Medicare payments to chiropractors coming from U.S. Department of Health and Human Services

The International Chiropractors Association (ICA) reminded chiropractors this week in a video announcement that the U.S. Department of Health and Human Services (HHS) will be providing chiropractors that received Medicare fee-for-service (FFS) reimbursements in 2019 with a payment from the CARES Act Provider Relief Fund.

The HHS announced $30 billion in immediate relief funding to providers in support of the national response to COVID-19 as part of the distribution of the $100 billion provider relief fund provided for in the Coronavirus Aid, Relief, and Economic Security (CARES) Act, states a HHS application website. This site is open to all providers, regardless of network affiliation or payer contract. HHS is contracting with UnitedHealth Group to facilitate delivery of the funds.

“You should expect payment to be deposited into your bank account from HHS [U.S. Department of Health and Human Services] payments,” said Selina Sigafoose-Jackson, DC, FICA, ICA and vice president of the ICA. “This hasn’t really been talked about, but where it’s coming from is Medicare, and it’s a stimulant for those that are providers. So if you are a provider for Medicare, there is a calculation, and you will be deposited into your account those funds.”

Providers who have been allocated a payment from the initial $30 billion general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment.

“Recognizing the importance of delivering funds in a fast and transparent manner, $30 billion is being distributed immediately…to eligible providers throughout the American healthcare system,” the HHS states. “These are payments, not loans, to health care providers, and will not need to be repaid.”

A provider can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments they received by $484,000,000,000, and multiply that ratio by $30,000,000,000. Providers can obtain their 2019 Medicare FFS billings from their organization’s revenue management system.

Eligible for payments are:

• All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial rapid distribution.
• Payments to practices that are part of larger medical groups will be sent to the group’s central billing office.
• All relief payments are made to the billing organization according to its Taxpayer Identification Number (TIN).

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

This quick dispersal of funds will provide relief to both providers in areas heavily impacted by the COVID-19 pandemic and those providers who are struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.

If you ceased operation as a result of the COVID-19 pandemic, you are still eligible to receive funds so long as you provided diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.

To read more go to hhs.gov/provider-relief/index.html.
To read or sign the eligibility form go to covid19.linkhealth.com/#/step/1.

For the latest COVID-19 info for doctors of chiropractic, including upcoming webinars, updates, resources and articles from Chiropractic Economics, go to chiroeco.com/coronavirus-covid-19.