reporting periods are properly evaluated.
  • Like Round One, providers must also have a profitability margin of 3% or less to qualify for
    safety net payments. In Round Two, HHS expanded this measurement by evaluating 5 years of financial data reported on the Medicare cost report Worksheet G-3 (as opposed to Round One whereby HHS evaluated one year of financial data). Hospitals qualified in Round Two with a
    “profit margin threshold of less than or equal to 3% averaged consecutively over two or more of
    the last five cost reporting periods.”
  • In Round Two, providers still must have a DSH percentage equal to or greater than 20.2% to
    qualify for safety net funds (no change from Round One).

$1 Billion in Round Two Rural Payments
On July 10, HHS also announced $1 billion in Round Two distributions for rural providers. In Round Two, sole community hospitals (SCH), Medicare dependent hospitals (MDH), and hospitals in small metro areas with fewer than 250,000 people qualified for payment. Hospitals are eligible for funds of 1% of operating expenses with a minimum payment of $100,000, a supplement of $50 for each “rural inpatient day,” and a maximum payment of $4.5 million. HHS also made payments to rural inpatient psychiatric facilities, inpatient rehabilitation facilities, and long-term acute care hospitals.

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IMPORTANT COVID-19 HOSPITAL FUNDING UPDATE

 

 

 

 

 

1. Important Deadline:

June 15 is the deadline to submit January 1 through June 10 COVID-19 inpatient admissions for the next round of High Impact Funding.

2.  HHS released updated FAQs including:

  • Reporting COVID-19 admissions.
  • Reporting expenses and lost revenues.
  • Clarifications for parent organizations with subsidiaries.

3. HHS allocated $25 billion toward:

  • $15 billion for Medicaid & CHIP providers.
  • $10 billion for Safety Net Hospital Funding.

 

Toyon is pleased to provide this update on the CARES Act Public Health and Social Services Emergency Fund (PHSSEF).   For more information, or to contact any of our team members, please feel free to visit Toyon’s website.

1. Important Deadline: Monday June 15
HHS contacted all hospitals requesting COVID-19 positive-inpatient admissions for January 1 through the end of the day June 10.  These cases will be used for the second round COVID-19 High Impact funding.  Funding from the first round of High Impact Payments will be taken into account in the second round.  Hospitals have until June 15 (9 PM EDT) to submit admission detail.  Toyon recommends hospitals evaluate HHS’s FAQs and contact TeleTracking for assistance 
(877-570-6903).
 
2. Observations from Updated FAQs
The CARES Act Provider Relief Fund FAQs were last updated Tuesday June 9.   Listed below are notable updates by category:
 
 
Reporting COVID-19 Admissions:
  • Patients with a pending positive test that came back positive after June 10 are not allowed in COVID-19 admissions data due June 15.
  • Do not include emergency department patients in COVID-19 admissions data.
  • Admissions occurring at multiple campuses, under the same TIN, should be reported separately and not rolled up into one count.
  • If the prior submission of COVID-19 positive admissions was submitted in error (i.e., all COVID-19 positive admissions submitted by system instead of by facility), HHS requests providers to use TeleTracking to correct and update the data to reflect all COVID-19 positive inpatient admissions from January 1 through June 10.
CARES Provider Relief Funding
  • HHS expects providers will only use Provider Relief Fund payments for permissible purposes. If, at the conclusion of the pandemic, providers have leftover Provider Relief Fund money that cannot be expended on permissible expenses or losses, then providers will return this money to HHS. 
COVID-19 Expenses and Lost Revenues
  • HHS will be providing further guidance about the type of documentation to provide per the terms and conditions (e.g., documentation due with quarterly reports July 10).  
  • HHS clarifies the term “healthcare related expenses attributable to coronavirus” is a broad term for determining eligibility of expenses and lost revenues eligible for reimbursement including:
    • supplies used to provide healthcare services for possible or actual COVID-19 patients,
    • equipment used to provide healthcare services for possible or actual COVID-19 patients,
    • workforce training; developing and staffing emergency operation centers; reporting COVID-19 test results to federal, state, or local governments,
    • building or constructing temporary structures to expand capacity for COVID-19 patient care or to provide healthcare services to non-COVID-19 patients in a separate area from where COVID-19 patients are being treated; and
    • acquiring additional resources, including facilities, equipment, supplies, healthcare practices, staffing, and technology to expand or preserve care delivery.
  • Providers may have incurred eligible health care related expenses attributable to coronavirus prior to the date on which they received their payment.  HHS expects that it would be highly unusual for providers to have incurred eligible expenses prior to January 1.
  • The term “lost revenues that are attributable to coronavirus” means any revenue lost to providers due to the coronavirus. 
  • HHS encourages the use of funds to cover lost revenue so providers can respond to the coronavirus public health emergency to cover employee or contractor payroll, employee health insurance, rent or mortgage payments, equipment lease payments and electronic health record licensing fees.
Parent Organizations and Subsidiaries
  • Parent organizations with multiple billing TINs that each received payments, may attest and keep the payments as long as providers associated with the parent organization were providing diagnoses, testing, or care for individuals with possible or actual cases of COVID-19 on or after January 31 and can otherwise attest to the Terms and Conditions.  The parent organization can allocate funds at its discretion to its subsidiaries. If the parent organization would like to control and allocate Provider Relief Fund payments to its subsidiaries, the parent organization must attest to accepting its subsidiaries’ payments and agreeing to the Terms and Conditions.
  • Providers with TINs covering all business lines can report lost revenues under the same TIN that are actively caring for patients with COVID-19 or actively working to prevent the spread of COVID-19.
  • Parent entities, submitting revenue information on behalf their subsidiaries may encounter an issue if they have multiple Medicare/Medicaid provider numbers (there is only one space in the HHS Portals to populate these numbers). HHS states these providers should submit a statement on the first page of the uploaded tax return file stating (i) the parent entity’s Filing TIN and that it does not bill Medicare and (ii) a schedule of the billing subsidiaries, their Billing TINs, their Medicare/Medicaid ID numbers, and gross sales or receipts.
On Tuesday, June 9, HHS announced the following funding allocations:
  • $15 billion Medicaid and CHIP funding to eligible providers that participate in state programs and have not received a payment from the Provider Relief Fund General Distribution. Approximately one million health care providers may be eligible for this funding.
  • $10 billion safety net funding to approximately 760 hospitals. HHS states the safety net distribution will occur this week. Recipients will receive a minimum payment of $5 million and a maximum payment of $50 million. In order to qualify for this funding, hospitals must have:
    • A Medicare Disproportionate Payment Percentage (DPP) of 20.2 percent or greater,
    • average Uncompensated Care per bed of $25,000 or more, and
    • profitability of 3 percent or less, as reported to CMS in its most recently filed Cost Report.

Toyon has updated our Provider Relief Fund estimates to include hospitals eligible for safety net funding. This information will soon be available on our website. In the meantime if you have any questions on these estimates, please contact Fred Fisher at 888.514.9312, fred.fisher@toyonassociates.com.  
 
Toyon is committed to apprising providers with important reimbursement updates and will keep you updated with the latest on UC DSH and COVID-19 funding and documentation. Please feel free to visit Toyon’s COVID-19 Resources for updates on hospital funding estimates, and recommendations on documenting cost and revenue losses associated with this public health emergency. Toyon’s website provides information on how to contact Toyon’s team members.  
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