The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing $20 billion in new funding for providers on the frontlines of the coronavirus pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Previously ineligible providers, such as those who began practicing in 2020 will also be invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.

 

Providers can begin applying for funds on Monday, October 5, 2020.

HHS has already issued over $100 billion in relief funding to providers through prior distributions. Still, HHS recognizes that many providers continue to struggle financially from COVID-19's impact. For eligible providers, the new Phase 3 General Distribution is designed to balance an equitable payment of 2 percent of annual revenue from patient care for all applicants plus an add-on payment to account for revenue losses and expenses attributable to COVID-19.

 

Further, HHS recognizes constraints such as the stay-at-home orders and social isolation have been particularly difficult for many Americans. A recent Centers for Disease Control and Prevention (CDC) report found the prevalence of symptoms of anxiety disorder in the second quarter of 2020 was approximately three times those that reported in the second quarter of 2019 (25.5% versus 8.1%); and the prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%). Our behavioral health providers have shouldered the burden of responding and confronting this expanded challenge triggered by the pandemic. When traditional face-to-face counseling was restricted and new telehealth flexibilities were put in place in response to the pandemic, many behavioral health providers invested in and  adopted - PDF telehealth technologies to continue providing patient care. While some Medicare or Medicaid behavioral health providers have already received prior General Distribution payments, others have not. Working with the Substance Abuse and Mental Health Services Administration (SAMHSA), HRSA developed a list of the nation's behavioral health providers now eligible for funding, which includes, for example, addiction counseling centers, mental health counselors, and psychiatrists.

 

HHS is making a large number of providers eligible for Phase 3 General Distribution funding, including:

Providers who previously received, rejected or accepted a General Distribution Provider Relief Fund payment. Providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment.

Behavioral Health providers, including those that previously received funding and new providers.

Healthcare providers that began practicing January 1, 2020 through March 31, 2020. This includes Medicare, Medicaid, CHIP, dentists, assisted living facilities and behavioral health providers.

 

All eligible providers will be considered for payment against the below criteria.

All provider submissions will be reviewed to confirm they have received a Provider Relief Fund payment equal to approximately 2 percent of patient care revenue from prior general distributions. Applicants that have not yet received Relief Fund payments of 2 percent of patient revenue will receive a payment that, when combined with prior payments (if any), equals 2 percent of patient care revenue.

With the remaining balance of the $20 billion budget, HRSA will then calculate an equitable add-on payment that considers the following:

• A provider's change in operating revenues from patient care
• A provider's change in operating expenses from patient care, including expenses incurred related to coronavirus
• Payments already received through prior Provider Relief Fund distributions.

We know providers want to receive payments shortly after submitting their information. However, this distribution requires cooperation on the part of all applicants. Again, HHS is urging all eligible providers to apply early; do not wait until the last day or week of the application period. Applying early will help to expedite HHS's review process and payment calculations, and ultimately accelerate the distribution of all payments.

All payment recipients will be required to attest to receiving the Phase 3 General Distribution payment and accept the associated Terms and Conditions.

 

Providers will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding. HHS's top priority is ensuring as many providers possible have an opportunity to apply. HHS will continue to host webinars to assist providers through the application process and the call center is also available to address questions.

HHS recognizes the multifaceted challenges of this pandemic cannot be won without frontline healthcare providers focused on containing the virus and delivering holistic care. Funding for this Phase 3 General Distribution was made possible through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers.

For updates and to learn more about the Provider Relief Program, visit:  hhs.gov/providerrelief.

 

North Carolina Department of Health and Human Services (DHHS) developed a program to reimburse primary care providers (PCP) with federal funds for providing care for COVID-19 related services (e.g. follow-up care) to uninsured North Carolina residents.

 

An NCTracks Portal to submit claims is scheduled to go live late October and claims will be retroactively reimbursed to Sept. 1, 2020. A payment of $150 per eligible encounter enables providers to recoup costs for COVID-19 related services provided for uninsured patients. $7.8M is available to support this program through Dec. 30, 2020, or until the funds are depleted, whichever occurs first. Reimbursement will be made on a first-come first-served basis.

 

For more information, review the fact sheet or see  SPECIAL BULLETIN COVID-19 #137: REIMBURSEMENT FOR COVID-19 RELATED PRIMARY CARE SERVICES FOR UNINSURED NC RESIDENTS - Steps to Prepare.

 

Members of the North Carolina House of Representatives stood together (although, at six-feet apart) in Thomas Foreman Park to push their health care plan. They say their number one priority this election season is expanding Medicaid, a health insurance program covered by the federal government for low-income people. N.C. House Minority Leader Darren Jackson, D-Wake, says their only challenge expanding Medicaid are Republicans in the State House "stonewalling" legislation. "Back in 2011 they passed a law, Speaker Thom Tillis said we couldn't expand Medicaid, Governor Purdue vetoed that bill, then McCrory was elected Governor in 2012 he immediately passed another one in 2013, again under Speaker Thom Tillis. We need to repeal that law and submit our application to Medicaid," Jackson said.

Democrats say that expanding Medicaid in North Carolina will come at no cost to voters. That's because hospitals and healthcare providers have agreed to pick up the 10 percent fee that comes with the application. North Carolinians are already paying for Medicaid in other states, and even in D.C. According to the U.S. Census Bureau, North Carolina ranks among the ten states with the least amount of insured residents. The number of residents without access are rising due to pandemic related job loss. Brian Farkas, Candidate for N.C. House of Representatives in District 9 says that expanding Medicaid could do much more than ensure citizens.

 

In a major change for healthcare and education in the Charlotte region, Atrium Health announced Friday it has officially combined with Wake Forest Baptist Health, including the Wake Forest School of Medicine. The partnership will bring a medical school to Charlotte, which is the largest city in the U.S. without a four-year medical school, according to Atrium. It's part of an ambitious move to "create a 'Silicon Valley' for healthcare innovation, spanning from Winston-Salem to Charlotte," Atrium CEO Gene Woods said in a news conference Friday.

The partnership was first announced in April 2019. The combined health system will have over 70,000 employees, 42 hospitals and more than 1,500 care locations, according to Atrium. Atrium gave a first look at renderings of the future Charlotte medical school in August. The medical school could launch with 3,200 students across 100 programs and 1,600 faculty members, Woods said at the time. Woods hasn't said when the medical school in Charlotte could open. The official combination announcement had to wait for approval from the Federal Trade Commission. That approval came last week, Woods said.

The announcement also comes just days after rival hospital system Novant Health landed a critical vote in a $5 billion deal to buy a Wilmington hospital, expanding into southeastern N.C. Novant could have more than 36,000 employees after that deal goes through state regulatory review. Both deals follow a trend toward hospital consolidation across the country. But some critics of consolidation warn it can mean rising prices for patients.

Some of the details of the Atrium and Wake Forest Baptist combination are still unclear. But if the two systems plan to negotiate with insurance companies as one entity, "Patients, frankly, can expect higher prices and expect higher insurance premiums," said Barak Richman, a Duke Law School professor with expertise in health care policy. "That's a prediction that is borne out very thoroughly."

In a statement, Atrium spokesman Dan Fogleman said all current agreements with insurance companies will remain in place, adding, "We will be approaching future contracts with a shared services approach when and where it makes sense." The health systems will combine under the name Atrium Health. Based on an independent economic analysis, the immediate direct and indirect annual economic and employment impact from the combined enterprise exceeds $32 billion and 180,000 jobs, according to Atrium.

 

Federal officials are firming up rules for a relatively new type of account that allows people with disabilities to save money without jeopardizing their government benefits.

The Internal Revenue Service issued final regulations this month spelling out details about how ABLE accounts should operate.

 

The accounts, which were established by the 2014 ABLE Act, allow individuals with disabilities to accrue up to $100,000 without risking eligibility for Social Security and other government benefits. Medicaid can be retained no matter how much money is saved in the accounts.

The rules released this month stem from when the accounts were originally created as well as tweaks to the law that came in 2017 tax-cut legislation. Many of the changes have already been in effect, but the IRS said the final regulations clarify specifics and address comments the agency received in response to previous proposals about how the law would be applied.

Annual deposits to ABLE accounts are capped at the value of the gift tax exclusion for any given year, currently $15,000 annually.

 

However, under the final rules, people with disabilities who are employed can deposit their earnings in ABLE accounts, above and beyond the existing contribution cap for the year. These individuals can save whatever money they earn in their ABLE account up to the value of the poverty line in the state where they live.

 

The IRS said that workers with disabilities who have ABLE accounts can also qualify for a Saver's Credit, which can reduce their federal tax bill.

Separately, money saved in a traditional 529 college savings plan for an individual with a disability or a family member can be rolled over into an ABLE account up to the maximum annual contribution limit. The rules indicate that this option is available until Jan. 1, 2026.

The regulations also offer guidance on the record-keeping and reporting requirements of ABLE programs as well as other specifics about the mechanics of the accounts.

 

ABLE accounts are open to people with disabilities that onset prior to age 26. Money saved in the accounts can be used for education, housing, transportation, employment training and support, assistive technology, personal support services and other "qualified disability expenses."

 

Currently, 42 states and Washington, D.C. have active ABLE programs, many of which are open to people with disabilities nationwide, according to the ABLE National Resource Center.

As of June, data from ISS Market Intelligence shows that there are nearly 71,000 ABLE accounts open nationally with $469.4 million in assets.