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The Department of Health and Human Services (HHS) released an initial $30 billion in relief funding to Medicare providers today as part of the CARES Act, bringing the total to be distributed in the coming months to more than $100 billion. Pennsylvania has been allocated more than $1 billion in funding, which is one of the highest distribution amounts in the country.

Providers who are enrolled in Medicare have been allotted a portion of these funds based on their share of 2019 Medicare fee-for-services reimbursements. These are payments, not loans, to health care providers and will not need to be repaid.

HHS is partnering with UnitedHealth Group to deliver the initial $30 billion distribution to providers as quickly as possible. Providers will be paid via Automated Clearing House account information on file with UHG, UnitedHealthcare, or Optum Bank, or used for reimbursements from CMS. Providers who normally receive a paper check for reimbursement from CMS will receive a paper check in the mail for this payment as well, within the next few weeks.

Within 30 days of receiving the payment, providers must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions of payment. The portal for signing the attestation will be open Monday and will be available here.

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CMS provided clarification around the suspension of sequestration in a special edition of MLNConnects: Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.

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From ACCSES:

The Federal Reserve made an announcement today that it would provide up to $2.3 trillion in loans to boost the economy. One of the loans they are creating is the Main Street Lending Program, which the Fed says “will enhance support for small and mid-sized businesses that were in good financial standing before the crisis by offering 4-year loans to companies employing up to 10,000 workers or with revenues of less than $2.5 billion. Principal and interest payments will be deferred for one year.

Firms seeking Main Street loans must commit to make reasonable efforts to maintain payroll and retain workers. Borrowers must also follow compensation, stock repurchase, and dividend restrictions that apply to direct loan programs under the CARES Act. Firms that have taken advantage of the PPP may also take out Main Street loans.”

The Federal Reserve announcement went on to say, “The Federal Reserve and the Treasury recognize that businesses vary widely in their financing needs, particularly at this time, and, as the program is being finalized, will continue to seek input from lenders, borrowers, and other stakeholders to make sure the program supports the economy as effectively and efficiently as possible while also safeguarding taxpayer funds.” Comments may be sent to the feedback form until April 16. The feedback form is here.

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The Centers for Medicare and Medicaid Services (CMS) received direction from President Trump to temporarily suspend a number of rules so that hospitals, clinics, and other health care facilities can boost their frontline medical staff as they take on the COVID-19 pandemic. The changes will focus on reducing supervision and certification requirements in order for practitioners to be hired quickly and perform work to the fullest extent of their licenses. As a result of this action, doctors can now directly care for patients at rural hospitals, across state lines if necessary without being physically present; Nurse practitioners can now perform some medical exams on Medicare patients at skilled nursing facilities so that patient needs can be met; Occupational therapists from home health agencies can now perform initial assessments on certain homebound patients; and Hospice nurses will be relieved of hospice aide in-service training tasks so they can spend more time with patients.

For additional guidance, CMS has published a list of workforce flexibilities that CMS has permitted thus far.

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Yesterday during the DHS weekly briefing, DHS Secretary Teresa Miller provided a progress update to where the Department is with fingerprinting.

DHS explained that many of the IdentGO locations are beginning to reopen and/or expand hours of operation; we encourage anyone needing fingerprints to call the closest locations to verify whether they are operating, as this may begin to change. See the Pennsylvania Statewide interactive MAP of IdentGO locations.

DHS is not able to broadly waive this requirement from the state level because it is contained in numerous federal laws like the Family First Prevention Services Act, the Adam Walsh Act, and the Child Care Development Block Grant Act.

DHS has released guidance on waiving licensing requirements in Personal Care Homes and Assisted Living Residences – but understand that this guidance does not align with information just issued by the Department of Aging. DHS is working with the Department of Aging to address the discrepancies and will provide clarification.

For those who first obtained clearances in 2015 following changes to the Child Protective Services Law who will need to renew these clearances this year, DHS is open to temporarily delaying the five-year requirement, but this would need to happen through legislative action. DHS and the Governor’s Office are working with the legislature to try to accomplish this; however, this cannot be the only option. DHS is also pursuing potentially opening additional, temporary fingerprinting sites that can help us meet this need.

RCPA will continue to update members on any further developments. If you have questions or feedback, please contact RCPA Children’s Director Jim Sharp.

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