The Provider Relief Funds supports American families, workers, and the heroic healthcare providers in the battle against the COVID-19 outbreak. HHS distributes $175 billion to hospitals and healthcare providers on the front lines of the coronavirus response.
CARES Act Provider Relief Fund: For Providers
The Provider Relief Fund supports healthcare providers in the battle against the COVID-19 pandemic. Through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act (PPPCHE), the federal government has allocated $175 billion in payments to be distributed through the Provider Relief Fund (PRF).
Qualified healthcare providers, services, and support may receive Provider Relief Fund payments for healthcare-related expenses or lost revenue due to COVID-19. Separately, the COVID-19 Uninsured Program reimburses providers for testing and treating uninsured individuals with COVID-19.
These distributions do not need to be repaid to the US government, assuming providers comply with the terms and conditions.
How to Apply for Phase 3 General Distribution
CARES Act Provider Relief Fund: General Information
Phase 1 General Distribution
HHS distributes $50 billion to providers who bill Medicare fee-for-service to provide financial relief during the coronavirus (COVID-19) pandemic. These funds are allocated proportionally to providers' share of 2018 patient revenue. On April 10, 2020, HHS immediately distributed $30 billion to eligible providers throughout the American healthcare system.
CARES Act Provider Relief Fund: Phase 2-3 and General Information
General Distribution ($50 billion)
$50 billion is allocated proportionally to providers' share of 2018 net patient revenue. The allocation methodology is designed to provide relief to providers who bill Medicare fee-for-service, with at least 2% of that provider's gross patient revenue regardless of its payer mix. Payments are determined based on the lesser of 2% of a provider's 2018 (or most recent complete tax year) net patient revenue or the sum of incurred losses for March and April.
Information about the Initial $30 Billion Distribution and Targeted Distributions
Reporting Requirements and Auditing
All recipients of Provider Relief Fund (PRF) payments must comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the Secretary.
For Recipients of Payments more than $10,000
Recipients of Provider Relief Fund (PRF) payments exceeding $10,000 in the aggregate must report required information, including intent, use of funds, and other data elements. For more details:
Download the Final Reporting Data Elements - PDF.
This document updates and supplements July 20, 2020, Post-Payment Notice of Reporting Requirements notice: General and Targeted Distribution Post-Payment Notice of Reporting Requirement - PDF.
View the summary of reporting guidelines for payments exceeding $10,000 - PDF.
These final reporting requirements do not apply to:
Nursing Home Infection Control distribution recipients
Rural Health Clinic Testing distribution recipients
Health Resources and Services Administration (HRSA) Uninsured Program reimbursement recipients
Separate reporting requirements may be announced in the future.
Auditing
The recipients of Provider Relief Fund payments may be subject to auditing to ensure the accuracy of the data submitted to HHS for payment. Any recipients identified as having provided inaccurate information to HHS will be subject to payment recoupment and other legal action. Further, all recipients of Provider Relief Fund payments shall maintain appropriate records and cost documentation including, as applicable, documentation described in 45 CFR § 75.302 – Financial management and 45 CFR § 75.361 through 75.365 – Record Retention and Access, and other information required by future program instructions to substantiate that recipients used all Provider Relief Fund payments appropriately.
Upon the Secretary's request, the recipient shall promptly submit copies of such records and cost documentation. The recipient must fully cooperate in all audits the Secretary, Inspector General, or Pandemic Response Accountability Committee conducts to ensure compliance with applicable Terms and Conditions. Deliberate omission, misrepresentation, or falsification of any information contained in payment applications or future reports may be punishable by criminal, civil, or administrative penalties, including but not limited to revocation of Medicare billing privileges, exclusion from federal health care programs, and/or the imposition of fines, civil damages, and/or imprisonment.
Please refer to the Terms and Conditions associated with each payment distribution and the Reporting Requirements and Auditing FAQs for more details.
CARES Act Provider Relief Fund: FAQs
CARES Act Provider Relief Fund: For Patients
If you have insurance
Private insurers must waive insurance plan members' cost-sharing payments for COVID-19 diagnostic testing and certain related items and services.
Some private insurers, including Humana, Cigna, UnitedHealth Group, and the Blue Cross Blue Shield system, have agreed to waive cost-sharing payments for insured patients' COVID-19 treatment.
If a patient has insurance and seeks COVID-19 treatment from an out-of-network provider that has received General or Targeted Distributions from the Provider Relief Fund, the provider has agreed not to seek to collect out-of-pocket payments more significant than what the patient would have otherwise been required to pay if an in-network provider had provided the care.
If you do not have insurance
Suppose you are uninsured and receive COVID-19-related testing and/or treatment services. In that case, your provider may have submitted a claim to the Health Resources & Services Administration (HRSA) to reimburse these services. Providers who participate in and are reimbursed from the HRSA COVID-19 Uninsured Program are not allowed to "balance bill" individuals who do not have health care coverage (uninsured).
If you receive a bill in which a portion of that bill is paid for by HRSA, you may not be responsible for the remainder of the bill if the rendered service was for COVID-19 testing and/or treatment.
If you received a bill and were charged for COVID-19 testing and/or treatment services and the statement shows HRSA reimbursement for those services, please contact your health care provider to discuss how best to resolve your bill's payment. (If your provider has questions, they can visit the HRSA COVID-19 Uninsured Program site .)
Please note that if your provider didn't submit a bill for your COVID-19-related testing and/or treatment to the HRSA COVID-19 Uninsured Program or the care was not eligible for reimbursement from the program, you may be responsible for full payment of the bill.