Hospitals accepting money from the massive CARES Act legislation will not be permitted to send patients surprise bills for visits associated with COVID-19, according to ABC News.

It has been widely reported in the past two months that the Trump Administration signed the bipartisan CARES Act legislation to provide relief to American families, workers, and the health care providers on the frontline of the COVID-19 outbreak. In April, the U.S. Department of Health and Human Services announced additional allocations of the CARES Provider Relief Fund to include $100 billion for health care providers including hospitals.

In allocating the funds, the administration sought to address the economic harm across the entire health care system due to the stoppage of elective procedures along with the economic impact on providers incurring additional expenses caring for COVID-19 patients, according to a press release issued by HHS.

The prohibition on surprise billing will protect patients covered by government programs, employer plans, or self-purchased insurance. Hospitals that accept the grants are required to certify that they will not try to collect more money than the patient would have otherwise owed if the medical attention had been provided in-network, ABC News reported.

Below are some additional highlights included in the Provider Relief Fund.

Access to Care

  • President Trump secured commitments from private insurers, including Humana, Cigna, UnitedHealth Group, and the Blue Cross Blue Shield system, to waive cost-sharing payments for treatment related to COVID-19 for plan members.
  • The Families First Coronavirus Response Act, as amended by the CARES Act, requires private insurers to waive an insurance plan member’s cost-sharing payments for COVID-19 testing. The president also secured funding to cover COVID-19 testing for uninsured Americans.

Rural Providers

  • $10 billion was allocated for rural health clinics and hospitals.
  • This money was distributed on the basis of operating expenses, using a methodology that distributes payments proportionately to each facility and clinic.
  • Rural hospitals are more financially exposed to significant declines in revenue or increases in expenses related to COVID-19 than their urban counterparts, HHS reported.

Uninsured

  • A portion of the $100 billion Provider Relief Fund reimbursed health care providers, at Medicare rates, for COVID-related treatment of the uninsured.
  • Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through the program and will be reimbursed at Medicare rates, subject to available funding.
  • The government began accepting claims in early May 2020. For more information, visit coviduninsuredclaim.hrsa.gov.

High Impact Areas

  • $10 billion was allocated for targeted distribution to hospitals in areas that have been particularly impacted by the COVID-19 outbreak. As an example, hospitals serving COVID-19 patients in New York, which has a high percentage of total confirmed COVID-19 cases, were expected to receive a large share of the funds.

Sources:

The ABC News story titled, “White House says no ‘surprise’ bills for COVID-19 patients,” may be accessed here: https://tinyurl.com/ycnomdu4

The HHS press release titled, “HHS Announces Additional Allocations of CARES Act Provider Relief Fund,” may be accessed here: https://tinyurl.com/y75nqal4


About Mnet Health

Mnet is the leading RCM & technology provider to the surgical industry delivering white glove patient-pay solutions. Mnet specializes in surgical hospitals, ambulatory surgery centers, and management companies.  As of 2020, Mnet is servicing more than 700 surgical facilities nationwide, both directly and in support of centralized billing offices.  Mnet’s patient-pay solutions significantly increase self-pay collections while creating a better financial experience for patients.

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