CMS Releases Allocation Details, Conditions of Participation for Emergency Payments to Home Health Providers

Home health and hospice providers now have greater clarity on how much initial emergency assistance they’ll be getting from the CARES Act Provider Relief Fund, as well as when those direct deposits will hit their bank accounts.

While details of the disbursements were originally scarce, it seems the Centers for Medicare & Medicaid Services (CMS) started doling out payments to Medicare-reimbursed providers as of Friday, April 10.

The goal is to divide $30 billion in grant funding up between all program participants to help them maintain stability amid COVID-19. The money comes from a pool of $100 billion in relief set aside for health care providers under the CARES Act.

While it’s unclear how long it will take CMS to send out all of the emergency funding, what’s become more predictable is how much of the $30 billion providers can expect to receive. At least some home health providers received their payments as of Friday, sources confirmed to HHCN.

Payment amounts will be proportional and based on 2019 Medicare revenue. As such, providers can use a relatively straight-forward formula to gain insight, according to the National Association for Home Care & Hospice (NAHC).

To find its estimated payment, a provider can divide its 2019 Medicare fee-for-service reimbursement total (excluding Medicare Advantage payments) by $484 billion, the total amount the program paid out last year. Then, multiply that ratio by $30 billion.

For example, if a provider billed Medicare $121 million last year, it can expect to receive an initial emergency payment from CMS of about $7.5 million — and that payment could come any day now in the form of a direct deposit.

While CMS Administration Seema Verma has said there are “no strings attached” to the funding and that it doesn’t have to be repaid, it does come with a few conditions.