According to CMS:
Accelerated and advance Medicare payments provide emergency funding and addresses cash flow issues based on historical payments when there is disruption in claims submission and/or claims processing. These expedited payments are typically offered in natural disasters to accelerate cash flow to the impacted health care providers and suppliers. In this situation, CMS is expanding the program for all Medicare providers throughout the country during the public health emergency related to COVID-19. The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers.
To qualify for accelerated or advance payments, the provider or supplier must:
- Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form,
- Not be in bankruptcy,
- Not be under active medical review or program integrity investigation, and
- Not have any outstanding delinquent Medicare overpayments.
Medicare will start accepting and processing the Accelerated/Advance Payment Requests immediately. CMS anticipates that the payments will be issued within seven days of the provider’s request.
An informational fact sheet on the accelerated/advance payment process and how to submit a request can be found here:
www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf
NOTE: CMS discontinued the Advance Medicare Payment Program on April 27th, 2020.
The CARES Act provides economic relief to small businesses through Small Business Administration (SBA) loan guarantees and subsidies, primarily through the 7(a) loan program. The CARES Act increases the maximum 7(a) loan amount from $5 million to $10 million. Entities that are eligible for 7(a) loans under this provision include small businesses, nonprofits and veteran organizations with fewer than 500 employees. Sole-proprietors, independent contractors, and other self-employed individuals are also eligible. Small businesses with more than one physical location are eligible for each location as long as it has no more than 500 employees per physical location.
Under this provision, a small business may apply to an SBA-approved lender for a loan of up to 250 percent of the business’ average monthly payroll costs to cover eight weeks of payroll as well as help with other expenses like rent, mortgage payments, and utilities. The loan can be forgiven so long as the employer maintains employee and salary levels. For any portion of the loan that is not forgiven, the terms include a maximum term of 10 years with a maximum interest rate of four percent. Small businesses and organizations will be able to apply if they were harmed by COVID-19 between February 15, 2020 and June 30, 2020. This program is retroactive to February 15, 2020 and are available through June 30, 2020.
Authorizes $10 billion for an “emergency” Economic Injury Disaster Loan (EIDL) for entities in states where the governor has declared a state of emergency under the Stafford Act and who have 500 or fewer employees. These loans may be up to $2 million. Eligible entities may apply for an EIDL loan and request an advance on that loan (maximum of $10,000) which the SBA must distribute within 3 days. Advance payments may be used for providing paid sick leave to employees, maintaining payroll, meeting increased costs to obtain materials, making rent or mortgage payments, and repaying obligations that cannot be met due to revenue losses. According to the AMA’s summary, “If a small business receives a Payroll Protection Program loan that is forgiven any advance amount received under the emergency EIDL would be subtracted from the amount forgiven in the Payroll Protection Program loan.” (see below for more information on the Paycheck Protection Program).
In addition to the EIDL grants and SBA 7(a) loans, another option available to small businesses is the Paycheck Protection Program (PPP). These are designed to help small businesses avoid closure or layoffs and can be used to cover payroll, utilities, insurance premiums, and rent and mortgage interest payments on a facility. The PPP is available until June 30, 2020 and is designed for businesses that typically wouldn’t qualify for a loan at a typical local or national bank. These loans require no collateral, credit test or personal guarantees from a business, only proof that the business was open and operating on February 15, 2020. The government is providing a 100% guarantee on loans through the end of 2020.
Under the CARES Act, all loans granted by the SBA as part of the COVID-19 response, including those granted through the PPP, are eligible for loan forgiveness equal to the amount the borrower spends during the 8 weeks after the loan originated. Any loans forgiven will not be included in income tax and can be applied to payroll costs up to $100,000. Employers will be required to provide payroll information from this year and the same time last year to demonstrate that they are maintaining wages. Employers will not be penalized for rehiring employees who were recently let go.
For a more detailed explanation of all of the options and resources available to small businesses, please see
The Small Business Owner's Guide to the CARES Act creatd by the U.S. Senate Committee on Small Business & Entrepreneurship.
The CARES Act includes $100 billion to address lost revenue and expenses (non-reimburseable) for hospitals and healthcare providers responding to COVID-19. Eligible providers include: public entities, Medicare or Medicaid enrolled suppliers and providers, for-profit entities and nonprofit entities in the U.S. that provide diagnoses, testing or care for patients with possible or actual cases of COVID-19. Providers seeking these funds will need to submit applications to the Secretary of Health and Human Services (HHS) that include statements justifying need for the funds. The Secretary of HHS is expected to set out the criteria it will use to allocate these funds shortly.
The CARES Act also provides supplemental awards and grants to support healthcare providers: $1.32 billion in supplemental funding to community health centers (CHCs), and reauthorizes Health Resources and Services Administration (HRSA) grant programs that promote the use of telehealth technology and strengthen rural healthcare.
Provider Relief Funds are being disbursed via both "General" and "Targeted" Distributions.
General Distribution
To be eligible for the general distribution, a provider must have billed Medicare in 2019 and provide or provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19. $50 billion will be disbursed in the General Distribution.
Targeted Disributions
Targeted distributions include allocations for such things as treatment of the uninsured, COVID-19 high impact areas, rural providers, and Indian Health Service. A description of the eligibility for the announced Targeted Distirbutions can be found
here.
More information about the CARES Act Provider Relief Fund and frequently asked questioncan be found
here.
- Seeks to mitigate shortages of emergency products by prioritizing review of drug applications and providing additional incentives.
- Places further reporting requirements on manufacturers related to drug shortages or production challenges (mainly related to products needed for the emergency response).
- Provides specific guidance for the coverage, reimbursement, and pricing related to COVID-19 diagnostic tests.
- Supports an awareness campaign and related activities related to the safety of the blood supply and importance of blood donation.
- Provides rapid coverage by third party-payers for preventative services and vaccines.
- Reauthorizes the Health Professions Workforce Programs (Title VII).
- Enhanced reporting requirements for the discontinuation of medical devices needed for the emergency response.
- Provides access to telehealth services for individuals with high deductible plans and health savings accounts (without incurring out of pocket costs).
- Further expands access to telehealth services to ensure patients have access to a broad range of providers.
- Provides flexibility to allow community health centers and rural health clinics to provide telehealth services.
- Provides flexibility for patients to access home health services.
- Removes Medicare sequester through the end of the calendar year, but then extends the sequestration for an additional year.
- Blocks scheduled reductions in Medicare payments for durable medical equipment.
- Eliminates Medicare Part B cost-sharing requirements for COVID-19 vaccines.
- Allows for a 90-day supply of medications under Medicare Part D.
- Ensures Medicaid patients can receive a COVID-19 test and related services with no cost-sharing requirements.
- Ensures Medicare beneficiaries can receive a test for COVID-19 under Medicare Part B with no cost-sharing requirements.
- Prevents 2021 scheduled reductions in Medicare diagnostic tests for clinical laboratories.
- Extends funding for the National Quality Forum to carry out ongoing quality management and performance improvement measures.
- Delays scheduled reductions to Medicaid payments for disproportionate share hospitals.
- Extends the Health Careers Opportunity Grant program.
- Extends authorization for and enhances funding for; 1) Community Health Centers, 2) the National Health Service Corps, and 3) Teaching Health Centers that operate GME programs.