Caring about CARES
The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act, was an economic stimulus designed to help individual Americans through the economic fallout of the COVID-19 pandemic. The CARES Act Provider Relief Fund provided funds to healthcare provider agencies and businesses to help them deal with the loss of revenue and added expenses due to the pandemic; these funds do not need to be paid back so long as the receiving entities meet requirements.
Under the provisions of the Provider Relief Fund, approximately 175-billion dollars was distributed nationwide to hospitals and frontline provider agencies. There has been, so far, two different disbursements, the first was sent automatically to providers who provided Medicare fee-for-service, the second was sent after providers submitted applications. Another application process was completed early this past November.
Although the funds do not have to be paid back, recipients may be audited to ensure that the funds meet the criteria and are used for specific supplies and costs related to the pandemic. Unlike most grant programs for EMS agencies, which usually provide detailed lists of specific equipment and items, there was initially no list of approved items. Recently the U.S. Department of Health and Human Services has provided guidelines as to eligibility requirements.
Generally to be eligible for funds under the CARES Act Provider Relief Fund, EMS agencies need to have billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan.1, 2018 and Mar.31, 2020; received a prior targeted distribution; and have provided patient care after Jan. 31, 2020. More specific details are available on the HHS.gov site at https://bit.ly/3qfKJfM. Conditions include that the recipient is eligible to bill Medicare and agrees to not seek out-of-pocket payments from a COVID-19 patient that are greater than what the patient would otherwise have been required to pay if the care had been provided by an in-network provider.
Nationally nearly 320-thousand providers received the initial allocation of $30-billion, with an additional distribution of $20-billion to 15-thousand providers. In New York State more than 250 EMS agencies have received funds — hospitals, fire-based ambulances, nursing homes, urgent care centers, medical equipment centers, and specified private doctors also received monies. These monies are grants, not loans or advanced payments and they will not be used toward FUTURE Medicare services. Grantees. Beneficiaries are required to confirm receipt of monies within 30 days and agree to Terms and Conditions.
Regarding what EMS agencies can spend these funds on the Terms and Conditions part of the agreement are very general, "That the Payment will only be used to prevent, prepare for, and respond to coronavirus, and that the Payment shall reimburse the Recipient only for healthcare related expenses or lost revenues that are attributable to coronavirus." After the initial allocations, HHS did clarify some of the terms to include items such as:
• Supplies used to provide healthcare services for possible or actual COVID-19 patients
• Equipment used to provide healthcare services for possible or actual COVID-19 patients
• Workforce training
• Developing and staffing emergency operation centers
• Reporting COVID-19 test results to federal, state, or local governments
• Building or constructing temporary structures to expand capacity for COVID-19 patient care or to provide healthcare services to non-COVID-19 patients in a separate area from where COVID-19 patients are being treated
• Acquiring additional resources, including facilities, equipment, supplies, healthcare practices, staffing, and technology to expand or preserve care delivery.