This week, HHS announced the opening of a new round of PRF disbursements, Phase 3. The department has allocated $20 billion of the PRF for behavioral health care providers and new providers that began practicing in the first quarter of 2020. These providers may submit applications for payment until November 6th, 2020, and providers that previously received, rejected, or accepted a General Distribution PRF payment of two percent of annual revenue from patient care may also apply for this round of funding. Click here to view HHS’s PRF Phase 3 factsheet!

In September, HHS released reporting requirements for remaining Provider Relief Fund (PRF) dollars, in some cases requiring repayment. The terms and conditions have caused significant heartburn for many providers, and NRHA believes HHS’s determination runs askew of congressional intent. Notably, on October 1st, Senate Majority Leader Mitch McConnell responded to HHS’s new reporting requirements saying, in part, “HHS must not impose requirements that will disproportionately affect rural hospitals that already operate on thin margins.”

The Centers for Disease Control and Prevention (CDC) has issued a Health Alert Advisory (HAN) for recent HIV clusters and outbreaks occurring across the U.S. in people who inject drugs and considerations during the COVID-19 pandemic. The purpose of the HAN is to alert public health departments and healthcare providers to the possibility of new injection-related HIV infections and outbreaks. It provides guidance for preventing, identifying, and responding to HIV among people who inject drugs. It also provides considerations for delivering services in the context of the COVID-19 pandemic.

CDC has released COVID-19 one-stop shop toolkits. The toolkits provide guidance to communicate with specific target audiences, such as young adults, childcare programs and summer camps, K-12 schools, and workplaces. They include videos, social media, PSAs, print resources, checklists, FAQs and web resources. Use and tell your patients about these communication toolkits to help meet their diverse needs to slow the spread of COVID-19.

Providers are encouraged to apply for the latest round of Provider Relief Fund (PRF) support. Applications will be considered regardless of whether your organization was previously eligible for, applied for, received, accepted, or rejected prior PRF payments. For this newest phase, funding will be allocated to providers based on assessed financial losses and changes in operating expenses caused by COVID-19.  For more information about the Phase 3-General Distribution, please visit the Provider Relief Fund webpage.

Apply here through November 6

Register for the webcast on October 15 at 3 p.m. ET to learn more.

The U.S. Department of Health and Human Services (HHS) and Department of Defense (DoD) on Sept. 16 released two documents outlining the Trump Administration’s detailed strategy to deliver safe and effective COVID-19 vaccine doses to the American people as quickly and reliably as possible. The documents, developed by HHS in coordination with DoD and the Centers for Disease Control and Prevention (CDC), provide a strategic distribution overview along with an interim playbook for state, tribal, territorial and local public health programs and their partners on how to plan and operationalize a vaccination response to COVID-19 within their respective jurisdictions. Access the plan and additional information here.

President Trump tweeted this week that, “I have instructed my representatives to stop negotiating until after the election when, immediately after I win, we will pass a major Stimulus Bill that focuses on hardworking Americans and Small Business. “Stocks fell, and even his allies were baffled by this move. He then tweeted the next evening, “If I am sent a Stand Alone Bill for Stimulus Checks ($1,200), they will go out to our great people IMMEDIATELY. I am ready to sign right now. Are you listening Nancy?” Indications are if there is another stimulus package it will be only stimulus checks. The House last week passed a $2.2 trillion stimulus package which included $7.6 billion for FQHCs.

The Centers for Medicare & Medicaid Services (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress. This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations. Under the Continuing Appropriations Act, 2021 and Other Extensions Act repayment will now begin one year from the issuance date of each provider or supplier’s accelerated or advance payment. CMS issued $106 billion in payments to providers and suppliers in order to alleviate the financial burden healthcare providers faced while experiencing cash flow issues in the early stages of combating the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE).

“In the throes of an unprecedented pandemic, providers and suppliers on the frontlines needed a lifeline to help keep them afloat,” said CMS Administrator Seema Verma. “CMS’ advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors. While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal,” she added.

CMS expanded the AAP Program on March 28, 2020 and gave these loans to healthcare providers and suppliers in order to combat the financial burden of the pandemic. CMS successfully paid more than 22,000 Part A providers, totaling more than $98 billion in accelerated payments. This included payments to Part A providers for Part B items and services they furnished. In addition, more than 28,000 Part B suppliers, including  doctors, non-physician practitioners, and Durable Medical Equipment (DME) suppliers, received advance payments totaling more than $8.5 billion.

Providers were required to make payments starting in August of this year, but with this action, repayment will be delayed until one year after payment was issued. After that first year, Medicare will automatically recoup 25 percent of Medicare payments otherwise owed to the provider or supplier for eleven months. At the end of the eleven-month period, recoupment will increase to 50 percent for another six months. If the provider or supplier is unable to repay the total amount of the AAP during this time-period (a total of 29 months), CMS will issue letters requiring repayment of any outstanding balance, subject to an interest rate of four percent.

The letter also provides guidance on how to request an Extended Repayment Schedule (ERS) for providers and suppliers who are experiencing financial hardships. An ERS is a debt installment payment plan that allows a provider or supplier to pay debts over the course of three years, or, up to five years in the case of extreme hardship. Providers and suppliers are encouraged to contact their Medicare Administrative Contractor (MAC) for information on how to request an ERS. To allow even more flexibility in paying back the loans, the $175 billion issued in Provider Relief funds can be used towards repayment of these Medicare loans. CMS will be communicating with each provider and supplier in the coming weeks as to the repayment terms and amounts owed as applicable for any accelerated or advance payment issued.

To view the fact sheet, click here: Fact Sheet
To view the frequently asked questions click here: FAQs

The Paycheck Protection Program and Health Care Enhancement Act authorized the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), to provide $225 million to RHCs for COVID-19 testing and related expenses. Beginning May 20, 2020, HRSA issued funding as one-time payments to RHC organizations of $49,461.42.

The terms and conditions for this program specify that, “The Recipient shall submit reports as the Secretary determines are needed to ensure compliance with conditions that are imposed on this Payment, and such reports shall be in such form, with such content, as specified by the Secretary in future program instructions directed to all Recipients.”

To monitor and assess the program, HRSA has established a set of proposed measures that funded RHCs report back to HRSA at the Tax Identification Number (TIN) level. This brief set of proposed measures includes basic information on the RHC organization, the number of and location of testing sites (active and inactive), information on the use of funds, the total number tests conducted, and the number of COVID-19 positive tests.

HRSA proposes to use this information to evaluate the effectiveness of the program at an aggregate level. As proposed, funded organizations must report the number of tests conducted and the number of positive tests on a monthly basis for the duration of the reporting period retroactively to May 2020. No personally identifiable, patient-level information is being requested.

HRSA will be in contact with RHCs in the coming weeks with more information on the RHC COVID-19 Testing Reporting (RHC CTR) website, upcoming webinar, and other additional information. Please forward the email to the best contact for your RHCs COVID-19 Testing Program and cc: RHCCOVID-19Testing@hrsa.gov if you are the incorrect recipient. HRSA has funded the National Association of Rural Health Clinics to provide technical assistance to RHCs on the RHC COVID-19 Testing Program.

If you have additional questions you may email RHCcovidreporting@narhc.org.

HRSA Rural Health Clinic COVID-19 Testing Program Team
RHCCOVID-19Testing@hrsa.gov
To subscribe or unsubscribe from the RHC COVID-19 Testing Program mailing list, click here.

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

• Increase Hospital Capacity – CMS Hospitals Without Walls;
• Rapidly Expand the Healthcare Workforce;
• Put Patients Over Paperwork; and
• Further Promote Telehealth in Medicare

Next Office Hours:

Tuesday, October 13^th at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 6379959
Audio Webcast link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2607

Tuesday, October 27^th at 5:00 – 6:00 PM Eastern – save the date, dial in to be provided

Weekly COVID-19 Care Site-Specific Calls

CMS hosts calls for certain types of organizations on an intermittent basis to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

Nursing Homes

Wednesday, October 14th at 4:30 – 5:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1897041 Audio Webcast Link: https://engage.vevent.com/rt/cms2/index.jsp?seid=2622

Wednesday, October 28^th at 4:30 – 5:00 PM Eastern – save the date, dial in to be provided

 For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.