COVID-19 Funding Resources

KHA Summary of Funding for Hospitals During COVID-19 Crisis

KHA Webinars on Funding Resources for Hospitals

Funding Resources for Hospitals 4-2-20

Compliance Issues Related to the Receipt of COVID-19 Funding (King & Spalding) 5-20-20

Medicare Cost Report Implications and Tracking Costs 5-28-20

CARES Act Overview

       KHA Contacts: Audrey Dunkel and Tish Hollingsworth

The Coronavirus Aid, Relief, and Economic Security (CARES) Act, Public Law 116-136, signed into law on March 27, included $100 billion in Public Health and Social Service Emergency Fund appropriations to be distributed by grants or other payment mechanisms to healthcare providers for expenses or lost revenues attributable to COVID-19 not reimbursable to by other sources.  Providers will be reimbursed through grants and other payment mechanisms.

 

Coronavirus Relief Fund

       KHA Contact: Audrey Dunkel

The CARES Act provides $150 billion in assistance for governments in states, territories and tribal areas through the Coronavirus Relief Fund. Eligibility is dependent on the location, level of government, and use of potential funds. The funds can be used to pay for three types of programs:

  1. Programs that are necessary expenditures incurred due to the public health emergency with respect to COVID-19;
  2. Programs that were not accounted for in the budget most recently approved as of the date of enactment (3-27-20) of this section for the State or government; and
  3. Programs that were incurred during the period that begins on 3-1-20 and ends on 12-3-20.

 

Federal Reserve Emergency Lending Program

       KHA Contact: Audrey Dunkel

 

Public Health and Social Services Emergency Fund (PHSSEF)

      KHA Contacts: Audrey Dunkel and Tish Hollingsworth

The CARES Act includes $100 billion in Public Health and Social Service Emergency Fund appropriations to be distributed by grants or other payment mechanisms to healthcare providers for expenses or lost revenues attributable to COVID-19 and not reimbursable by other sources.  Providers will be reimbursed through grants and other payment mechanisms.  The Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA) became law on April 24 providing more funding to health care providers by adding $75 billion to the CARES Act Provider Relief Funding (see more information below).

   -   CARES Act Provider Relief Fund General Distribution ($30 billion)

      KHA Contact: Tish Hollingsworth
In order to expedite emergency funds to hospitals and health systems from the CARES Act, HHS disbursed $30 billion to all facilities and providers that received Medicare fee-for-service payments in 2019.  Health care providers received a disbursement on either April 10 or April 17 based on their share of the total 2019 Medicare fee-for-service (FFS) payments.

 

   -   CARES Act Provider Relief Fund General Distribution Round 2 ($20 billion)

      KHA Contact: Tish Hollingsworth

An additional tranche of $20 billion will be disbursed to a portion of providers on April 24 based on revenue data from their 2018 Medicare cost reports.  The payment made to each provider will take into account what they previously received under the first round of Provider Relief Funds, so that their total allocation under both waves ($50 billion total) is proportional to their share of 2018 total net patient revenue.  HHS states that on April 24th, a portion of providers will automatically be sent a payment based on the revenue data from their Medicare cost reports.  Providers without adequate cost report data must submit this information to a portal.

Payments will go out weekly, on a rolling basis, as information is validated.


   -   CARES Act Targeted Funding High-Impact Hospitals

      KHA Contact: Audrey Dunkel

The Department of Health and Human Services announced on July 17 that it would distribute an additional $10 billion from the PHSSEF to hospitals that have been highly impacted by COVID-19.  The second round of funding is based on a formula for hospitals with over 161 COVID-19 admissions between Jan. 1 and June 10, 2020, or one admission per day, or that experienced a disproportionate intensity of COVID admissions (exceeding the average ratio of a COVID admissions/bed).  Hospitals will be paid $50, per eligible admission.  The payments will go out to over 1,000 hospitals as early as July 20.  Kansas hospitals will receive approximately $22 million in additional funding.

On April 21, HHS announced that it would be distributing $10 billion to hospitals in areas that have been particularly impacted by the COVID-19 outbreak.  Hospitals have been asked to apply for the funds by submitting four pieces of data through the Teletracking website by 12:00 PM Pacific Time on Saturday, April 25, 2020.  Hospitals are being asked to provide: Tax Identification Number, National Provider Identifier, total number of Intensive Care Unit beds as of April 10, 2020, and total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020 to April 10, 2020.  In addition, HHS has indicated that the distribution formula will use Medicare Disproportionate Share Hospital (DSH) adjustment to make adjustments for hospitals serving a significantly disproportionate number of low-income patients.

   -   CARES Act Targeted Funding for Rural Providers ($10 billion)

      KHA Contact: Audrey Dunkel

On July 10, HHS announced that an additional $1 billion would be going out to specialty rural hospitals, urban hospitals with certain Medicare designations, and hospitals in small metropolitan areas.  The additional funding is an expansion of the criteria for the initial $10 billion rural payments and will go to 500 hospitals.

HHS is allocating $10 billion to rural hospitals and rural health clinics as early as the week of April 27 on the basis of operating expenses, using a methodology that distributes payment proportionately to each facility and clinic.

 
   -   CARES Act Targeted Funding for Medicaid and CHIP

      KHA Contact: Audrey Dunkel

HHS is allocating approximately $15 billion for Medicaid and CHIP providers who did not receive funding as part of the General Distributions of $30 and $20 billion.  The distribution amount will be approximately 2 percent of patient care revenue for the calendar year 2017, 2018, or 2019 as selected by the provider.  In order to be eligible, a provider:

  1. Must not have received payment from the $50 billion General Distribution; and
  2. Must have directly billed Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services during the period of January 1, 2018, to December 31, 2019, or (ii) own (on the application date) an included subsidiary that has billed Medicaid for healthcare-related services during the period of January 1, 2018, to December 31, 2019; and
  3. Must have either (i) filed a federal income tax return for fiscal years 2017, 2018 or 2019 or (ii) be an entity exempt from the requirement to file a federal income tax return and have no beneficial owner that is required to file a federal income tax return. (e.g., a state-owned hospital or healthcare clinic); and
  4. Must have provided patient care after January 31, 2020; and
  5. Must not have permanently ceased providing patient care directly, or indirectly through included subsidiaries; and
  6. If the applicant is an individual, have gross receipts or sales from providing patient care reported on Form 1040, Schedule C, Line 1, excluding income reported on a W-2 as a (statutory) employee.

Providers must apply for this funding using the Enhanced Provider Relief Fund Payment Portal by August 28, 2020.

 

   -   CARES Act Targeted Funding for Treatment of the Uninsured

      KHA Contact: Tish Hollingsworth

HHS announced that providers that have treated uninsured patients with COVID-19 on or after February 4, 2020, can request reimbursement at Medicare rates, subject to available funding.  Steps will involve: enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit.  HHS stated that providers can register for the program on April 27, 2020, and begin submitting claims in early May 2020.  Additional information is available on the HRSA website.

 

   -   CARES Act Targeted Funding for Indian Health Service ($500 million)

Recognizing the strain experiences by the Indian Health Service, $500 million will be allocated for IHS facilities distributed on the basis of operating expenses for the facilities.

 

  -   CARES Act Targeted Funding for Skilled Nursing Facilities ($4.9 billion)

      KHA Contact: Tish Hollingsworth

Beginning on May 22, HHS began distributing payments to Skilled Nursing Facilities (SNF) to provide relief from the effects of COVID-19.  Each SNF with more than six beds will receive a fixed distribution of $50,000 plus a distribution of $2,500 per bed.

 

  -   CARES Act Targeted Funding for Safety Net Hospitals ($13 billion)

      KHA Contact: Tish Hollingsworth

On June 12, HHS announced that $10 billion in funding would be made to eligible hospitals serving a disproportionate share number of Medicaid patients and who provided large amounts of uncompensated care.

An additional distribution of $3 billion was announced by HHS on July 10 to allow hospitals that did not qualify for the June distribution to receive funding.  HHS expanded the criterion for the payment qualification for the profitability threshold that was established in the earlier distribution.

 

CARES Act Small Business Administration (SBA) 7(a) Loans/Payroll Protection Program (PPP)

      KHA Contact: Steve Poage 


Paycheck Protection Program and Health Care Enhancement Act (PPPHCEA)

      KHA Contact: Steve Poage and Tish Hollingsworth

On April 24, the PPPHCEA was signed into law, which adds another $484 billion in a COVID-19 “3.5” relief package.  This package includes an additional $75 billion in funding to hospitals and other health care providers to reimburse eligible health care providers for health care-related expenses or lost revenues not otherwise reimbursed that are directly attributable to COVID-19.  The package also includes an additional $349 billion for the Paycheck Protection Program as well as providing funding to support efforts to research, develop, validate, manufacture, purchase and expand capacity for COVID-19 tests.

 

-   Rural Health Clinic Funding ($225 million)

      KHA Contact: Tish Hollingsworth

On 5-20-20 HHS distributed $225 million nationally to RHCs at a rate of almost $50,000 per site to support COVID-19 testing efforts and expand access to testing in rural communities. There were 174 Kansas RHCs in Kansas received a total of around $8.6 million.

 

ASPR Grant (Assistant Secretary for Preparedness and Response)

      KHA Contact: Ron Marshall

HHS announced it would provide $100 million in aid to hospitals and health care systems in preparing for a surge in COVID-19 patients.  Of that funding, $50 million was allotted to State Hospitals Associations for distribution through competitive grant applications.  KHA received $784,542 in funds, which were distributed on May 1.  Recently KHA was awarded an additional $1.95 million to be distributed in the future.

 

FEMA

      KHA Contact: Steve Poage


Medicare Accelerated/Advance Payment Program

      KHA Contact: Tish Hollingsworth

Payroll and Taxes

      KHA Contact: Steve Poage

 

Private Loan Financing: Kansas Bankers Association (KBA)

      KHA Contact: Steve Poage

 

COVID-19 SHIP Funds (Small Hospital Improvement Program)

      KHA Contact: Jennifer Findley

The Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy (FORHP) received funding through the CARES Act.  HRSA will use CARES funding to assist hospitals that are eligible through the Small Rural Hospital Improvement Program (SHIP).  One-time funding will provide support to hospitals to prevent, prepare for, and respond to the COVID-19 public health emergency.  The Kansas COVID-19 SHIP is managed by the State Office of Rural Health within the Bureau of Community Health Systems (BCHS) at the Kansas Department of Health and Environment.  KDHE has contracted with KHERF to administer this program.

 

State of Kansas COVID-19 Grant

      KHA Contact: Tish Hollingsworth

On April 16, Governor Laura Kelly announced a special emergency grant funding program for Kansas hospitals.  This emergency funding was requested by KHA on behalf of the community hospitals and is being distributed to help offset the financial strains caused by the COVID-19 pandemic.  Hospitals are not required to complete an application, and there are no specific requirements tied to the utilization of the funds.  The grant funds are being distributed in the following manner: Critical Access Hospitals will receive $100,000; Rural PPS hospitals will receive $150,000; and Semi-Urban (as noted by KDHE's Map of Peer County Groups below) and Urban PPS hospitals will receive $250,000.  Payments will be distributed electronically on April 24.

 

KHA Sponsor COVID-19 Resources

 

Other Funding Options/Resources