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Updated CARES Act Funding for Waiver Assisted Living Providers

Posted Aug 11, 20203 min Read

Payment & Reimbursement

On June 10, 2020, the U.S. Department of Health and Human Services (HHS) announced $15 billion from the Provider Relief Fund will be dedicated to Medicaid and Children’s Health Insurance Program (CHIP) providers who have lost revenue or experienced increased expenses as a result of COVID-19, including Medicaid-only nursing facilities, assisted living communities, intermediate care facilities, and other home and community-based service providers.

Medicaid-only nursing facilities will receive funds directly.  Other Medicaid providers, including Aged & Disabled Waiver assisted living providers, must submit information through HHS’s Provider Relief Fund Payment Portal.  The application can be found here, and HHS’s instructions for Medicaid providers submitting an application can be found here.

Please note, the application serves as a worksheet, and then that information must be entered into the Portal. Applicants must be submit their Tax Identification Number (TIN) for validation through HHS’s Provider Relief Fund Portal by the August 28 deadline and otherwise meet eligibility requirements. HHS will then distribute payments on a rolling basis.

To be eligible to apply, the applicant must meet the following requirements:

  • Must have billed Medicaid for services during the period of January 1, 2018, to December 31, 2019, or own (on the application date) a subsidiary that billed Medicaid for services during the period of January 1, 2018, to December 31, 2019;
  • Must have filed a federal income tax return for fiscal years 2017, 2018, or 2019, or be an entity exempt from the requirement to file a federal income tax return;
  • Must have provided patient care after January 31, 2020; and
  • Must not have permanently ceased providing patient care.

Additional considerations and instructions include:

  • Aged & Disabled Waiver assisted living providers should select “RF,” or Residential Facilities, for “Applicant Type” on the application.
  • “Registration Type” refers to whether you are applying for a group of TINs or an individual TIN.  The Portal will ask you to select “Group” or “Individual.”
  • The Medicaid distribution methodology will be based upon 2% of (Gross Revenues multiplied by the Percent of Gross Revenues from Patient Care) for 2017, or 2018 or 2019, as selected by the applicant and with accompanying tax documentation.  However, the final amount each provider receives will be determined after the data is submitted.
  • Ensuring accuracy of web portal data entry is critical because once an application is submitted, it can not be modified.
  • After applicants receive their payment, an icon on their Portal dashboard will appear to take them through the attestation process.  Providers must attest within ninety (90) days of receiving their payment.

For more information, HHS’s FAQ on the Provider Relief Fund can be found here, and ACHA/NCAL’s FAQ on this available funding for Medicaid providers can be found here.  Providers are encouraged to work with their accounting and legal counsel as needed to ensure the accuracy of the data submitted and call the CARES Act Fund Hotline with any specific questions regarding the Portal: 1-866-569-3522.

About the Author

Laura Brown, Director of Legislative and Legal Affairs