COVID-19 Update: CMS Payments to O&P Providers


Among many other financial stipulations, the CARES Act, signed into law late last month, provides $100 billion to certain healthcare providers, including O&P providers. To expedite providers getting money as quickly as possible, $30 billion is being distributed beginning TODAY, April 10, proportionate to providers’ share of Medicare fee-for-service reimbursements in 2019. All facilities and providers that received Medicare fee-for-service (FFS) reimbursements in 2019 are eligible for this initial distribution. These are payments, not loans, to healthcare providers; they will not need to be repaid and are separate and distinct from Medicare advance payments and any small business loans/forgivable loans providers may have applied for.

We have heard that O&P providers have received these payments today and we recommend you check the account you would normally receive EFT funds from CMS for your payment. HHS has partnered with UnitedHealth Group to provide rapid payment to providers eligible for the initial distribution. Providers will be paid via Automated Clearing House account information on file with UHG or CMS. The automatic payments will come to you via Optum Bank with “HHSPAYMENT” as the payment description. Providers who normally receive a paper check for reimbursement from CMS, will be mailed this payment within the next few weeks.

Providers must sign an attestation confirming receipt of funds via a provider portal that will open on HHS’ website next week, and agree to the terms and conditions of payment within 30 days. In addition, 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.

CMS has indicated that the remaining $70 billion in the fund will have a more formal application process, and that some portion of future allocations could be targeted towards providers that do not typically bill Medicare. AOPA is seeking guidance on how those who did not qualify for this first round of funding may benefit from future distributions. In addition, we are seeking clarification of the tax implications of the distributed funds, and will update our members via our COVID-19 Responses and Resources Page.

Questions about this should be directed to Justin Beland at jbeland@AOPAnet.org.