$30 Billion Is Being Infused Into the Health Care System: Who Is Receiving Money and What You Should Know If You Keep It

Who is eligible for this initial rapid distribution?

• All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019.

How are the payments being distributed?

• All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN). Thus, employed physicians and physicians who are part of a group will not receive the payment directly; the payment will be received like a routine payment for medical services.
• Payments to practices that are part of larger medical groups will be sent to the group’s central billing office.
• The direct deposit will come via Optum Bank with “HHSPAYMENT” as the payment description.
• Providers that normally receive a paper check for reimbursement from CMS will receive a paper check in the mail.

How much can you expect to receive?

• Health care providers can anticipate receiving an amount that is proportional to their billing of the total FFS payments in 2019, which was approximately $484 billion.
• HHS provides the following formula: A provider can estimate their payment by dividing the 2019 Medicare FFS payments they received (not including Medicare Advantage) by $484,000,000,000, and multiply that ratio by $30,000,000,000. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.

What’s the catch?

• Not returning the money within 30 days will be considered an acceptance of the Terms and Conditions, even if an attestation was not provided.

What do you need to do?

• The Terms and Conditions impose very strict recordkeeping requirements and depending on the amount received, there might be an affirmative duty to submit reports quarterly.

• Additionally, the money cannot be used to cover expenses that have already been reimbursed through other sources or that other sources are obligated to reimburse.