CARES Provider Relief Payment

Published in Women's Health on April 22, 2020

Many EW members who have billed Medicare in 2019 have received a check for the relief payment, but within that check states that they are required to sign an attestation form and agree to terms and conditions. Many are confused about particular items in these terms and conditions, including the statement that they must be involved in providing care for COVID-19 patients and use the funds to provide care or respond to COVID-19. 

Craig Douglas, VP of Payer and Member Relations for VGM & Associates, provides his insight on the matter here:

"Below are the points I have sent others that explain why you qualify to receive them and are well within your rights to keep the money if you so choose. Really, your decision to keep the money should be more about your willingness to agree to the terms and conditions than about your qualification to receive and keep the money. 

1. Yes, I still believe you qualify to receive and keep this money, because I believe all of these statements are true for you and your business meets the following requirements for eligibility:

  • Eligibility to receive funds: All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
  • This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.
  • You are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.

2. I haven’t seen anything stating you have to provide care regardless of an individual’s ability to pay. You are simply required to accept the fee schedule, which would include any applicable deductible and co-insurance, as payment in full, and not charge the patient above and beyond the published allowable.

  • The Secretary has concluded that the COVID-19 public health emergency has caused many healthcare providers to have capacity constraints. As a result, patients that would ordinarily be able to choose to receive all care from in-network healthcare providers may no longer be able to receive such care in-network. Accordingly, for all care for a possible or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.

3. At the end of the day, if you are not comfortable with keeping the funds for whatever reason, you can return the funds for peace of mind. If you decide not to keep the funds, you can call United Healthcare to begin the process of refunding the payment if you decide you don’t want to keep it."


TAGS

  1. covid-19
  2. essentially women
  3. vgm government
  4. women's health

From Our Experts

Take Holistic Approach to Women's Health thumbnail Take Holistic Approach to Women's Health Women's health comprises many sectors, and although those sectors have very different characteristics, they actually represent an opportunity for HME providers to care for female patients over the course of their lives. Think Pink and Get Ready: Gearing Up for Breast Cancer Awareness Month thumbnail Think Pink and Get Ready: Gearing Up for Breast Cancer Awareness Month 2023 is quickly nearing the end, and October is just around the corner. Is your women's health business ready for Breast Cancer Awareness Month? Cybersecurity: Five Tips For Remaining Secure thumbnail Cybersecurity: Five Tips For Remaining Secure We are providing five tips from VGM Group's SVP of Corporate Information Services, Jay Bracken, Certified Information Systems Security Professional (CISSP). An Update on Focus: The EW Conference thumbnail An Update on Focus: The EW Conference Watch the video to learn about a major update to Focus: The EW Conference! Lymphedema Update August 2023 thumbnail Lymphedema Update August 2023 Watch the video to learn about important updates regarding Medicare coverage for lymphedema-related compression garments. Bill to Provide Medicare Coverage of Custom Breast Prostheses Reintroduced in Congress thumbnail Bill to Provide Medicare Coverage of Custom Breast Prostheses Reintroduced in Congress U.S. Representatives Judy Chu (D-CA) and Mariannette Miller-Meeks (R-IA) have reintroduced the bipartisan H.R. 4779: Breast Cancer Patient Equity Act, which would provide Medicare coverage of custom breast prostheses to breast cancer survivors. Medicare to Cover Lymphedema Compression Garments in 2024 thumbnail Medicare to Cover Lymphedema Compression Garments in 2024 One of the topics discussed within the proposed rule was the fact that, through the passage of the Lymphedema Treatment Act (LTA), Medicare will offer coverage for lymphedema-related compression garments beginning Jan. 1, 2024. Summary of Proposed Rule 1780-P; DME Reimbursement Rates and Medicare Coverage for Lymphedema-Related Compression Items thumbnail Summary of Proposed Rule 1780-P; DME Reimbursement Rates and Medicare Coverage for Lymphedema-Related Compression Items On July 10, 2023, CMS published a proposed rule in the Federal Register which contained information regarding a few DME-related topics