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COVID-19
This Week
Loans and Grants
Loans and Grants:
The Four Major Programs
SBA Loans HHS Grants
Telehealth Funding
Advanced/Accelerated
Payments
SBA Paycheck Protection Loan to Grant
• $349 billion in forgivable loans to help small businesses ride out this economic storm.
• Money must be used to pay employees and expenses (utilities and rent or mortgage
insurance), and you must not have any layoffs. If you follow these guidelines, loan may be
forgiven.
• “First come, first served “– already more than $217billion given out (880,000 applications)
• More money may be on the way, if Congress agrees.
• “Know Your Customer” regulations – must deal with bank with which you already have a
relationship
Our recommendation:
Be Persistent
HHS Grants
• The Department of Health and Human Services is delivering $30 billion to providers through
direct deposit disbursements.
• Payments are based off 2019 Medicare fee-for-service revenues (not including Medicare
Advantage) and proportional share.
• Providers that don’t have an automated account and get a paper check from CMS for
reimbursement will receive a paper check in the mail for this payment within the next few
weeks.
• Providers have 30 days after getting the payment to sign an attestation confirming they got the
funds and agree to terms and conditions. HHS will launch an online portal for providers to sign
the attestation next week.
• HHS has announced general principles for the next round of funding ($100 billion is the figure
quoted) including favoring providers in coronavirus hotspots but has not yet announced timing
or a formula for the next round.
• We recognize this shortchanged providers without Medicare FFS, but the $100bn will be
allocated differently, and hopefully include more providers. We will provide details, when they
are available.
Telehealth Program:
On April 2, 2020, the Federal Communications Commission (FCC)
released a Report and Order establishing the COVID-19 Telehealth
Program
•Provides $200 million in funding
•Funding will be targeted towards areas that have been hardest hit by
COVID–19
•Limited to nonprofit and public eligible health care providers (More
information on Eligibility in FCC Form 460)
•Provides immediate support to eligible health care providers
responding to the COVID-19 pandemic by fully funding their
telecommunications services
o Telecommunications
o Information services
o Connected patient monitoring devices (e.g., pulse-ox, BP
monitoring devices)
• Must apply through PDF. If portal is down, keep checking.
Advance/
Accelerated Medicare Payments
• More than 25,000 requests from health care providers have been received
• More than17,000 of those requests have been approved
• Total for those is more than $51 billion.
Providers or suppliers 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
• Not have any outstanding delinquent Medicare overpayments
Advance/
Accelerated Medicare Payments, too:
Health Insurers Join the Group
“The American Hospital Association this month sent letters to the largest health
insurers asking them to "support stable cash flow" by offering accelerated payments
or periodic interim payments during the pandemic.”
“Insurers including UnitedHealth Group, Pittsburgh-based Blue Cross and Blue Shield
insurer Highmark, Blue Shield of California, and Blue Cross of Idaho are providing
services such as advance and expedited payments, loans, and more favorable
repayment terms to providers.”
https://www.modernhealthcare.com/payment/insurers-speed-payments-
offer-loans-support-providers-during-covid-19
Advance/
Accelerated Medicare Payments
We can help
Our team of experts can assist in two ways:
If you are comfortable with completing the application
and submission on your own, we will provide written
instructions for the entire process.
This is a free service.
We can take care of the entire process for you.
These services will be billed on an hourly basis.
CareOptimize
COVID-19
FREE
Template &
Report
Monitoring and reporting of patients remain two
challenging areas. CareOptimize has developed two
free utilities to help:
1) A template for logging
in data on patients who
test positive. This
template also allows
streamlining notifications
on those patients to the
CDC, state health agency,
and/or local health
department.
2) A report showing all high-risk patients in your
organization who should be considered for additional
screening or other preventative measures.
The Report: How We Created It
CareOptimize employed our service-as-software Analitico Quality Module to identify high, medium,
and low-risk COVID-19 patients, so practices can focus their resources accordingly.
The primary use of this quality gap module is to easily uncover quality measures and
readily suggest actionable solutions at point-of-care. However, we were able to expand its utility,
proving the module invaluable for this particular purpose.
Patients identified per CDC guidelines and tracked to see whether or not intervention has been
completed via phone call or video visit.
The Analitico Quality Module
• Risk adjustment and quality programs drive health plan revenue. Providers are
focused on providing good medical care and consider coding and quality programs
a frustrating distraction.
• Analitico aligns health plan and provider goals by simplifying the process into a
centralized list for closing both coding and quality gaps.
• Information is then placed into a single checklist at point-of-care for suspected
code and quality gaps, leading to an increase in scores and revenue.
• MIPS and HEDIS-certified registry.
• Available immediately for demos.
Allows for custom writing of quality measures, so COVID-19 information
was created quickly and easily
EHRs
Agent
APIs
CCDs
D
A
T
A
HIE
Eligibility Data
Machine
Learning
Reconciliation
Claims
Labs
Hospital
Quality
&
Coding
Health Plans/Registries
RAPS & Supplemental Data
The Analitico Quality Module
More Resources
www.careoptimize.com/insights
https://www.cms.gov/About-CMS/Agency-
Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page
https://www.hhs.gov/about/news/2020/03/24/hhs-awards-100-million-to-
health-centers-for-covid-19-response.html
https://www.sba.gov/page/coronavirus-covid-19-small-business-guidance-loan-
resources
https://www.cms.gov/Medicare/Medicare-General-
Information/Telehealth/Telehealth-Codes
CONTACT
Lauren.Picone@careoptimize.com
info@careoptimize.com

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Insights2020 covid19 episode 4

  • 3. Loans and Grants: The Four Major Programs SBA Loans HHS Grants Telehealth Funding Advanced/Accelerated Payments
  • 4. SBA Paycheck Protection Loan to Grant • $349 billion in forgivable loans to help small businesses ride out this economic storm. • Money must be used to pay employees and expenses (utilities and rent or mortgage insurance), and you must not have any layoffs. If you follow these guidelines, loan may be forgiven. • “First come, first served “– already more than $217billion given out (880,000 applications) • More money may be on the way, if Congress agrees. • “Know Your Customer” regulations – must deal with bank with which you already have a relationship Our recommendation: Be Persistent
  • 5. HHS Grants • The Department of Health and Human Services is delivering $30 billion to providers through direct deposit disbursements. • Payments are based off 2019 Medicare fee-for-service revenues (not including Medicare Advantage) and proportional share. • Providers that don’t have an automated account and get a paper check from CMS for reimbursement will receive a paper check in the mail for this payment within the next few weeks. • Providers have 30 days after getting the payment to sign an attestation confirming they got the funds and agree to terms and conditions. HHS will launch an online portal for providers to sign the attestation next week. • HHS has announced general principles for the next round of funding ($100 billion is the figure quoted) including favoring providers in coronavirus hotspots but has not yet announced timing or a formula for the next round. • We recognize this shortchanged providers without Medicare FFS, but the $100bn will be allocated differently, and hopefully include more providers. We will provide details, when they are available.
  • 6. Telehealth Program: On April 2, 2020, the Federal Communications Commission (FCC) released a Report and Order establishing the COVID-19 Telehealth Program •Provides $200 million in funding •Funding will be targeted towards areas that have been hardest hit by COVID–19 •Limited to nonprofit and public eligible health care providers (More information on Eligibility in FCC Form 460) •Provides immediate support to eligible health care providers responding to the COVID-19 pandemic by fully funding their telecommunications services o Telecommunications o Information services o Connected patient monitoring devices (e.g., pulse-ox, BP monitoring devices) • Must apply through PDF. If portal is down, keep checking.
  • 7. Advance/ Accelerated Medicare Payments • More than 25,000 requests from health care providers have been received • More than17,000 of those requests have been approved • Total for those is more than $51 billion. Providers or suppliers 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 • Not have any outstanding delinquent Medicare overpayments
  • 8. Advance/ Accelerated Medicare Payments, too: Health Insurers Join the Group “The American Hospital Association this month sent letters to the largest health insurers asking them to "support stable cash flow" by offering accelerated payments or periodic interim payments during the pandemic.” “Insurers including UnitedHealth Group, Pittsburgh-based Blue Cross and Blue Shield insurer Highmark, Blue Shield of California, and Blue Cross of Idaho are providing services such as advance and expedited payments, loans, and more favorable repayment terms to providers.” https://www.modernhealthcare.com/payment/insurers-speed-payments- offer-loans-support-providers-during-covid-19
  • 9. Advance/ Accelerated Medicare Payments We can help Our team of experts can assist in two ways: If you are comfortable with completing the application and submission on your own, we will provide written instructions for the entire process. This is a free service. We can take care of the entire process for you. These services will be billed on an hourly basis.
  • 10. CareOptimize COVID-19 FREE Template & Report Monitoring and reporting of patients remain two challenging areas. CareOptimize has developed two free utilities to help: 1) A template for logging in data on patients who test positive. This template also allows streamlining notifications on those patients to the CDC, state health agency, and/or local health department. 2) A report showing all high-risk patients in your organization who should be considered for additional screening or other preventative measures.
  • 11. The Report: How We Created It CareOptimize employed our service-as-software Analitico Quality Module to identify high, medium, and low-risk COVID-19 patients, so practices can focus their resources accordingly. The primary use of this quality gap module is to easily uncover quality measures and readily suggest actionable solutions at point-of-care. However, we were able to expand its utility, proving the module invaluable for this particular purpose. Patients identified per CDC guidelines and tracked to see whether or not intervention has been completed via phone call or video visit.
  • 12. The Analitico Quality Module • Risk adjustment and quality programs drive health plan revenue. Providers are focused on providing good medical care and consider coding and quality programs a frustrating distraction. • Analitico aligns health plan and provider goals by simplifying the process into a centralized list for closing both coding and quality gaps. • Information is then placed into a single checklist at point-of-care for suspected code and quality gaps, leading to an increase in scores and revenue. • MIPS and HEDIS-certified registry. • Available immediately for demos. Allows for custom writing of quality measures, so COVID-19 information was created quickly and easily