Yet another provision of the “Coronavirus Aid, Relief, and Economic Security Act” (CARES Act) will directly impact doctors who billed Medicare in 2019. Although initial indications were this provision would focus on hospitals, the federal government has allocated $30 billion in “relief funds” that will include individual providers including chiropractic physicians. This is NOT a loan. Instead, it is an automatic grant.

To determine your portion of the funds, you would take your Medicare reimbursable billings (i.e. Medicare allowed charges for 98940, 98941, 98942) divided by $484 billion (total Medicare billings in 2019) and multiply by $30 billion. A doctor who had $32,250 in Medicare allowed charges billings in 2019 would receive approximately $2,000 (32,250 / 484,000,000,000 x 30,000,000,000 = 1,999).

Beginning Friday, April 10, the funds will be automatically deposited into your bank account via Optum Bank (CMS partner in this project) with “HHSPAYMENT” as the payment description. If you are typically paid by Medicare via check, then your funds will arrive in the next 2 weeks.

[Updated 5/11/2020] HHS has placed “terms and conditions” on the funds that must be accepted within 45 days (was 30 days) of receipt through the HHS portal starting sometime in the week of April 13 which will be located on the provider relief fund page. Included in those conditions:

  • “Providers must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider;”
  • “The Recipient certifies that it will not use the Payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.” This would include funds for PPP loans or EIDL loans;
  • “shall reimburse the Recipient only for health care related expenses or lost revenues that are attributable to coronavirus.” Thus, lost revenues are a component of these funds that would NOT be included in the PPP or EIDL funds.
  • Recipient must also keep documentation regarding the use of the funds.

[Updated 5/11/2020] Additionally, HHS has indicated that if the terms and conditions are not accepted within the 45-day timeframe and the funds are not returned, they will automatically assume the provider agrees to the terms and conditions.

HHS gives further clarification of intent on the main relief page:

  • “This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.
  • If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.” [emphasis added]

More information is available on the HHS provider relief site.