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CSWA - CMS REIMBURSEMENTS FOR MEDICARE - 4-18-20

18 Apr 2020 2:52 PM | CSWA Administrator (Administrator)

Many members have begun to get Medicare ‘reimbursements’ as a result of the CARES Act. This has caused some confusion which I will try to clear up here.

1.   Funding Source - These funds come from the from the $34 billion provided in the Coronavirus Aid, Relief, and Economic Security (CARES) Act through DHHS. The CARES Act appropriation is a payment that does not need to be repaid.

2.   Amounts Reimbursed - The amounts are based on the treatment that an LCSW provided to Medicare patients on a fee-for-service basis in 2019; this does not apply to Medicare Advantage patients. The amount is based on the LCSW’s share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.

3.   Reason for Reimbursement – Though these funds are primarily for services provided connected to COVID-19 issues, it applies to other mental health problems as well. It goes without saying that there is widespread anxiety and depression as a result of the pandemic which affects almost everyone in the country.

4.   United Health Care Role - The reimbursements are distributed by HHS through United Health Care in a public/private partnership. Most reimbursements are under $2000, many under $500 from what I have heard.

5.   Attestation - You can either ‘attest’ that you accept the funds directly at https://covid19.linkhealth.com/  or do nothing which will be seen as an affirmative attestation in 30 days from distribution.  There is no penalty if an affirmative attestation is not made.

For more information go to https://www.cms.gov/newsroom/press-releases/cms-approves-approximately-34-billion-providers-acceleratedadvance-payment-program-medicare , hhs.gov/providerrelief  or call the CARES Provider Relief line at  (866) 569-3522.

There is another program which provides loans to LCSWs and other health care providers who need financial assistance as a result of the COVID-19 crisis. The CMS Accelerated and Advance Payment Program has delivered billions of dollars to healthcare providers, including some LCSWs. These accelerated and advance payments are loans that providers must start paying back within 120 days and complete paying back by 210 days. For more information on applying for these loans, go to https://www.cms.gov/newsroom/press-releases/cms-approves-approximately-34-billion-providers-acceleratedadvance-payment-program-medicare

I hope this is helpful.  Let me know if you have any further questions.

Laura Groshong, LICSW, Director, Policy and Practice

PO Box 10
Garrisonville, Virginia  22463

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