Research

The CFO’s guide to navigating federal funding sources of Covid-19 relief

By Dan Galambos, Lauren Robinson, Patrick Cary, and Mackenzie Barta.

In response to the financial impact that Covid-19 is having on hospitals and health systems, leaders have a range of cash relief options to navigate, including philanthropy, state resources, and a host of federal programs.

Sources of federal relief funds

This tool helps finance executives unpack the array of federal sources available through three main categories: grants, loans, and reimbursement changes. Select the category and program below to review key details of each option, current as of July 19, 2021, and updated to include the $900 billion stimulus bill passed December 27, 2020, and the latest $1.9 trillion stimulus bill passed March 11, 2021. Then, check out our related infographic to see the distributions providing Covid-19 relief.

Start here and select a category and program below

Source of funds

  • CARES Act and Consolidated Appropriations Act, 2021
  • Consolidated Appropriations Act, 2021
  • H.R. 1868 (Public Law No: 117-7)

Category

  • Delayed payment cuts

Funding status

  • Currently funded

Description

  • The CARES Act temporarily suspended the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration effective May 1, 2020, through December 31, 2020.
  • The Consolidated Appropriations Act, 2021, extended the suspension from December 31, 2020, through March 31, 2021.
  • The subsequent H.R. 1868 bill was signed into law on April 14, 2021, extending the suspension of the Medicare sequestration through December 31, 2021.

Eligibility

  • Medicare providers who bill fee-for-service are eligible.

Restrictions

  • N/A

Amount

  • Health care providers can expect to receive an increase in fee-for-service Medicare payments by approximately 2% as compared to what they would have otherwise received during this period. There will also be a 20% increase in the weighting factor that would otherwise apply to the diagnosis-related group (DRG) for Medicare patients discharged with a diagnosis of Covid-19.

Purpose

  • Boost fee-for-service reimbursement for providers affected by Covid-19.

Timeline

  • Effective May 1, 2020, through the end of the public health emergency, which is expected to run through December 31, 2021.

Process to get money

  • Automatic increase in reimbursement payments.

Governing authority

  • CMS

Repayment terms

  • N/A

Additional considerations

  • In exchange for this temporary suspension, the CARES Act also postpones the sunset of sequestration as it applies to Medicare from the end of 2029 to the end of 2030. Medicare Advantage plans will benefit from both the temporary suspension and the increased DRG payment.
  • H.R. 1868 further postpones the sunset of sequestration from 2030 to the year 2031 to pay for the cuts.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Reimbursement

Funding status

  • Currently funded

Repayment terms

  • N/A

Description

  • Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can furnish and bill for distant site telehealth services to Medicare beneficiaries during the emergency period.

Eligibility

  • RHCs and FQHCs

Restrictions

  • There are no restrictions on where the telehealth service is provided, meaning physicians or practitioners may provide the service from their homes. Providers must use audio and video telecommuniations technology during the telehealth visits.

Amount

  • Total amount unspecified. CMS will pay RHCs and FQHCs $92 for each telehealth service provided by physicians or practitioners.

Purpose

  • To support telehealth with greater flexibility for RHCs and FQHCs to reach their patients during the Covid-19 emergency period as margins have drastically narrowed.

Timeline

  • The program is effective March 1, 2020, through the duration of the public health emergency.

Process to get money

Governing authority

  • CMS

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Reimbursement

Funding status

  • Automatic add on

Description

  • Provides for a 20% add-on to the inpatient prospective payment system diagnosis-related group (DRG) rate for inpatient hospital Covid-19 patients.

Eligibility

  • Both rural and urban hospitals providing inpatient care of a patient diagnosed with Covid-19.

Restrictions

  • Restricted to payments associated with ICD-10 diagnosis codes:
    • U07.1 (Covid-19) for discharges occurring on or after April 1, 2020
    • B97.29 (Other coronavirus as the cause of diseases classified elsewhere) for discharges occurring on or after January 27, 2020, and on or before March 31, 2020
  • For admissions on or after September 1, 2020, a positive Covid-19 laboratory test must be documented in the patient’s medical record to receive the 20% increase. More information can be found here.

Amount

  • Total amount unspecified. 20% add-on payment.

Purpose

  • Support health care-related expenses or lost revenue attributable to Covid-19.

Timeline

Process to get money

  • Automatic increase in reimbursement payments from normal claims processing.

Governing authority

  • CMS

Repayment terms

  • N/A

Additional considerations

  • This provision is also an amendment to the Social Security Act.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Consolidated Appropriations Act, 2021

Category

  • Delayed payment cuts

Funding status

  • Automatic

Description

  • The CARES Act eliminated the fiscal year 2020 Medicaid DSH allotment reductions and the Consolidated Appropriations Act, 2021, further delays scheduled payment cuts through fiscal year 2023.

Eligibility

  • Disproportionate Share Hospitals are eligible.

Restrictions

  • N/A

Amount

  • Eliminates $4 billion in Medicaid DSH allotment reductions that were scheduled to go into effect in 2021 and further eliminates the $8 billion allotment reductions scheduled to take place in 2022 and 2023.

Purpose

  • Originating from the Affordable Care Act (ACA), which sought to reduce payments to safety-net hospitals, as the country in general has observed a declining trend in the number of uninsured Americans. The delayed payment cuts are intended to offset hospitals’ uncompensated care costs attributable to Covid-19.

Timeline

  • On December 27, 2020, the Consolidated Appropriations Act, 2021, was signed into law, delaying payment reductions through fiscal year 2023.

Process to get money

  • Automatic delay in payment cuts.

Governing authority

  • CMS

Repayment terms

  • N/A

Additional considerations

  • The original postponement of Medicaid DSH payment cuts was May 22, 2020, but was subsequently extended by applicable passed bills to December 1, 2020, December 11, 2020, and finally through the fiscal year 2023.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Consolidated Appropriations Act, 2021

Category

  • Reimbursement

Funding status

  • Currently exhausted

Description

  • The telehealth program will provide immediate support to eligible health care providers responding to the Covid-19 pandemic by fully funding their telecommunications services, information services, and devices necessary to provide critical connected care services until the program’s funds have been expended or the Covid-19 pandemic has ended.

Eligibility

  • Nonprofit and public health care providers that fall into the following categories:
    • Post-secondary educational institutions offering health care instruction, teaching hospitals and medical schools
    • Community health centers or health centers providing health care to migrants
    • Local health departments or agencies
    • Community mental health centers
    • Not-for-profit hospitals
    • Rural health clinics
    • Skilled nursing facilities
    • A consortia of health care providers consisting of one or more entities falling into the first seven categories

Restrictions

  • Funds may be used to purchase services and connected devices to provide connected care services in response to Covid-19.

Amount

  • $200 million in the first round of funding from the CARES Act
  • $249.95 million in the second round of funding from the Consolidated Appropriations Act, 2021

Purpose

  • Support efforts of health care providers by providing telecommunications services, information services, and devices necessary for telehealth services to connect patients in response to Covid-19.

Timeline

  • On June 25, 2020, the program stopped accepting new applications. On July 8, 2020, the FCC approved the final set of telehealth program applications. Funding determinations will be made on a rolling basis until program’s funds have been expended or the federal state of emergency declaration has ended.
  • On December 27, 2020, the Consolidated Appropriations Act, 2021, was passed, providing an additional $249.95 million to the Covid-19 telehealth program. The application window for round two of funding opened on April 29th, 2021, and closed on May 6, 2021.

Process to get money

  • Providers must submit an application through the FCC website.

Governing authority

  • Federal Communications Commission (FCC)

Repayment terms

  • N/A

Additional considerations

  • The FCC Covid-19 Telehealth Program is not a grant program. To receive disbursements, eligible health care providers that are approved for funding will be required to submit an invoicing form and supporting documentation in order to receive reimbursement for eligible expenses and services. Applicants who receive funding will be required to comply with all program rules and requirements, including applicable reporting requirements, and may be subject to compliance audits.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Consolidated Appropriations Act, 2021
  • American Rescue Plan Act of 2021

Category

  • Loan

Funding status

  • Currently exhausted

Description

  • The Paycheck Protection Program provides loans to small businesses to help them pay for payroll costs, mortgage interest, rent, utilities, worker protections related to Covid-19, property damage caused by looting or vandalism, and certain operational expenses. The Flexibility Act amended the PPP to be more flexible including:
    • Extends the loan forgiveness use period of PPP loan proceeds from 8 weeks following funding to 24 weeks following funding or December 31, 2020, whichever is earlier.
    • Rehire and restoration of salary date in order to avoid proportional reduction of loan forgiveness extended from June 20, 2020, to December 31, 2020.
    • Portion of PPP loan proceeds required to be applied to payroll costs in order to qualify for loan forgiveness decreased from 75% to 60% of loan proceeds.
    • Increase repayment period for non-forgiven portion of loans from 2 years to 5 years, but only for loans approved on or after June 5, 2020.
  • The SBA initially stopped accepting applications for PPP loans on August 8, 2020. On December 27, 2020, the Consolidated Appropriations Act, 2021, reopened the Paycheck Protection Program for First Draw and Second Draw Loans beginning the week of January 11, 2021. Certain borrowers that previously received a PPP loan are eligible to apply for a Second Draw Loan and borrowers that haven’t received a PPP loan may be eligible to apply for a First Draw Loan.
  • The American Rescue Plan Act of 2021 allocated an additional $7.25 billion to the Paycheck Protection Program.

Eligibility

  • To receive a First Draw PPP Loan, borrowers must have 500 or fewer employees. Eligible entities include nonprofits, veterans’ organizations, tribal concerns, self-employed individuals, sole proprietorships, and independent contractors. Borrowers with more than 500 employees in certain industries are also eligible to apply.
  • To receive a Second Draw PPP Loan borrowers must have previously received a First Draw PPP Loan and used, or will use, the full amount, have 300 or fewer employees, and demonstrate a 25% or greater reduction in gross revenue between comparable quarters in 2019 and 2020.
  • On March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, expanding the loan eligibility to include larger nonprofits by counting employees per physical location of the organization. It also expanded the eligibility to include digital news services providing public health guidance during the pandemic with 500 or fewer employees per physical location of the organization.

Restrictions

  • Companies must have already been in business as of February 15, 2020. Per treasury guidance issued on April 3, 2020, many companies funded by private equity or venture capital may be ineligible for loans due to SBA affiliation rules. Bankrupt hospitals or hospitals in bankruptcy proceedings are not eligible.
  • The maximum amount of a Second Draw PPP Loan is 2.5 times the borrower’s average monthly 2019 or 2020 payroll costs or up to $2 million.

Amount

  • CARES Act - $321 billion
  • Consolidated Appropriations Act - $284 billion
  • American Rescue Plan Act of 2021 - $7.25 billion

Purpose

  • To incentivize employers to maintain payroll during the Covid-19 crisis, the SBA is providing 100% federally-backed loans for certain payroll expenses.

Timeline

  • The original application deadline for a PPP loan closed June 30, 2020, however $130 billion remained in available funding. The Flexibility Act was passed June 5, 2020, which amended extending the borrowing eligibility for qualifying first-time PPP borrowers from June 30, 2020, to August 8, 2020.
  • On December 27, 2020, the Consolidated Appropriations Act, 2021, reopened the Paycheck Protection Program for First Draw and Second Draw Loans beginning the week of January 11, 2021. The deadline to apply for loans is March 31, 2021.
  • On March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, allocating $7.25 billion in funding to the Paycheck Protection Program.
  • On May 31, 2021, the Paycheck Protection Program ended.

Process to get money

  • When an application is accepted, funds should be available promptly. The First Draw Loan application form can be found here and the Second Draw Loan application can be found here.

Governing authority

  • Small Business Administration (SBA)

Repayment terms

  • The first payment is due 10 months after the last day of the covered period, while the loan must be fully repaid within 2 years (5 years for loans approved on or after June 5, 2020) if it isn’t forgiven. If borrowers seek loan forgiveness by this date, repayments commence on the date that any forgiveness is remitted by the SBA. Loans may be forgiven if during the covered period: employee and compensation levels are maintained, at least 60% of the loan is spent on payroll costs, and the rest of the loan is only spent on other eligible expenses.
  • The Consolidated Appropriations Act, 2021, simplifies the loan forgiveness process for loans under $150,000.

Additional considerations

  • The PPP also waives all SBA fees and provides deferral on loan repayments for a minimum of six months up to a maximum of one year. The CARES Act caps interest rates at 4%, but the initial rate has been set much lower: 1.0%. Hospitals accepting loans under the PPP face the potential of public backlash, especially considering the clause that loanees agree that "current economic uncertainty makes this loan necessary to support" ongoing operations.
  • $15 billion is being set aside for First Draw PPP Loans and $25 billion for Second Draw PPP Loans to eligible borrowers with 10 or fewer employees or for loans of $250,000 or less to eligible borrowers in low- or moderate-income neighborhoods.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Loan

Funding status

  • Currently exhausted

Description

  • The Main Street Lending Program is a program in which the Federal Reserve will purchase loans that banks give to small and mid-sized businesses. The Fed will purchase 95% of each loan, with the bank keeping 5% of the loan on its books to discourage irresponsible lending. The MSLP includes five types of term loan facilities:
    • Main Street New Loan Facility (MSNLF): Refers to loans originated on or after April 24, 2020. The value of the loans purchased may be between $100,000 and the lower of $35 million in value or an amount that, when added to current debt, doesn't exceed four times its 2019 EBITDA.
    • Main Street Priority Loan Facility (MSPLF): Refers to loans originated on or after April 24, 2020. The value of the loans purchased may be between $100,000 and the lower of $50 million in value or an amount that, when added to current debt, doesn't exceed six times its 2019 EBITDA.
    • Main Street Expanded Loan Facility (MSELF): Refers to increases in the amount of existing term loan or revolving credit facilities on or before April 24, 2020. The value of the loans purchased may be between $10 million and the lesser of $300 million, or an amount that when added to outstanding and available debt, doesn't exceed six times its 2019 EBITDA.
    • Nonprofit Organization New Loan Facility (NONLF): Refers to loans originated on or after June 15, 2020. The value of loans purchased may be between $100,000 and the lower of $35 million in value or the eligible borrower’s average 2019 quarterly revenue.
    • Nonprofit Organization Expanded Loan Facility (NOELF): Refers to loans originated on or after June 15, 2020. The value of loans purchased may be between $10 million and the lower of $300 million or the eligible borrower’s average 2019 quarterly revenue.”
    Unlike the popular Payroll Protection Program, MSLP loans will not be eligible for loan forgiveness.

Eligibility

  • Businesses created or organized for profit in the U.S. or under U.S. law prior to March 13, 2020, that were in good financial standing before the Covid-19 crisis are eligible to obtain a Main Street loan if they have either no more than 15,000 employees or had 2019 annual revenues of less than $5 billion. Additional eligibility criteria can be found here.
  • On September 4, 2020, the Federal Reserve announced they are accepting submissions of loans to non-profits through the Main Street Lending Program. More information can be found here.

Restrictions

  • Loan may not be used to pay other loans, or reduce any other lines of credit; Borrower must attest that that its outstanding debt does not exceed four times the borrower's 2019 EBITDA; Must satisfy the "conflicts of interest prohibition" outlined in the CARES Act; Borrowers had to have existed before January 1, 2015; Until 12 months after the date on which the loan is no longer outstanding, borrower must agree to certain restrictions on employee and officer compensation in excess of $425,000. Additional restrictions can be found here.

Amount

  • $600 billion. Minimum and maximum loans size considerations can be found here.

Purpose

  • The program is designed to keep credit flowing to small and mid-sized businesses that were in sound financial condition before the onset of the Covid-19 crisis, but which are now under tremendous stress.

Timeline

  • The program became fully operational on July 6, 2020. The Federal Reserve ceased issuing loans on January 8, 2021.

Process to get money

Governing authority

  • Federal Reserve

Repayment terms

Additional considerations

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Loan

Funding status

  • Currently funded, but suspended

Description

  • Allows providers advance payments (up to six months) to provide emergency funding and address cash flow issues. Payments under the program are essentially advances of Medicare revenues that CMS expects would be paid to the provider or supplier for future services.

Eligibility

  • To qualify for advance/accelerated payments the provider/supplier must: have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form, not be in bankruptcy, not be under active medical review or program integrity investigation, and not have any outstanding delinquent Medicare overpayments.

Restrictions

  • Services not covered by traditional Medicare will also not be covered under this program. The following services are excluded: Any treatment without a Covid-19 primary diagnosis, except for pregnancy when the Covid-19 code may be listed as secondary; hospice services; outpatient prescription drugs.

Amount

  • Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period.

Purpose

  • The program has existed for many years to provide liquidity for hospitals through emergency funding to address cash flow issues where there is a disruption in claims submission or claims processing for Medicare providers and suppliers. CMS had expanded it to include non-hospital providers that may be experiencing cash-flow issues as a result of the Covid-19 public health emergency.

Timeline

Process to get money

Governing authority

  • CMS

Repayment terms

  • CMS has extended the repayment of these accelerated payments to begin one year after the date of issuance of the payment. The repayment timeline is broken out by provider type.

Additional considerations

  • The advance does not become a debt that accrues interest unless the provider fails to satisfy the advance through offsets against future claims or direct repayment within a certain timeframe. The repayment process for hospitals is up to one year to repay the balance owed. After one year, the third-party administrator will send a request for repayment.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Paycheck Protection Program and Health Care Enhancement Act
  • Consolidated Appropriations Act, 2021

Category

  • Grant

Funding status

  • Currently funded

Description

  • HHS is distributing $178 billion to hospitals and health care providers to prevent, prepare for, and respond to coronavirus.
  • Congress appropriated three lump sum relief packages of $100 billion (from the CARES Act), $75 billion (from the Paycheck Protection Program and Health Care Enhancement Act), and an additional $3 billion (from the Consolidated Appropriations Act, 2021) to reimburse eligible health care providers for expenses or lost revenues attributable to coronavirus; together they make up the Provider Relief Fund (PRF).
  • HHS has the discretion to allow funds to be used for temporary facilities, leasing properties, supplies and equipment, testing supplies, increased workforce and training costs, emergency operation centers, retrofitting facilities and surge capacity.

Eligibility

  • Provider Relief Funds are broken down into “General” and “Targeted” Distributions. According to HHS, the basic requirement for General Distribution funds is that the provider billed Medicare fee-for-service in 2019, is a Medicaid and CHIP or dental provider, and provides or provided "diagnoses, testing, or care for individuals with possible or actual cases of Covid-19." HHS has construed any medical encounter to be a possible case of Covid-19. Eligibility requirements for Targeted Distribution funds vary; more information can be found here.
  • Your provider facility does not have to be "currently taking patients" as long as your facility was still seeing patients after January 31, 2020.

Restrictions

  • Funds can't be used to reimburse expenses or losses that have been reimbursed by other sources or that another source is obligated to reimburse.

Amount

  • $178 billion ($100 billion, $75 billion, and $3 billion)

Purpose

  • Support providers to prevent, prepare for, and respond to coronavirus and to reimburse eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus.

Timeline

  • On March 27, 2020, the CARES Act was signed into law that included $100 billion in the Provider Relief Fund. April 10, 2020, through April 17, 2020, began first round General Distributions to providers. On April 24, 2020, an additional $75 billion was added to the Provider Relief Fund. On December 27, 2020, the Consolidated Appropriations Act, 2021, earmarked $3 billion for the Provider Relief Fund. Funds are still currently being distributed by HHS.

Process to get money

  • Applicants “shall submit to the Secretary of Health and Human Services an application that includes a statement justifying the need of the provider for the payment and the eligible health care provider shall have a valid tax identification number.” The CARES Act does not provide any further direction on the application process. Recipients must sign an attestation, accept or refuse funds, agree to terms and conditions, submit revenue information, and request reimbursement.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • All providers receiving Provider Relief Fund payments will be required to comply with the reporting requirements described in the terms and conditions and specified in future directions issued by the Secretary. The Reporting Portal opened July 1, 2021, for providers who received payments in Period 1, from April 10, 2020, to June 30, 2020.
  • The Consolidated Appropriations Act, 2021, requires that 85% of PRF distributions made after the passing of the bill be provided based on applications that consider financial losses and changes in expenses in the second half of 2020 and the first quarter of 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Grant

Funding status

  • Currently funded

Description

  • $46.02 billion of the Phase 1 General Distribution was distributed to facilities and providers which billed Medicare in 2019, and were impacted by Covid-19, based on providers' 2018 net patient revenue. The initial round of $30 billion (Tranche 1) payment allocation was proportional to providers’ portion of Medicare fee-for-service revenue. The second round distribution of $16.02 billion (Tranche 2) was based on revenue submissions to the provider portal.

Eligibility

  • Eligible health care providers are Medicare or Medicaid enrolled suppliers and providers that "provide diagnoses, testing, or care for individuals with possible or actual cases of Covid-19." Providers need to have billed Medicare in 2019; and provided some patient care after January 31, 2020.

Restrictions

Amount

  • $46.02 billion ($30 billion initial & $16.02 billion additional)

Purpose

  • Provide support to eligible health care providers incurring expenses or lost revenue attributable to Covid-19.

Timeline

  • The initial round of $30 billion (Tranche 1) was distributed between April 10, 2020, and April 17, 2020. The second round of $16.02 billion (Tranche 2) began distribution on April 24, 2020.

Process to get money

  • Applicants “shall submit to the Secretary of Health and Human Services an application that includes a statement justifying the need of the provider for the payment and the eligible health care provider shall have a valid tax identification number.” The CARES Act does not provide any further direction on the application process. You must sign an attestation confirming receipt of the funds and agree to the Terms and Conditions within 90 days of ACH payment or 90 days of check payment issuance.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • All providers who had automatically received funds prior to 5:00 pm, Friday, April 24th, 2020, must provide HHS with an accounting of their annual revenues by submitting tax forms or financial statements.
  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Grant

Funding status

  • Currently funded

Description

  • This distribution provided approximately $5.98 billion to eligible providers that participate in state Medicaid/CHIP programs and Medicaid managed care plans, dentists, certain Medicare providers, and assisted living facilities. The payment to each provider will be up to 2% of reported gross revenue from patient care.

Eligibility

  • Eligible providers must meet all of the following requirements:
    • Either:
      • Must have either (i) directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for health care-related services during the period of January 1, 2018, to December 31, 2019, or (ii) own (on the application date) an included subsidiary that has either directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for health care-related services during the period of January 1, 2018, to December 31, 2019; or
      • Must be a dental service provider who has either (i) directly billed health insurance companies for oral health care-related services, or (ii) owns (on the application date) an included subsidiary that has directly billed health insurance companies for oral health care-related services; or
      • Must be a licensed dental service provider who does not accept insurance and has either (i) directly billed patients for oral health care-related services, or (ii) who owns (on the application date) an included subsidiary that does not accept insurance and has directly billed patients for oral health care-related services;
      • Must have billed Medicare fee-for-service during the period of January 1, 2019 and December 31, 2019; or
      • Must be a Medicare Part A provider that experienced a change in ownership and billed Medicare fee-for-service in 2019 and 2020 that prevented the otherwise eligible provider from receiving a Phase 1 - General Distribution payment; or
    • Must be a state-licensed/certified assisted living facility.
    • Must have either (i) filed a federal income tax return for fiscal years 2017, 2018 or 2019 or (ii) be an entity exempt from the requirement to file a federal income tax return and have no beneficial owner that is required to file a federal income tax return. (e.g. a state-owned hospital or health care clinic); and
    • Must have provided patient care after January 31, 2020; and
    • Must not have permanently ceased providing patient care directly, or indirectly through included subsidiaries; and
    • If the applicant is an individual, have gross receipts or sales from providing patient care reported on Form 1040, Schedule C, Line 1, excluding income reported on a W-2 as a (statutory) employee.
  • Review the updated HHS FAQ for further clarity surrounding the eligibility requirements.

Restrictions

Amount

  • $5.98 billion

Purpose

  • To support providers that participate in state Medicaid/CHIP programs and/or Medicaid managed care programs as well as Medicare providers who may have missed the Phase 1 General Distribution deadline.

Timeline

  • Distribution began the week of June 9, 2020. The deadline to apply for the Phase 2 General Distribution was September 13, 2020.

Process to get money

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • HHS estimated that nearly 1 million providers might be eligible for the funding. Approximately 62% of all providers participating in state Medicaid and CHIP programs received payments during the initial general distribution.
  • Providers who already received a payment under the Phase 1 General Distribution were eligible to apply. If they have not yet received a payment of approximately 2% of their annual revenue from patient care, they may receive additional funds.
  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Paycheck Protection Program and Health Care Enhancement Act
  • Consolidated Appropriations Act, 2021

Category

  • Grant

Funding status

  • Currently funded

Description

  • AnnouncedOctober 1, 2020, HHS is allocating for general distribution $20 billion in funding to support frontline health care providers that have endured financial losses because of the Covid-19 pandemic. This Phase 3 General Distribution will stem from the Provider Relief Fund.
  • Announced December 16, 2020, HHS began distributing $24.5 billion in Phase 3 General Distributions, adding $4.5 billion to the initial $20 billion allocation announced October 1, 2020.

Eligibility

  • Eligible providers must meet one of the following criteria:
    • Billed Medicaid/CHIP programs or Medicaid managed care plans for health-related services between January 1, 2018, and March 31, 2020; or
    • Billed a health insurance company for oral healthcare-related services as a dental service provider as of March 31, 2020; or
    • Be a licensed dental service provider as of March. 31, 2020, who does not accept insurance and has billed patients for oral healthcare-related services; or
    • Billed Medicare fee-for-service during the period of January 1, 2019, and March 31, 2020; or
    • Be a Medicare Part A provider that experienced a CMS approved change in ownership prior to August 10, 2020; or
    • Be a state-licensed / certified assisted living facility as of March 31, 2020
    • Be a behavioral health provider as of March 31, 2020 who has billed a health insurance company or who does not accept insurance and has billed patients for healthcare-related services as of March 31, 2020
    • Additionally, eligible providers must meet all of the following requirements:
    • Filed a federal income tax return for fiscal years 2017, 2018, 2019 if in operation before January 1, 2020; or be exempt from filing a return; and
    • Provided patient care after January 31, 2020 (Note: patient care includes health care, services, and support, as provided in a medical setting, at home, or in the community); and
    • Did not permanently cease providing patient care directly or indirectly; and
    • For individuals providing care before January 1, 2020, have gross receipts or sales from patient care reported on Form 1040 (or other tax form)
  • Visit this pagefor more information on eligibility requirements.

Restrictions

  • Payment recipients are required to attest to receiving the Phase 3 General Distribution payment and accept the Terms and Conditions.

Amount

  • $24.5 billion ($20 billion initial and $4.5 billion additional)

Purpose

  • To provide additional support to eligible providers who have lost revenues and/or increased expenses attributable to Covid-19.

Timeline

  • Providers can apply for Phase 3 General Distribution funding from October 5, 2020, through November 6, 2020.

Process to get money

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • HHS is encouraging all eligible providers to apply early to expedite the review process and payment calculations, and ultimately to speed up the distribution of all payments.
  • Providers will be considered for payment based on the following criteria:
    • Applicants who have already received a PRF payment of approximately 2% of patient care revenue will receive an additional payment based on the provider’s change in operating revenue and expenses for patient care and payments already received through prior PRF distributions.
    • Applicants who have not yet received a PRF payment of 2% of patient care revenue will receive a payment that equals that 2% when combined with previous payments (if any).

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Grant

Funding status

  • Currently exhausted

Description

  • HHS distributed funding to hospitals in areas that have been particularly hard hit with a high number of confirmed Covid-19 positive inpatient admissions. This is a targeted distribution stemming from the original $100 billion Provider Relief Fund.

Eligibility

  • First round allocation: Hospitals and other health care providers that provided inpatient care for 100 or more Covid-19 patients between January 1 and April 10, 2020, may receive $76,975 per eligible admission.
  • Second round allocation: Hospitals and other health care providers that provided inpatient care for 161 (one admission per day) or more Covid-19 patients between January 1 and June 10, 2020, may receive $50,000 per eligible admission.

Restrictions

Amount

  • $20.75 billion

Purpose

  • Support health care related expenses or lost revenue for hospitals in areas particularly impacted by Covid-19.

Timeline

  • On May 7, 2020, HHS automatically distributed first round funding to 395 hospitals, based on data requested from hospitals in April. The first round of funding deadline was April 25, 2020. Second round of funding for the Hospital Hot-Spot Distribution began during week of July 20, 2020. The second round of funding deadline was June 15, 2020.

Process to get money

  • Within 45 days of receipt of the funds, providers must sign an attestation through the program portal confirming receipt and agree to the terms and conditions.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • Previous high impact payments were also taken into account when determining each hospital’s payment in the second round distribution.
  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Currently funded

Description

  • HHS distributed $10.02 billion in funding to over 8,000 rural hospitals, including rural acute care general hospitals and Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs), and Community Health Centers located in rural areas. This is a targeted distribution stemming from the original $100 billion Provider Relief Fund, as part of the CARES Act.
  • HHS distributed an additional $107 billion in funding to over 500 specialty rural hospitals, urban hospitals with certain rural Medicare designations, and hospitals in small metropolitan areas.
  • The American Rescue Plan Act of 2021 allocated an additional $8.5 billion in funding for rural hospitals and facilities for healthcare-related expenses and lost revenues attributable to Covid-19. Although this funding provision largely mirrors previous language utilized to create the Provider Relief Fund, it is a separate fund.

Eligibility

  • Eligible providers must be located in a geography that meets the rural definition located here.
  • Funding provided by the American Rescue Plan Act of 2021 limits spending to Medicare and/or Medicaid providers and suppliers located in a rural area or treated as located in a rural area pursuant to Section 1886(d)(8)(e) of the Social Security Act. Criteria to be a rural provider or supplier include being located in a rural census tract of a metropolitan statistical area or a state-designated rural area or being a rural referral center or sole community hospital.

Restrictions

Amount

  • CARES Act - $11.09 billion (Initial $10.02 billion plus an additional $1.07 billion)
  • American Rescue Plan Act of 2021 – $8.5 billion

Purpose

  • Support health care related expenses or lost revenue attributable to Covid-19 for hospitals in areas that are identified as rural. This funding recognizes that rural hospitals, health clinics, and health centers function with lower operating margins than urban and suburban providers and thus are at greater risk of closure as a result of reduced volumes attributable to Covid-19.

Timeline

  • On May 6, 2020, HHS automatically distributed the initial $10.02 billion in funds. On July 10, 2020, the additional $1.07 billion was distributed to specialty rural hospitals, urban hospitals with certain rural Medicare designations, and hospitals in small metropolitan areas.
  • On March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, allocating $8.5 billion in funding for rural hospitals and facilities.

Process to get money

  • As directed by the CARES Act, HHS used the December 2019 CMS Provider of Services file to identify hospitals, CAHs, and RHCs. Hospitals needed to provide specific information by April 23, 2020.
  • As directed by the American Rescue Plan Act of 2021, eligible rural providers will need to submit an application, including documentation of actual healthcare-related expenses and lost revenues attributable to Covid-19.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • Payments range from $100,000 to $4.5 million depending on the rural criteria.
  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Currently funded (American Rescue Plan Act of 2021)

Description

  • HHS distributed $5 billion to support nursing homes suffering from significant expenses or lost revenue attributable to Covid-19. Approximately 13,000 certified Skilled Nursing Facilities received a fixed distribution of $50,000, plus an additional $2,500 per bed. This is a targeted distribution stemming from the original $100 billion Provider Relief Fund.
  • The American Rescue Plan Act of 2021 allocated an additional $450 million to HHS outside of the Provider Relief Fund to support skilled nursing facilities during Covid-19.

Eligibility

  • All certified SNFs with six or more certified beds are eligible for the funding from the CARES Act.

Restrictions

Amount

  • CARES Act - $5 billion
  • American Rescue Plan of 2021 - $450 million, including:
    • $200 million to HHS to carry out Covid-19 infection control support in skilled nursing facilities
    • $250 million to HHS to distribute to states and territories to respond to Covid-19 outbreaks in skilled nursing homes using strike teams

Purpose

  • Support nursing homes to address critical needs such as labor, scaling up their testing capacity, acquiring personal protective equipment, lost revenue, and a range of other expenses attributable to Covid-19.

Timeline

  • On May 22, 2020, HHS automatically distributed funds via ACH to each organization’s central billing office.
  • On March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, allocating an additional $450 million to HHS outside of the Provider Relief Fund to support skilled nursing facilities during Covid-19.

Process to get money

  • The funding from the CARES Act was automatically distributed.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Paycheck Protection Program and Health Care Enhancement Act

Category

  • Grant

Funding status

  • Currently funded

Description

  • Announced August 7, 2020, HHS allocated $5 billion from the Provider Relief Fund to nursing homes and long-term care facilities to help protect the Americans most vulnerable to Covid-19. The initial distribution (Allocation for Nursing Home Infection Control) provided $2.75 billion upfront to support the critical needs of nursing homes including increasing testing, staffing, and the supply of personal protective equipment.
  • The second distribution (Allocation for Nursing Home Quality Incentive Payment Program) of $2.25 billion is being dispersed based on nursing home performance, as determined by HHS. Nursing home performance will be evaluated on the ability of the facility to minimize the spread of Covid-19 and reduce attributable fatalities among residents. Because almost 40% of all Covid-19 deaths in America are nursing home related, a performance-based distribution structure will promote better outcomes and nursing home accountability. The performance evaluation will also factor in the prevalence of Covid-19 in the local community of the respective nursing home.

Eligibility

  • Medicare-certified long-term care facilities and state veterans’ homes, or nursing homes.
  • In partnership with the CDC, CMS is releasing an online Nursing Home Covid-19 Training which focuses on best practices and infection control. The training has 23 educational and scenario-based learning modules to equip nursing homes to mitigate the spread of the virus. Nursing homes must participate in the CMS Nursing Home Covid-19 Training in order to qualify for funding.

Restrictions

Amount

  • $5 billion:
    • Allocation for Nursing Home Infection Control: $2.75 billion
    • Allocation for Nursing Home Quality Incentive Payment Program: $2.25 billion

Purpose

  • To help nursing homes and long-term care facilities better protect their residents from Covid-19.

Timeline

  • The initial $2.75 billion was distributed on August 27, 2020.
  • On October 28, 2020, $333 million in first round performance payments was distributed to over 10,000 nursing homes. On December 7, 2020, $523 million in second round performance payments was distributed to over 9,000 nursing homes.

Process to get money

  • The initial $2.75 billion was automatically distributed to nursing homes.
  • Average-sized nursing homes that received an antigen testing device as part of a separate HHS initiative will receive $90,000 and those that did not receive the device will receive $170,000.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • This new funding is in addition to the $5 billion that was distributed to Skilled Nursing Facilities (SNFs) by HHS in May 2020.
  • The $2.25 billion performance-based distribution program will be entirely prospective and will not penalize facilities for past performance. The program does not penalize for admitting positive patients into dedicated Covid-19 units.
  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Currently funded (American Rescue Plan Act of 2021)

Description

  • HHS distributed $520 million to approximately 400 tribal hospitals, clinics, and urban health centers, based on operating expenses. This is a targeted distribution stemming from the original $100 billion Provider Relief Fund as part of the CARES Act.
  • The American Rescue Plan Act of 2021 allocated an additional $5.4 billion to support the activities of the Indian Health Service outside of the Provider Relief Fund.

Eligibility

  • Must be an Indian Health Service (IHS) provider to have received funding from the CARES Act.
  • The funding from the American Rescue Plan Act of 2021 is available to Tribes and Tribal organizations to restore funds lost since the beginning of the public health emergency.

Restrictions

Amount

  • CARES Act - $520 million
  • American Rescue Plan of 2021 - $5.4 billion

Purpose

  • The pandemic has disproportionately impacted IHS providers and programs critical to stopping the spread of Covid-19. This funding provides vital support to these health care facilities, which in some cases may be the only health care facility within a day's traveling distance for those served.
  • This funding complements other funding provided to expand IHS capacity for telehealth and testing.

Timeline

  • On May 29, 2020, HHS automatically distributed funds to approximately 400 Indian Health Service programs.
  • On March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, providing an additional $5.4 billion to support the activities of the Indian Health Service outside of the Provider Relief Fund.

Process to get money

  • The funding from the CARES Act was automatically distributed.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Paycheck Protection Program and Health Care Enhancement Act

Category

  • Grant

Funding status

  • Currently funded

Description

  • HHS distributed $14.13 billion in provider relief funds to safety net hospitals that disproportionately provide care to the most vulnerable, those without insurance coverage, and traditionally operate on thin margins. An initial $10.11 billion distribution to 764 qualified hospitals provided targeted funding to safety net hospitals. An additional $2.96 billion distribution went to 227 acute care hospitals under the revised profitability threshold. HHS also distributed $1.06 billion to almost 80 free-standing children's hospitals facing financial hardships caused by the pandemic. This is a targeted distribution stemming from the original $100 billion Provider Relief Fund.

Eligibility

  • Safety net hospitals: Hospitals with Medicare Disproportionate Payment Percentage (DPP) of 20.2% or greater, average uncompensated care per bed of $25,000 or more, and profitability of 3% or less.
  • Children’s hospitals: Qualifying free-standing children’s hospital must either be an exempt hospital under the CMS inpatient prospective payment system (IPPS) or be a HRSA defined Children’s Hospital Graduate Medical Education facility.

Restrictions

Amount

  • $14.13 billion ($10.11 billion for eligible safety net hospitals, $2.96 billion for acute care facilities, and $1.06 billion for free-standing children’s hospitals)

Purpose

  • Recognizing the incredibly thin margins safety net hospitals operate on, HHS allocated funding to be distributed to safety net hospitals that serve the most vulnerable citizens and operate at low or negative profit margins, and thus are at greater risk of closure as a result of reduced volumes attributable to Covid-19. Certain free-standing children’s hospitals that are not a part of a larger hospital system did not receive funding from HHS’s original allocation to safety net hospitals. This additional funding will ensure that these hospitals receive the relief they need to continue safely caring for children.

Timeline

  • Initial distribution began the week of June 8, 2020. Hospitals must have submitted their information by June 15, 2020. On July 10, 2020, HHS announced additional Safety Net Expansion funding of $2.96 billion.
  • Announced August 14, 2020, HHS began distributing $1.06 billion to free-standing children’s hospitals beginning the week of August 17, 2020.

Process to get money

  • Payment to safety net hospitals and acute care facilities is being sent directly via direct deposit. Eligible hospitals will receive a minimum of $5 million and a maximum of $50 million. Additional information on the application process can be found here. The automatic payment allocation for the almost 80 eligible free-standing children’s hospitals will be 2.5% of their net revenue from patient care.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • HHS stated that it expanded the Safety-Net Distribution after learning that certain acute care hospitals believed to be the target of the allocation did not previously qualify. Hospitals may be subject to audits to ensure the data provided to HHS is accurate.
  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Currently funded

Description

  • Within the Provider Relief Fund, a portion of the funding will be used to support health care-related expenses attributable to the treatment of uninsured individuals with Covid-19.
  • HHS will provide claims reimbursement to health care providers generally at Medicare rates for testing uninsured individuals for Covid-19 and treating uninsured individuals with a Covid-19 diagnosis.

Eligibility

  • Health care providers who have conducted Covid-19 testing or provided treatment for uninsured individuals with a Covid-19 diagnosis on or after February 4, 2020.

Restrictions

  • Providers may submit claims for individuals in the U.S. without health care coverage. Services not covered by traditional Medicare will also not be covered under this program. Health care providers are not required to confirm immigration status when submitting claims.

Amount

  • The Families First Coronavirus Response Act Relief Fund includes $2 billion ($1 billion appropriated through the FFCRA and $1 billion appropriated through the Paycheck Protection Program) to reimburse providers for Covid-19 testing for uninsured individuals.
  • A portion of the $175 billion Provider Relief Fund will be used to reimburse providers treating uninsured individuals with Covid-19. Because Congress has not appropriated any money specifically for this purpose, it is unclear how much funding has been allocated to this program.
  • HHS dedicated $4.8 billion from the American Rescue Plan to reimburse providers for testing uninsured individuals for Covid-19.
  • Cost estimates for uninsured patients range from $13.9 billion to $41.8 billion.

Purpose

  • To fully protect people who are uninsured, this program reimburses providers for treating uninsured patients with Covid-19.

Timeline

  • April 22, 2020: Program details launch
  • April 27, 2020: Sign up period begins for the program
  • April 29, 2020: On demand training starts
  • May 6, 2020: Begin submitting claims electronically
  • May 18, 2020: Begin receiving reimbursement
  • Program end date is to be determined.

Process to get money

  • Providers who have conducted Covid-19 testing or provided treatment for uninsured individuals with a Covid-19 diagnosis on or after February 4, 2020, can begin the process to file claims for reimbursement for testing and treating the uninsured.
  • Steps will involve enrolling as a provider participant, checking patient eligibility, submitting patient information, submitting claims electronically, and receiving payment via direct deposit.
  • Reimbursement subject to available funding.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Currently funded (American Rescue Plan Act of 2021)

Description

  • Originally funded by the Protecting Access to Medicare Act of 2014, the Certified Community Behavioral Health Clinic Expansion Grant program received an additional $250 million in emergency Covid-19 funding under the CARES Act to expand access to mental health and substance use disorder treatment services through certified community behavioral health clinics.
  • The American Rescue Plan of 2021 provides an additional $3 billion for block grants to states for the Community Mental Health Services Block Grant program and for the Substance Abuse Prevention Treatment Block Grant program. $420 million in funding is allocated for SAMHSA Certified Community Behavioral Health Clinics (CCBHCs) Expansion Grants.
  • Funding is also provided for a variety of mental and behavioral health-related programs, including $20 million for an awareness campaign focused on healthcare professionals; $40 million for healthcare workforce mental and behavioral care; $30 million for community-based overdose prevention programs, syringe service programs and other harm reduction programs; and $50 million for community behavioral health needs worsened by Covid-19.

Eligibility

  • Certified community behavioral health clinics or community-based behavioral health clinics who may not yet be certified but meet the certification criteria and can be certified within four months of award. There are four separate registrations that must be completed for all applicants to apply to a SAMHSA grant. Eligibility requirements may change according to grant.
  • According to the American Rescue Plan of 2021, the block grant programs provide funding to all U.S. states and territories for programs targeting those with serious mental illnesses and to prevent and treat substance abuse.

Restrictions

  • N/A

Amount

  • CARES Act – $250 million
  • American Rescue Plan Act of 2021
    • $3 billion in block grants to states for community mental health services and for substance abuse prevention treatment programs
    • $420 million in funding is allocated for SAMHSA Certified Community Behavioral Health Clinics (CCBHCs) Expansion Grants
    • $20 million for an awareness campaign focused on healthcare professionals
    • $40 million for healthcare workforce mental and behavioral care
    • $30 million for community-based overdose prevention programs
    • $50 million for community behavioral health needs

Purpose

  • Provide crisis intervention services, mental and substance use disorder treatment, and other related recovery support for children and adults impacted by Covid-19.

Timeline

Process to get money

  • Application instructions, from the CARES Act allocation.
  • Application for or distribution of funding from the American Rescue Plan Act of 2021 have not yet been released.

Governing authority

  • Substance Abuse and Mental Health Services Administration (SAMHSA), a subsidiary of HHS.

Repayment terms

  • N/A

Additional considerations

  • It is strongly recommended that applicants start the registration process six weeks in advance of the application due date, per the CARES Act allocation.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Grant

Funding status

  • Currently funded

Description

  • FEMA’s Disaster Relief Fund became available for Public Assistance (PA) grant funding after the President’s emergency declaration under the Stafford Act, Congress appropriated an additional $45 billion for FEMA’s Disaster Relief Fund.
  • Funds may be used to support new construction needed to respond to the disaster, and to cover unanticipated staffing and supplies cost. For nonprofits struggling with cash flow and financial sustainability during this unprecedented time, FEMA funds can help offset some significant costs.

Eligibility

  • State agencies, local governments, tribal governments, certain types of private nonprofit (PNP) organizations (including hospitals, clinics, and long-term care facilities, among others). FEMA must first determine whether the PNP owns or operates an eligible facility. An eligible facility is one that provides eligible services, including:
    • A critical service, which is defined as education, utility, emergency or medical; or
    • A facility that provides noncritical but essential social services AND provides these services to the general public; or
    • Certain types of facilities such as senior centers that restrict access in a manner clearly related to the nature of the facility but that are still considered to provide essential social services to the general public.
  • Work and costs eligible for FEMA PA Program funding are Category B Emergency Protective Measures, including:
    • Virus testing
    • Medical supplies and equipment
    • Shelters or emergency care
    • Provision of food, water, ice or other essential needs
    • Security for temporary facilities

Restrictions

  • To be eligible, costs must be:
    • Directly tied to the performance of eligible work;
    • Adequately documented;
    • Reduced by all applicable credits, such as insurance proceeds and salvage values;
    • Authorized and not prohibited under federal, state, territorial, tribal or local government laws or regulations;
    • Consistent with the applicant’s internal policies, regulations, and procedures that apply uniformly to both federal awards and other activities of the applicant; and
    • Necessary and reasonable to accomplish the work properly and efficiently.
  • It is important to note that all costs must be documented, must comply with appropriate guidelines, and must be reasonable and necessary to protect the public from the Covid-19 pandemic.

Amount

  • $45 billion

Purpose

  • Reimburse entities for actions taken before, during and following the Covid-19 pandemic to save lives, protect public health and safety, or eliminate immediate threat of significant damage to improve public health and property.

Timeline

  • Funds available until expended. To be eligible, costs must be incurred within the approved period of performance: January 20, 2020, and September 19, 2020. Recommended to apply ASAP, but deadline is waived.

Process to get money

  • An overview of the application process and steps to apply through the FEMA Public Assistance Grants Portal are available here.

Governing authority

  • Federal Emergency Management Agency (FEMA)

Repayment terms

  • N/A

Additional considerations

  • Successful grant applicants can receive funding to cover 75% of the eligible expenses (except California, Washington and New York, waiver for 100%).

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Grant

Funding status

  • Program closed

Description

  • The Distance Learning and Telemedicine program helps rural communities use the unique capabilities of telecommunications to connect to each other and to the world, overcoming the effects of remoteness and low population density.

Eligibility

  • Entities that provide education or health care through telecommunications including most state and local governmental entities, federally recognized tribes, nonprofits, and for-profit businesses.

Restrictions

  • Grant funds may be used for:
    • Acquisition of eligible capital assets, such as:
      • Broadband facilities
      • Audio, video and interactive video equipment
      • Terminal and data terminal equipment
      • Computer hardware, network components and software
      • Inside wiring and similar infrastructure that further DLT services
    • Acquisition of instructional programming that is a capital asset
    • Acquisition of technical assistance and instruction for using eligible equipment

Amount

  • $42.3 million from the USDA, including the $25 million added by CARES Act to the $72 million already available.

Purpose

  • Support the use of telecoms-enabled information, audio and video equipment, and related advanced technologies by students, teachers, medical professional and rural residents, and to increase rural access to education, training and health care resources that are otherwise unavailable or limited in scope as affected by the Covid-19 pandemic.

Timeline

  • Funds available until expended. Second application deadline is July 13, 2020.
  • On February 25, 2021, the USDA announced it was investing $42.3 million in distance learning and telemedicine infrastructure, including the $25 million provided in the CARES Act.
  • On April 6, 2021, the USDA announced that it was accepting applications for DLT program grants beginning April 5, 2021, and ending June 4, 2021. The USDA planned to appropriate $44.5 million in funding towards DLT programs in FY2021.

Process to get money

Governing authority

  • U.S. Department of Agriculture (USDA) Rural Development

Repayment terms

  • N/A

Additional considerations

  • Grant-only funds with a 15% match required.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Grant

Funding status

  • Currently exhausted

Description

  • HRSA awarded $20 million to increase telehealth access and infrastructure for providers and families to help prevent and respond to Covid-19.
  • HRSA’s Maternal and Child Health Bureau (MCHB) awarded a total of $15 million to four recipients. Each award supports a key area in maternal and child health: pediatric care, maternal health care, state public health systems and family engagement for children with special health care needs.
  • HRSA’s Federal Office of Rural Health Policy (FORHP) awarded a total of $5 million to two recipients through the Licensure Portability Grant Program. This investment will assist telehealth clinicians nationally on licensure and credentialing to meet the emerging needs with the Covid-19 public health emergency.

Eligibility

  • Telehealth providers, and associations of licensing boards. Organization needs to have the technical expertise, personnel, and financial capacity to successfully implement the project.

Restrictions

  • Restricted to telehealth services.

Amount

  • $20 million total. $15 million awarded by the Maternal and Child Health Bureau, and $5 million by the Federal Office of Rural Health Policy.

Purpose

  • The funds will increase capability, capacity, and access to telehealth and distant care services for providers, pregnant women, children, adolescents and families, and will assist telehealth providers with cross-state licensure to improve access to health care during the pandemic.

Timeline

  • As of April 30, 2020, full awarding has already been fulfilled.

Process to get money

  • Information on application can be found here.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • N/A

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020

Category

  • Grant

Funding status

  • Currently exhausted

Description

  • The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 appropriated $100 million for grants under the Health Center Program, to boost Health Centers' ability and capacity to respond to the Covid-19 pandemic with testing, screening, safety education, telehealth, and adequate medical supplies.

Eligibility

  • Federally Qualified Health Centers are community-based health care providers that receive funds from the HRSA Health Center Program to provide primary care services in underserved areas. They must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients.

Restrictions

  • HRSA-funded health centers may use the awards to address screening and testing needs, acquire medical supplies and boost telehealth capacity in response to Covid-19.

Amount

  • $100 million

Purpose

  • To improve health care access to people who are geographically isolated and economically or medically vulnerable.

Timeline

Process to get money

  • All funding has been awarded and was not dependent on application submission.
  • HRSA used the following distribution formula: a base value of $50,464 per grant, plus $0.50 per patient reported in the 2018 Uniform Data System (UDS), plus $2.50 per uninsured patient reported in the 2018 UDS. Awards ranged from approximately $50,000 to more than $300,000, with an average of approximately $70,000 per health center.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • The performance period for this funding is 12 months. Funding is available for immediate use, and pre-award costs are permitted for Covid-19 prevention, preparedness, and response-related expenses dating back to January 20, 2020. Health centers have flexibility to use Covid-19 funds as circumstances and needs evolve.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020
  • CARES Act
  • Paycheck Protection Program and Health Care Enhancement Act
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Currently funded (American Rescue Plan Act of 2021)

Description

  • Initially, HSRA awarded $100 million to health centers on March 24, 2020, through the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, as an early response to Covid-19. HRSA-funded health centers may use the awards to address screening and testing needs, acquire medical supplies and boost telehealth capacity.
  • On April 8, 2020, HSRA awarded more than $1.3 billion to 1,387 health centers, through the CARES Act, to help bolster the response to the Covid-19 pandemic. The grant awards may be used to help health centers' ability detect, prevent, diagnose, and treat Covid-19, as well as maintaining or increasing health centers’ capacity and staffing levels to address the public health emergency.
  • On May 7, 2020, HSRA awarded and nearly $583 million to 1,385 HRSA-funded health centers, through the Paycheck Protection Program and Health Care Enhancement Act. The legislation provides funding for small businesses and individuals financially affected by Covid-19, additional funding for hospitals and healthcare providers, and increased testing capabilities to help track the spread and impact of the coronavirus.
  • The American Rescue Plan of 2021 provides an additional $7.6 billion to health centers, federally qualified health centers and the Papa Ola Lokahi (see Additional considerations). The awards under this provision must be used for Covid-19-related purposes which include promoting, distributing and administering the Covid-19 vaccine, as well as detecting Covid-19 infection, tracing and mitigation efforts, and developing a workforce necessary to respond to Covid-19.

Eligibility

  • Community health centers must be preventing, treating and testing patients for Covid-19.

Restrictions

  • Guidance for allowable uses of funds found here.
  • According to the American Rescue Plan of 2021, the centers may use awards to acquire equipment and supplies for mobile testing or vaccinations. Awards can be used to “modify, enhance, and expand health care services and infrastructure” and to work within communities for Covid-19 outreach and education.

Amount

  • Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020: $100 million
  • CARES Act: $1.32 billion
  • PPP Act: $583 million
  • American Rescue Plan of 2021: $7.6 billion

Purpose

  • HRSA-funded health centers play a critical role by delivering essential services, serving as community testing and screening sites, and alleviating burdens on our nation's emergency rooms and hospitals. These health centers care for the nation’s most vulnerable individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and veterans. HRSA-funded health centers serve 1 in 12 people nationwide.

Timeline

  • On March 24, 2020, HRSA awarded $100 million.
  • On April 8, 2020, HRSA awarded $1.32 billion.
  • On May 7, 2020, HRSA awarded $583 million.
  • On March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, allocating $7.6 million.

Process to get money

  • HHS automatically dispersed the funds in March, April, and May 2020. See the full list of award recipients here.
  • HRSA used the following distribution formula for the $1.32 billion allocation: a base value of $503,000 per grant, plus $15.00 per patient reported in the 2018 Uniform Data System (UDS), plus $30.00 per uninsured patient reported in the 2018 UDS.
  • Application for or distribution of funding from the American Rescue Plan Act of 2021 have not yet been released.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • Funds must be used through the 2020 fiscal year (September 2020). Recipients of FY 2020 coronavirus-related supplemental awards for health centers are required to submit quarterly progress reports.
  • The Papa Ola Lokahi, who seek to improve the health status and wellbeing of Native Hawaiians and their families, are eligible along with other entities named in the Native Hawaiian Health Care Improvement Act.
  • HHS revised its reported distribution amounts in June 2021.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act
  • Coronavirus Response and Relief Supplemental Appropriations Act, 2021
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Currently exhausted

Description

  • The CARES Act provides supplemental funding for programs authorized by the Older Americans Act of 1965 and the Rehabilitation Act of 1973, as amended by the Workforce Innovation and Opportunity Act of 2014.
  • The Administration for Community Living (ACL) is distributing grants of $955 million from the CARES Act, $275 million from the Coronavirus Response and Relief Supplemental Appropriations Act of 2021, and $1.4 billion from the American Rescue Plan Act of 2021 in grants to help meet the needs of older adults and people with disabilities as communities implement measures to prevent the spread of Covid-19. The grants will fund home-delivered meals; care services in the home; respite care and other support to families and caregivers; information about and referral to supports; and more.

Eligibility

  • The majority of funds ($905 million) are being awarded to states, territories, and tribes for subsequent allocation to local service providers. $50 million was awarded based on criteria determined for Aging and Disability Resource Centers.

Restrictions

  • Overview and guidance for allowable grant uses can be found here.

Amount

  • $955 million from the CARES Act. ($200 million for Home and Community Based Services (HCBS); $480 million for home-delivered meals for older adults; $85 million for Centers for Independent Living; $20 million for nutrition and related services for Native American Programs; $100 million for the National Family Caregiver Support Program; $20 million to support State Long-term Care Ombudsman programs; and $50 million for Aging and Disability Resource Centers.)
  • $275 million from the Coronavirus Response and Relief Supplemental Appropriations Act of 2021. ($168 million for Nutrition Services; $7 million for Native American Nutrition and Supportive Services; and $100 million for Elder Justice Activities/Adult Protective Services.)
  • $1.4 billion from the American Rescue Plan Act of 2021.

Purpose

  • ACL programs support a network of community-based organizations providing a vast array of resources and services to help older adults and people with disabilities stay healthy and live independently in their communities.
  • The need for these services has increased as community measures to slow transmission of Covid-19 have closed locations where many people typically receive services and made it difficult for families to assist loved ones who live alone. In addition, the adaptations necessary to provide these services in the current environment have increased costs to service providers.

Timeline

  • On April 21, 2020, HHS announced the distribution of $955 million from the CARES Act.
  • On January 29, 2021, the ACL announced the allocation of $275 million in grants from the Coronavirus Response and Relief Supplemental Appropriations Act of 2021.
  • On May 4, 2021, the ACL announced the distribution of $1.4 billion in grants from the American Rescue Plan, 2021.

Process to get money

  • Grant amounts are determined based on the formulas defined under the program authorizing statutes.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • The $955 million supplemental funding represents an increase of over 40% in this year’s funding for ACL’s programs.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • Paycheck Protection Program and Health Care Enhancement Act (PPP-HCE)
  • Consolidated Appropriations Act, 2021
  • American Rescue Plan Act of 2021

Category

  • Grant

Funding status

  • Original funding from the Paycheck Protection Program and Health Care Enhancement Act has been exhausted, while the allocation from the Consolidated Appropriations Act, 2021, is currently funded.

Description

  • With funding allocated from the Paycheck Protection Program and Health Care Enhancement Act, HHS delivered $11 billion in new funding to support testing for Covid-19. The Centers for Disease Control and Prevention (CDC) provided $10.25 billion to states, territories, and local jurisdictions. The Indian Health Service (IHS) provided $750 million to IHS, tribal, and urban Indian health programs to expand testing capacity and testing-related activities.
  • The Consolidated Appropriations Act, 2021, allocated an additional $22.4 billion to states, localities, territories, and tribes for Covid-19 testing, contact tracing, and surveillance. Eligibility requirements for the new allocation have not yet been released.
  • The American Rescue Plan Act of 2021 allocated an additional $91 billion through HHS for accelerated research, development, manufacturing and distribution of vaccines and therapeutics, diagnostic testing and contact tracing, and increasing the health care workforce.
  • The funding seeks to provide critical support to develop, purchase, administer, process, and analyze Covid-19 tests, conduct surveillance, trace contacts, and related activities.

Eligibility

  • An eligible health care provider must submit an application that includes a statement justifying the need of the provider for the payment.
  • Eligible health care providers are public entities, Medicare or Medicaid enrolled suppliers and providers, and other non-profit and for-profit entities specified by the Secretary of HHS, in each case within the United States, that diagnose, test or care for individuals with possible or actual cases of Covid-19. Each applicant for funding must have a tax identification number.

Restrictions

  • The additional funds can be used to support testing, contact tracing, and surveillance for employers, schools, childcare facilities, and long-term care facilities. The funds can also be used to help scale up testing capacity.

Amount

  • $11 billion for states, local government, territories and tribes to increase testing by public health entities and employers, including further specific allocations of at least:
    • $4.25 billion to states, localities and territories based on the number of Covid-19 cases in each location;
    • $2 billion to states according to an existing public health grant distribution formula; and
    • $750 million to tribes and tribal organizations in coordination with the Indian Health Service.
  • The bill leaves approximately $4 billion to HHS discretion for distribution among states and local governments.
  • An additional $22 billion for states, localities, territories, and tribes, including:
    • $2.5 billion to improve testing and contact tracing for high-risk and underserved populations
    • $790 million for the Indian Health Service (IHS)
    • American Rescue Plan Act of 2021 – $91 billion
      • $47.8 billion for HHS activities to detect, diagnose, trace and monitor COVID-19 infections, directing HHS to implement a national strategy for testing, contact tracing, surveillance and mitigation.
      • $7.5 billion for the CDC to prepare, promote, administer, monitor and track vaccines.
      • $7.6 billion for vaccination, testing at Community Health Centers.
      • $7.7 billion for HHS to establish, expand and sustain a public health workforce.
      • $6.1 billion for research, development, manufacturing, production and purchase of vaccines, therapeutics and ancillary medical products
      • $10 billion to support the production, purchase and distribution of critical materials and equipment under the Defense Production Act (DPA).

Purpose

  • This funding is part of the broader effort to ensure that states, territories, and tribes have the resources necessary to meet their testing and vaccine goals as they begin to reopen.

Timeline

  • On May 18, 2020, HHS announced the distribution of $13 billion. HHS announced that all testing related funds were awarded as of May 30, 2020.
  • On December 27, 2020, the Consolidated Appropriations Act, 2021, was passed, allocating an additional $22.4 billion to Covid-19 testing and contact tracing. The distribution timeline is yet to be released.
  • On March 11, 2021, the American Rescue Plan Act of 2021 was signed into law, allocating $91 billion for manufacturing and distribution of vaccines, diagnostic testing, and contact tracing. The distribution timeline is yet to be released.

Process to get money

  • All original funding has been awarded.
  • Additional funding from the Consolidated Appropriations Act, 2021, will be distributed in the form of direct grants to states, localities, territories, and tribes.
  • Additional funding from the American Rescue Plan Act of 2021 will be distributed to programs and agencies within HHS. Funds will be paid to certain states and localities for vaccination grants pursuant to a prescribed formula based on the Public Health Emergency Preparedness awards made in FY2020.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • States must submit their Covid-19 testing and contact tracing plans to HHS within 60 days of receipt of funds and then provide HHS with quarterly updates on the use of those funds.

Source: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html

Source of funds

  • CARES Act

Category

  • Grant

Funding status

  • Currently funded

Description

  • Within the Provider Relief Fund, a portion of the funding will be used to cover the costs to health care providers for administering Covid-19 vaccines to patients whose health insurance either doesn’t cover vaccine administration fees or requires patient cost-sharing.
  • HHS will provide claims reimbursement to health care providers at the Medicare rate for administering vaccines and for patient charges related to vaccination.

Eligibility

  • Eligible providers are those who have administrated FDA authorized Covid-19 vaccines under an Emergency Use Authorization (EUA) or FDA-licensed Covid-19 vaccines under a Biologics License Application (BLA) to underinsured individuals on or after December 14, 2020.

Restrictions

  • To receive reimbursement, eligible providers must have submitted a claim for vaccine administration to the individual’s health plan for payment and had the claim denied or only partially paid.
  • Eligible providers must accept the Terms and Conditions.

Amount

  • A portion of the $178 billion Provider Relief Fund will be used to reimburse providers administering vaccines to underinsured individuals. Vaccine administration fees will be based on national Medicare rates for administering Covid-19 vaccines:
    • For dates of service through March 14, 2021:
      • Single-dose Covid-19 vaccine: $28.39
      • First dose of a Covid-19 vaccine requiring a series of two or more doses: $16.94
      • Final dose of a Covid-19 vaccine requiring a series of two or more doses: $28.39
    • For dates of service on or after March 15, 2021:
      • Each dose of a Covid-19 vaccine: $40.00

Purpose

  • To ensure that providers are compensated for vaccinating underinsured individuals and that they don’t hesitate to provide vaccines to patients over reimbursement concerns.

Timeline

  • On May 3, 2021, HHS announced the launch of the Coverage Assistance Fund. The end date has yet to be determined.

Process to get money

  • Eligible providers should create an account on the Coverage Assistance Fund Portal to request claims reimbursement. Providers can either submit claims through the Portal or their current clearinghouse.
  • Reimbursement is subject to available funding.

Governing authority

  • HHS

Repayment terms

  • N/A

Additional considerations

  • The Coverage Assistance Fund builds on the Covid-19 Uninsured Program, which reimburses providers who administer vaccines to uninsured individuals.


Frequently Asked Questions

What is the significance of the public health emergency?
The renewal of the public health emergency (PHE) allows for funds that are contingent on the emergency waiver to continue to be disbursed. However, the PHE can be ended by the HHS secretary at any time, resulting in the forfeiture of funding opportunities directly tied to the mandate. On April 15, 2021, HHS secretary Xavier Becerra extended the PHE effective April 21, 2021, likely through the end of 2021.

What does it mean when a program’s funding status is “Funding exhausted”?
We included programs that are currently inactive (Funding exhausted) because Congress and administering agencies frequently announce deadline extensions and obligate additional funding to programs. These changes can happen quickly, reviving an inactive program. In these cases, we will update the program’s details and funding status to “Currently funded”.

Is this a complete list of federal funding sources?
Our funding source navigation tool and related research focus on the highest profile programs but is not meant as an exhaustive resource. Although our categorical approach does include important components to consider before applying, leaders should also consider state and market-level nuances.

How up to date is the information provided?
Federal funding continues to change as agencies announce additional funding distributions and Congress debates new legislation. We plan to regularly update this tool, which is current as of July 19, 2021.

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