HRSA Health Centers Supplemental COVID-19 Funding

The Health Resources and Services Administration (HRSA) awarded more than $1.3 billion to 1,387 health centers to respond to the COVID-19 pandemic. HRSA-funded health centers can use these funds, appropriated in the CARES Act, to detect coronavirus; prevent, diagnose, and treat COVID-19; and maintain or increase health capacity and staffing levels to address the public health emergency. 
 

Eligibility 

This supplemental health center funding is designation for participants on the Health Center Program, as defined by section 330 of the Public Health Service Act. Health Center Program look-alikes are authorized under a different statute and are not eligible to receive these funds. HRSA is researching what other coronavirus funds may be available for Health Center Program look-alikes and will provide this information as soon as possible. 

Terms 

Health centers do not need to apply for this funding. HRSA made the funds available in early April according to the following formula: 

  • Base value of $503,000, plus: 
    • $15.00 per patient reported in the 2018 Uniform Data System (UDS), plus 
    • $30.00 per uninsured patient reported in the 2018 UDS. 

The average award is approximately $950,000. Funding is available immediately and can be used to support COVID-19 expenses back to January 20, 2020.  

This supplemental funding is separate from Health Center Program operational grants and health centers will need to separately track and account for their COVID-19 prevention, preparedness, and response-related activities supported through this funding. 

For more information visit:  

https://bphc.hrsa.gov/emergency-response/coronavirus-frequently-asked-questions.html#cares  

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Public Health and Social Services Emergency Fund

Emergency legislation appropriated $175 billion to the Public Health and Social Services Emergency Fund for health providers to cover lost revenue or health care related expenses attributed to coronavirus. These funds can also be used for building or construction of temporary structures, leasing of properties, medical supplies and equipment including PPE and testing supplies, increased workforce and trainings, emergency operation centers, retrofitting facilities, and surge capacity. 

Eligibility 

Public, private, and non-profit health providers that diagnose, test, or care for possible or actual COVID-19 patients are eligible to receive funds.  

Timeline 

CMS began disbursing $50 billion of the fund to Medicare providers starting April 10, 2020. These are grants, not loans, and will not need to be repaid.  

HHS has announced a number of set-asides for specific groups of providers from the fund. This includes a $10 billion allocation for hospitals most impacted by COVID-19 and $10 billion for rural health clinics and rural hospitals. Funds are also set aside for the Indian Health Service and COVID-related treatment of the uninsured. 

Providers receiving funds must agree not to seek collection of out-of-pocket payments from a COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider. 

For more information: This HHS website has more details https://www.hhs.gov/provider-relief/index.html  

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Accelerated and Advance Medicare Payments 

UPDATE – On April 26, CMS announced they are reevaluating the amounts paid under the Accelerated Payment Program and suspending the Advance Payment Program to Part B suppliers effective immediately. We will provide more updates as they become available.  
 
CMS press release available here: https://www.cms.gov/newsroom/press-releases/cms-reevaluates-accelerated-payment-program-and-suspends-advance-payment-program

Accelerated and advance Medicare payments provide emergency funding to address cash flow issues based on historical payments when there is disruption in claims submission and/or claims processing.  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.  The expansion of this program is only for the duration of the public health emergency. 

Maximum Advance Payment per Organization 

Based on each provider/suppliers request  

  • Most can request up to 100% of the Medicare payment amount for three-months  

  • Inpatient acute care hospitals, children’s hospitals, and certain cancer hospitals are able to request up to 100% of the Medicare payment amount for a six-month period 

  • Critical access hospitals (CAH) can request up to 125% of their payment amount for a six-month period  

Eligibility 

  1. Billed Medicare claims within the last 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form 

  1. Not in bankruptcy 

  1. Not under active medical review or program integrity investigation 

  1. Not have any outstanding delinquent Medicare overpayments 

Application Period 

Starts immediately 

Terms 

CMS will begin to apply claims payments to offset the accelerated/advance payments 120 days after disbursement 

  • Inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and Critical Access Hospitals (CAH) have up to one year from the date the accelerated payment was made to repay the balance. 
  • All other Part A providers and Part B suppliers will have 210 days from the date of the accelerated or advance payment was made to repay the balance  

Issuance of Payment 

CMS expects payments to be issued within seven days of the provider’s request 

How to Apply 

Each Medicare Administrative Contractor (MAC) has an application process that you can find by state at the following link:  

https://www.cms.gov/Medicare/Medicare-Contracting/FFSProvCustSvcGen/MAC-Website-List 

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Paycheck Protection Program (PPP) 

The Paycheck Protection Program was created as part of the legislation in the “CARES Act” and is intended to provide small businesses up to 8 weeks of funding to support payroll, benefits, mortgage interest, rent, and utilities to keep then financially viable during the COVID-19 Emergency Declaration. The fund was replenished on April 24, 2020 after the initial appropriation was depleted.  

Total Amount Appropriated 

$659,000,000,000 

Maximum Loan Amount per Business 

$10,000,000 

Eligibility 

A U.S. based public or private non-profit organization in operation on February 15, 2020, veterans organizations, self-employed individuals, sole proprietorships, tribal concerns with not more than 500 employees.  Businesses with more than 500 employees can be eligible if they meet the Small Business Administrations (SBA) standard based on revenue.

Use this size calculator to determine your eligibility: https://www.sba.gov/size-standards/  

Application Period 

First-come, first-served starting April 3rd, 2020 for small businesses. The Paycheck Protection Program and Health Care Enhancement Act added $320 billion to replenish the program funds. 

Coverage Period  

February 15, 2020 to June 30, 2020 or until funds are exhausted 

Loan Amount & Terms 

  • Loan amount is the lesser of $10 million or an amount that the borrower calculates using a payroll-based formula specified in the Act
    • Average monthly payroll costs multiplied by 2.5 
  • No collateral or personal guarantee required 
  • 8-weeks of funding to the max loan amount 
  • Payment deferral (continuous interest accrual) up to 6-months with a 2-year maturity 
  • Loan rate – 100 basis points or 1% 
  • Loan can be forgiven up to 100% if 75% or more of loan is used for payroll and not more than 25% of loan is used for non-payroll (utilities, rents, mortgages, etc..) 
    • Rehiring commences quickly and employee headcount does not decline 
    • Wages do not decline 
  • Repayment – 2-year loan term 
  • One loan per borrower 

Lenders 

Current SBA lenders and additionally identified to support the PPP as found on the SBA website 

Exclusions 

  1. Employees who compensation exceeds $100,000 are removed from the payroll-based calculation 

  1. Taxes imposed or withheld under chapters 21, 22, or 24 of the Internal Revenue Code of 1986 during the covered period 

  1. Any compensation of an employee whose principal place of residence is outside of the United States 

  1. Qualified sick leave wages for which a credit is allowed under section 7001 of the Families First Coronavirus Response Act (Public Law 116–127) 

  1. Qualified family leave wages for which a credit is allowed under section 7003 of the Families First Coronavirus Response Act (Public Law 116–127) 

  1. Shall not apply to a nonprofit entity eligible for payment for items or services furnished under a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 15 et seq.) or under a waiver of the Medicaid plan.  

  1. Have not received and do not plan to apply for a second PPP loan. 

How to Apply 

Submit form 2483 and payroll documentation on the form below or utilize the SBA gateway to register and submit 

https://www.sba.gov/sites/default/files/2020-04/PPP%20Borrower%20Application%20Form.pdf  

SBA Gate to register and submit 

https://connect.sba.gov/  

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Economic Injury Disaster Loan (EIDL) 

Small business owners in all U.S. states and territories are currently eligible to apply for a low-interest loan for working capital if they have sustained substantial economic injury as a result of the Coronavirus (COVID-19).   This loan program is part of the Small Business Administration (SBA) Disaster Assistance.   

Maximum Loan Amount per Business 

$2,000,000 

Eligibility 

A U.S. based public or private non-profit organization in operation on February 15, 2020 with less than 500 employees, veterans organizations, self-employed individuals, sole proprietorships, tribal concerns. Businesses with more than 500 employees can be eligible if they meet the Small Business Administrations (SBA) standard based on revenue. Use this size calculator to determine your eligibility: https://www.sba.gov/size-standards/  

Application Period 

First-come, first-served  

Coverage Period  

January 31, 2020 to December 31, 2020 or until funds are exhausted 

Loan Amount & Terms 

  • Can be used to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the disaster’s impact 
  • Applicant can request a loan advance of up to $10,000 
    • This amount could be forgivable 
  • Interest rate  
    • 3.75% for small businesses 
    • 2.75% for non-profits 
  • Loan repayment – up to 30 years and is determined on a case-by-case basis 
  • Collateral required for loans over $25,000 

Exclusions 

  1. Applicant is not in the lobbying business 
  2. Applicant cannot be a state, local, or municipal entity or a member of Congress 

How to Apply 

Follow this link to apply https://covid19relief.sba.gov/#/  

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Federal Communications Commission COVID-19 Telehealth Program 

The CARES Act appropriated $200 million to FCC to support health providers addressing coronavirus through telehealth. The funds can pay for services and devices to aid telehealth programs.  

Eligibility 

Health care providers addressing coronavirus can have their telecommunications services, information services, and devices necessary to provide telehealth services throughout the COVID-19 pandemic funded through this program. The funds cannot be used for personnel, IT, administrative, and training costs, or the building of websites or development of new platforms for providing connected care services. The funds can be used to treat non-COVID-19 patients in order to free up funds for COVID-19 treatment. Consortia of eligible providers may apply.  

The FCC strongly encourages awardees to use the funds to serve high-risk and vulnerable populations and areas that have been hardest hit by COVID-19. 

To submit an application and request for funding, the applicant must first obtain an FCC Registration Number (FRN). 

Further instructions available here: https://www.fcc.gov/document/guidance-covid-19-telehealth-program-application-process 

Terms 

The FCC’s Wireline Competition Bureau will review applications, select participants, and make funding awards of up to $1 million per applicant.   

Link to more information: https://www.fcc.gov/covid-19-telehealth-program

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Federal Emergency Management Agency (FEMA) Public Assistance Fund 

During a declared disaster, FEMA can reimburse state, local, territorial, and tribal entities for certain emergency medical care expenses. In some limited circumstances, certain non-profit organizations can apply to FEMA for assistance with essential facility costs.  

Eligibility 
In general, applicants will be state, local, territorial, and tribal entities, as well as non-profit organizations in some limited circumstances. Private for-profit or non-profit hospitals are not eligible to apply to have care costs reimbursed directly but can provide services under agreement with an eligible governmental applicant, which can pay the private entity.  

Terms 
Generally, FEMA assistance through the PA Fund is subject to a cost-share with the recipient. The federal share is typically 75 percent but can be increased under limited circumstances.  

More information:

https://www.fema.gov/news-release/2020/03/31/coronavirus-covid-19-pandemic-emergency-medical-care 

https://www.fema.gov/news-release/2020/04/02/coronavirus-covid19-pandemic-private-nonprofit-organizations 

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