Physician & Practice Timeline®

Performance Year 1 application portal for the Direct Contracting Professional and Global options is now open. Concurrently, the Letter of Intent (LOI) submission is also open. The applications and LOIs are due by July 6, 2020 at 11:59 PM ET. Performance Year 1 will start April 1, 2021. The second cohort of Direct Contracting Professional and Global options will start on January 1, 2021. Visit the Direct Contracting website for more information.

Health and Human Services (HHS) is distributing $15 billion in CARES Act Provider Relief Fund payments to eligible Medicaid and CHIP physicians and organizations. The payment will be at least 2% of reported gross revenue from patient care, and the final amount will be determined based on submitted data including the number of Medicaid patients served. Eligible physicians and organizations have until July 20, 2020 to submit their application and report other necessary information. HHS is hosting two webcasts at 2 p.m. EST on Tuesday, June 23rd and Thursday, June 25th for those that are interested in learning more about the application process. Registration is required.

On March 27, 2020, President Trump signed the bipartisan CARES Act that provides $100 billion in relief funds to hospitals and other healthcare providers on the front lines during COVID-19. $30 billion out of the $100 billion is being automatically distributed to physician practices and hospitals to offset their estimated losses in Medicare revenue without requiring an application or repayment. Providers who have been allocated a payment from the initial $30 billion general distribution must sign the CARES Act Provider Relief Fund Payment Attestation within 90 days to confirm receipt of the funds and agree to the terms and conditions. Providers will only have until June 3rd to access the application portal to submit their revenue/loss information; the attestation portal will remain open for 90 days. If an eligible provider did not receive payment, please contact UGH’s Provider Relations at 866-569-3522. If direct deposit was not set up through CMS or UGH’s Optum Pay, a check will be sent at a later date.

ACP members that also applied to the Medicare Accelerated and Advance Payment Program are beginning to see funds deposited into their Medicare billing account. This program is separate from the emergency fund payments; it requires an application and acts as a loan to be repaid to Medicare.

Read ACP’s press release, Internists Applaud CMS for Rapidly Distributing Emergency Funding to Physician Practices for more information.

Physicians can now submit patient information and claims for payment for uninsured patients treated for COVID-19. Physicians will need to verify and attest that the patient does not have individual, employer-sponsored, Medicare or Medicaid coverage and that no other payer will reimburse them for COVID-19 testing and/or treatment for the patient. Claims will be reimbursed for dates of service or admittance on or after February 4, 2020. You can submit your claim through the uninsured portal.

On April 24, HHS started to distribute the remaining $20 billion as part of the Provider Relief Fund. Providers will need to submit their financial data through the General Distribution Portal and confirm payment through the attestation portal. For more information on this and other funding opportunities, visit our COVID-19 Practice Management Resources and Practice Financial Assistance pages.

Every week, CMS hosts a variety of stakeholder calls to share information related to their COVID-19 response. On Tuesdays and Thursdays, CMS hosts COVID-19 office hour calls from 5:00-6:00 PM ET for providers, hospitals, and health systems to ask questions regarding CMS’s actions. To join these weekly calls including other stakeholder calls, visit the Coronavirus (COVID-19) Stakeholder Calls page.

CMS recently announced that effective March 28, 2020, it will offer accelerated and advance payments for Medicare participating health care clinicians and suppliers to lessen financial hardships for physician practices. Clinicians who meet the qualifying criteria may request up to 100% Medicare payments for a three-month period. The payments will be subject to recoupment within 180 days. Visit the press release and fact sheet for more information.