Tag: Department of Health and Human Services (HHS)

Rural Healthcare Grants from HRSA FORH

From the HRSA Federal Office of Rural Health Policy

The Health Resources and Services Administration’s Federal Office of Rural Health Policy has released the Notice of Funding Opportunity (NOFO) for the Rural Health Care Services Outreach Program (Outreach) (HRSA-21-027).  HRSA plans to award 60 grants to rural communities as part of this funding opportunity.

Review the Funding Opportunity

The Outreach Program administered by HRSA’s FORHP focuses on expanding the delivery of health care services to include new and enhanced services exclusively in rural communities. Applicants are required to deliver health care services through a consortium of at least three health care provider organizations, use an evidence-based or promising practice model to inform their approach, and demonstrate health outcomes and sustainability by the end of the four-year performance period.

In addition to funding Outreach programs through the regular Outreach track, in FY 21, FORHP will also afford applicants a unique opportunity to take part in a national effort that targets rural health disparities through a second track called the “Healthy Rural Hometown Initiative.” This initiative was created through the HHS Rural Task Force and driven by findings from a report published by the Centers of Disease Control and Prevention (CDC) that noted that the number of preventable death from the five leading cause of death in rural areas was higher than those in urban areas. Unfortunately, these findings echo earlier CDC research on the rural disparities in avoidable or excess death in 2017.

The Healthy Rural Hometown Initiative (HRHI) is an effort that seeks to address the underlying factors that are driving growing rural health disparities related to the five leading causes of avoidable death (heart disease, cancer, unintentional injury/substance use, chronic lower respiratory disease, and stroke). The goal of the HRHI track is to demonstrate the collective impact of projects that better manage conditions, address risk factors and focus on prevention that relate to the leading causes of death in rural communities. This track should be a good fit for applicants who want to identify and bridge the gap between the social determinants of health and other systemic issues that contribute to achieving health equity with regards to excess death in rural communities. Furthermore, this is a rural-specific and community-based approach to addressing these disparities and represents a new and more targeted strategy given the enduring health gaps between rural and urban populations.

Of the successful 60 award recipients, HRSA aims to award approximately 45 to regular Outreach track applicants and at least 15 to HRHI applicants for a ceiling amount of up to $200,000 (Regular Outreach) or $250,000 (HRHI) total cost (includes both direct and indirect, facilities and administrative costs) per year (and final numbers will be subject to how applicants score). 

The HRHI is part of an ongoing multi-year effort by FORHP to highlight how rural community health efforts can improve health at the local level. We are encouraging rural health stakeholders to join us in this broader effort while also taking on the challenge of addressing these long-standing rural health disparities related to the five leading causes of death.    

NOTE: The eligibility criteria for this program has changed and now includes all domestic public and private, nonprofit and for-profit entities with demonstrated experience serving, or the capacity to serve, rural underserved populations. Urban-based organizations applying as the lead applicant should ensure there is a high degree of rural control in the project. The applicant organization must represent a network that includes at least three or more health care provider organizations and, at least 66% (or two-thirds) of consortium members must be located in a HRSA-designated rural area.

Please review the guidance in its entirety for more information about eligibility criteria and specific program requirements. Visit www.grants.gov to review the Outreach NOFO and apply. Learn about the Outreach Program.

A webinar for applicants is scheduled on Tuesday October 13, from 3-4:30 p.m., EST. A recording will be made available for those who cannot attend.

For more information about this funding opportunity, contact the Program Coordinator, Alexa Ofori, at RuralOutreachProgram@hrsa.gov.

HHS Funding Portal Open for Tranche 3

The online portal for ambulance service providers and suppliers to submit applications for additional funding under the HHS Provider Relief Fund is now open.

Access Portal Now

Apply Soon for Funds!

While providers and suppliers have until November 6 to apply for funding, we strongly recommend that AAA members submit applications as soon as you are prepared as funding is on a first-come, first-served basis. HHS allocated a total of $20 billion for this round of funding.

Attend Today’s AAA Funding Webinar

The AAA will be hosting a webinar today, Monday, October 5, at 11:00 am (eastern), on how to apply for the funds and what information you will need in applying.

Register for the Webinar

Thank You AAA Members!

As reported by the AAA on October 1, the additional funds are a direct result of the efforts of the AAA and our members and we thank all of you who reached out to the White House or your members of Congress advocating for the funds.




Newsmax | Will Trump Get Ambulance Services Needed Pay From Government?

By John Gizzi via Newsmax.com

Although President Donald Trump promised Newsmax earlier this month that he would “certainly look into it,” several ambulance professionals and their representatives have since told us they have seen none of the operating funds in question from the Department of Health and Human Services.

Continue Reading on Newsmax.com

Department of Health and Human Services Extends Deadline to Apply for Provider Relief Funds

The Department of Health and Human Services (HHS) recently announced that it would be extending the deadline for health care providers to apply to receive general distribution funding from the HHS Provider Relief Fund.  The deadline to apply for these funds was previously June 3, 2020.

Relevant Background

On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).  As part of that Act, Congress allocated $100 billion to the creation of a “CARES Act Provider Relief Fund,” which will be used to support hospitals and other healthcare providers on the front lines of the nation’s coronavirus response.  An additional $75 billion was allocated as part of the Paycheck Protection Program and Health Care Enhancement Act, bringing the total “Provider Relief Fund” up to $175 billion.  This $175 billion will be distributed to health care providers and suppliers to fund healthcare-related expenses or to offset lost revenue attributable to COVID-10.

HHS ultimately elected to allocate these funds through a $50 billion “general allocation,” and multiple smaller “targeted allocations.”

Under its general allocation program, HHS intended to provide health care providers with funds roughly equal to 2% of the provider’s 2018 “net patient revenue,” i.e., the provider’s total revenues from patient care minus provisions for bad debt, contractual write-offs, and certain other adjustments.   This general allocation was made in two tranches, with the first tranche being distributed to all providers in mid-April.  This first tranche was made based on provider’s 2019 Medicare revenues.  As a result, any provider that received payments from the Medicare Fee-for-Service Program in 2019 automatically received an initial relief payment.  However, HHS required providers to submit an application to receive relief funding as part of the second tranche.  The deadline for applying for the second tranche of relief funding was June 3, 2020.

Scope of New Extension

 HHS indicated that the new extension is limited to health care providers that missed the June 3, 2020 deadline to apply for the second tranche of relief funding.  The extension also applies to providers that were ineligible for the first tranche of relief funding due to a recent change of ownership.  The specific situations that HHS indicated would meet the requirements for the extension include:

  • Health care providers who were ineligible for the first tranche of relief funding because: (1) they underwent a change in ownership in calendar year 2019 or 2020 under Medicare Part A and (2) did not have Medicare Fee-for-Service revenues in calendar year 2019;
  • Health care providers who received a payment in the first tranche of funding but: (1) missed the June 3, 2020 deadline to submit revenue information or (2) did not receive funds in the first tranche that total approximately 2% of their net patient revenue; or
  • Health care providers who received a payment in the first tranche of funding, but who ultimately elected to refund that payment (e.g., because they did not believe they met the eligibility requirements), and who are now interested in reapplying.

Health care providers that meet one of the requirements listed above will have until August 28, 2020 to submit an application for additional relief funds.  This deadline aligns with the extended deadline for other eligible Phase 2 providers, such as Medicaid, Medicaid Managed Care, CHIP, and dental providers.

Applications should be submitted through the CARES Provider Relief Fund webpage, which can be found at: https://cares.linkhealth.com/#/.

HHS Report Calls for Congressional Action to Combat Surprise Billing

From HHS.gov on July 29, 2020

HHS Secretary’s Report Calls for Congressional Action to Combat Surprise Billing and Promote Price Transparency

Today, the U.S. Department of Health and Human Services released the HHS Secretary’s Report on Addressing Surprise Billing. The report, called for in Section 7 of President Trump’s Executive Order 13877, Improving Price and Quality Transparency in American Healthcare to Put Patients First, outlines critical steps, including Congressional action, to implement the Administration’s principles on surprise billing. Sound surprise billing legislation will not only protect patients but will encourage a fairer, more transparent, patient-centered healthcare system that benefits all Americans.

“Americans have the right to know what a healthcare service is going to cost before they receive it,” said HHS Secretary Alex Azar. “President Trump and his administration have done their part to deliver historic transparency around the prices of many procedures. Now it’s time for Congress to do what we all agree is necessary: combat surprise billing with an approach that puts patients in control and benefits all Americans.”

Surprise medical billing is a widespread and costly problem in the United States, and the need to address it has been highlighted during the Public Health Emergency (PHE) presented by COVID-19. Research shows that 41 percent of insured adults nationwide were surprised by a medical bill in the past two years alone, and that two thirds of adults worry about their ability to afford an unexpected medical bill.  At a time when Americans are increasingly seeking medical care, practices such as surprise billing leave many patients vulnerable to the financial burdens presented by a nationwide pandemic.

HHS has taken regulatory and administrative action to increase price transparency permanently. On June 24, 2019, President Trump signed Executive Order 13877. Following direction from this Executive Order, HHS published two rules supporting the Administration’s mission to improve accessibility of healthcare price information to help patients make informed decisions about their use of healthcare services. The first, poised to go into effect January 1, 2021, requires hospitals operating in the United States to establish, update, and make public, at least annually, a list of their standard charges for the items and services that they provide. The second companion proposed rule would demand similar transparency from most group health plans and issuers of health insurance coverage within both the individual and group markets.

To supplement this progress, Congress must take additional action to build on the achievements of the Administration to eliminate the threat of surprise billing once and for all. This should be accomplished with the following principles in mind, as laid out by the Trump Administration on May 9th, 2019:

  • Patients receiving emergency care should not be forced to shoulder extra costs billed by a care provider but not covered by their insurer;
  • Patients receiving scheduled care should have information about whether providers are in or out of their network and what costs they may face;
  • Patients should not receive surprise bills from out-of-network providers they did not choose; and
  • Federal healthcare expenditures should not increase.

If done swiftly, a remarkable burden will be lifted from the shoulders of millions of Americans. By building on the foundation placed by Executive Order 13877, there is an opportunity to fill the remaining gaps and solve comprehensively a longstanding flaw, equivalent to price-gouging, within our healthcare industry.


HHS | Post-Payment Notice of Reporting Requirements

From HHS on July 20, 2020

General and Targeted Distribution Post-Payment Notice of Reporting Requirements

July 20, 2020


The purpose of this notice is to inform Provider Relief Fund (PRF) recipients that received one or more payments exceeding $10,000 in the aggregate from the PRF of the timing of future reporting requirements. Detailed instructions regarding these reports will be released by August 17, 2020.


Congress appropriated funding to reimburse eligible health care providers for health care related expenses or lost revenues attributable to coronavirus. The Health Resources and Services Administration (HRSA) is administering the distribution of payments under the PRF program, funded through appropriations in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136) and the Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139). Each recipient of a payment from the PRF that used any part of that payment agreed to a set of Terms and Conditions (T&Cs) which, among other obligations, require each recipient to submit reports to the Department of Health and Human Services (HHS). The reports shall be in such form, with such content, as specified by the Secretary of HHS in future program instructions directed to all recipients. HHS will be releasing detailed reporting instructions by August 17, 2020.

These reporting instructions will provide directions on reporting obligations applicable to any provider that received a payment from the following CARES Act/PRF distributions:

General Distributions:
  • Initial Medicare Distribution
  • Additional Medicare Distribution
  •  Medicaid, Dental & CHIP Distribution
Targeted Distributions:
  • High Impact Area Distribution
  •  Rural Distribution
  •  Skilled Nursing Facilities Distribution
  •  Indian Health Service Distribution
  •  Safety Net Hospital Distribution

The reports will allow providers to demonstrate compliance with the T&Cs, including use of funds for allowable purposes, for each PRF payment. HRSA plans to provide recipients with Question and Answer (Q&A) Sessions via Webinar in advance of the submission deadline. Additional details will follow regarding the Q&A Sessions.

Notice on Timing of Reports

The reporting system will become available to recipients for reporting on October 1, 2020.

  • All recipients must report within 45 days of the end of calendar year 2020 on their expenditures through the period ending December 31, 2020.
  •  Recipients who have expended funds in full prior to December 31, 2020 may submit a single final report at any time during the window that begins October 1, 2020, but no later than February 15, 2021.
  •  Recipients with funds unexpended after December 31, 2020, must submit a second and final report no later than July 31, 2021.
  •  Detailed PRF reporting instructions and a data collection template with the necessary data elements will be available through the HRSA website by August 17, 2020.


HHS Renews the Declaration of a Public Health Emergency

On July 23, HHS Secretary Alex M. Azar III renewed the COVID-19 Public Health Emergency declaration.

As a result of the continued consequences of Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Alex M. Azar II, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective July 25, 2020, my January 31, 2020, determination that I previously renewed on April 21, 2020, that a public health emergency exists and has existed since January 27, 2020, nationwide.

OCR Issues Guidance on Civil Rights Protections Prohibiting Race, Color, and National Origin Discrimination During COVID-19

News Release from the U.S. Department of Health and Human Services |  Monday, July 20, 2020

OCR Issues Guidance on Civil Rights Protections Prohibiting Race, Color, and  National Origin Discrimination During COVID-19

Yesterday, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) is issuing guidance to ensure that recipients of federal financial assistance understand that they must comply with applicable federal civil rights laws and regulations that prohibit discrimination on the basis of race, color, and national origin in HHS-funded programs during COVID-19. This Bulletin focuses on recipients’ compliance with Title VI of the Civil Rights Act of 1964 (Title VI).

To help ensure Title VI compliance during the COVID-19 public health emergency, recipients of federal financial assistance, including state and local agencies, hospitals, and other health care providers, should:

  • Adopt policies to prevent and address harassment or other unlawful discrimination on the basis of race, color, or national origin.
  • Ensure – when site selection is determined by a recipient of federal financial assistance from HHS – that Community-Based Testing Sites and Alternate Care Sites are accessible to racial and ethnic minority populations.
  • Confirm that existing policies and procedures with respect to COVID-19 related services (including testing) do not exclude or otherwise deny persons on the basis of race, color, or national origin.
  • Ensure that individuals from racial and ethnic minority groups are not subjected to excessive wait times, rejected for hospital admissions, or denied access to intensive care units compared to similarly situated non-minority individuals.
  • Provide – if part of the program or services offered by the recipient – ambulance service, non-emergency medical transportation, and home health services to all neighborhoods within the recipient’s service area, without regard to race, color, or national origin.
  • Appoint or select individuals to participate as members of a planning or advisory body which is an integral part of the recipient’s program, without exclusions on the basis of race, color, or national origin.
  • Assign staff, including physicians, nurses, and volunteer caregivers, without regard to race, color, or national origin. Recipients should not honor a patient’s request for a same-race physician, nurse, or volunteer caregiver.
  • Assign beds and rooms, without regard to race, color, or national origin.
  • Make available to patients, beneficiaries, and customers information on how the recipient does not discriminate on the basis of race, color, or national origin in accordance with applicable laws and regulations.

OCR is responsible for enforcing Title VI’s prohibitions against race, color, and national origin discrimination. As part of the federal response to this public health emergency, OCR will continue to work in close coordination with our HHS partners and recipients to remove discriminatory barriers which impede equal access to quality health care, recognizing the high priority of COVID-19 testing and treatment.

Roger Severino, OCR Director, stated, “HHS is committed to helping populations hardest hit by COVID-19, including African-American, Native American, and Hispanic communities.” Severino concluded, “This guidance reminds providers that unlawful racial discrimination in healthcare will not be tolerated, especially during a pandemic.

“Minorities have long experienced disparities related to the medical and social determinants of health – all of the things that contribute to your health and wellbeing. The COVID-19 pandemic has magnified those disparities, but it has also given us the opportunity to acknowledge their existence and impact, and deepen our resolve to address them,” said Vice Admiral Jerome M. Adams, Surgeon General, MD, MPH. “This timely guidance reinforces that goal and I look forward to working across HHS and with our states and communities to ensure it is implemented.”

To read the new OCR Bulletin, please visit: Title VI Bulletin – PDF

To learn more about non-discrimination on the basis of race, color, national origin, sex, age, and disability; conscience and religious freedom; and health information privacy laws, and to file a complaint with OCR, please visit: www.hhs.gov/ocr.

For more OCR announcements related to civil rights and COVID-19, please visit: https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/index.html.

On Demand Presentation: Emergency Medical Services and 911

Healthcare Resilience Task Force: EMS/911

May 29, 2020
Dr. Jon Krohmer, NHTSA, HRTF EMS/Pre-hospital Team Lead
Kate Elkins, NHTSA, HRTF EMS/Pre-hospital Deputy Team Lead

911, the universal number to call for emergency help nationwide, is a proven, life-saving service to the public. NHTSA’s Office of EMS oversees the National 911 Program, which envisions an emergency response system that best serves the public, providing immediate help in all emergency situations. This presentation covered the current Emergency Medical Services (EMS) Environment, Impacts and Next Steps for EMS in regards to COVID-19, and EMS and Fire Impacts on Community Lifelines.

Download Presentation



AAA Sends letter on Accelerated Payments

On May 26, the AAA sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma, requesting improvements to the Medicare Accelerated and Advance Payment (MAAP) Programs. The nation’s response to the COVID-19 pandemic is putting an increased financial strain on emergency medical services, and ground ambulance service providers and suppliers already faced significant funding challenges. The suggested improvements include:

  • Extending the interim period prior to the date repayment begins from four months to at least 12 months;
  • Reducing the amount that is withheld during the repayment period from one hundred percent (100%) of the Medicare payment to not more than twenty-five percent (25%);
  • Extending the date on which interest first begins to accrue from 210 days to at least 2 years (preferably 3 years);
  • Reduce the interest rate that would be applicable after that date from the current 9.625 percent to a rate of no more than 2%; and
  • Reopen the MAAP to allow EMS agencies that did not request a Medicare advance prior to April 26, 2020 to request an advance.

The AAA believes the improvements to the MAAP discussed above would provide short-term financial relief to ambulance service providers and suppliers nationwide and allow us to continue our critical work during this difficult time for our country. Read our letter HERE.

CMS Issues Additional Staffing and Licensing Waivers

On May 1, 2020, CMS updated its “COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing.”  The full document can be viewed by clicking here.

In the updated FAQ, CMS answers three important questions related to ambulance vehicle and staffing requirements:

  1. Expired Ambulance Operating Licenses. CMS was asked whether a ground ambulance vehicle operating under an expired license could nevertheless satisfy the Medicare regulations related to vehicle licensing.  CMS indicated that the ground ambulance would remain in compliance with Medicare Program rules to the extent it was permitted to operate without a renewed license under a valid state or local law, regulation, or legally adequate waiver.  It is important to note that this is not a “waiver” of CMS rules per se.  Rather, CMS correctly noted that additional flexibility being provided is based on the state waiving or relaxing its existing rules related to licensures.
  2. Modified Staffing Requirements. CMS was asked whether an ambulance service that staffs its vehicles with personnel that fall below the previously required levels of certification would be in compliance with Medicare Program rules.  The Medicare regulations at 42 C.F.R. §410.41(b) set forth the requirements for vehicle staffing.  These regulations largely defer to state and local laws.  However, they do require a certain minimum level of staffing.  Specifically, the Medicare regulations require that: (i) BLS vehicles be staffed with at least two people, at least one of whom must be certified as an EMT and (ii) ALS vehicles be staffed by at least two people, at least one of whom must be certified as a paramedic or an EMT that is permitted to perform one or more ALS services (e.g., an EMT-Intermediate).  CMS is indicating that it is waiving this minimum staffing requirement under its 1135 Waiver Authority for the duration of the Public Health Emergency.  Under this waiver, CMS will consider the vehicle staffing requirement to be met to the extent state or local law, regulation, or waiver permits an alternative staffing arrangement.  CMS specifically cited examples where the state or locality would permit BLS vehicles to be staffed with EMRs instead of EMT-Basics, or ALS vehicles staffed with RNs instead of paramedics.  Note: claims submitted in reliance upon this waiver should be submitted using the “CR” modifier after the origin/destination modifiers.
  3. Ambulance Services Rendered Across State Lines. CMS was asked whether an ambulance service that provides care across state lines, in a state where it is not certified to provider services or in which its personnel are not licensed, would be in compliance with Medicare Program rules.  CMS indicated that it is using its 1135 Waiver Authority to waive the requirement under 42 C.F.R. 410.41(b) that vehicle personnel be licensed in the state in which they are furnishing services to the extent that: (i) they have an equivalent licensing or certification in another state and (ii) they are not affirmatively excluded from practicing in that state or any other state.  Please note that this waiver only applies to the Medicare certification requirements.  CMS lacks the authority to waive the licensing requirements of the other state or locality.  Thus, for this waiver to apply, you must be permitted to operate in the other state pursuant to that state’s laws, regulations, and/or validly issued waiver.  Note: claims submitted in reliance upon this waiver should be submitted using the “CR” modifier after the origin/destination modifiers.

COVID-19 Uninsured Program Now Includes Air, Water

HHS Updates Guidance on Provider Relief Funding for Uninsured to include Air and Water Ambulance

The Department of Health and Human Services recently updated its guidance on the disbursement of provider relief funds under the CARES Act for the testing and treatment of the uninsured.  Previously, HHS indicated that this allocation was only available for the reimbursement of emergency and non-emergency ground ambulance transportation.  However, in its most recent update, HHS has removed the restriction that limited participation to ground ambulance providers and suppliers.  The new guidance indicates that the relief funds are now available for all emergency ambulance transportation and non-emergency patient transfers via ambulance.

Thus, it appears that air and water ambulance providers and suppliers are now eligible to receive funding for the treatment of COVID-19 patients. 

Is there anything my air or water ambulance organization needs to do to claim reimbursement for treatment of uninsured COVID patients?

Yes.  In order to be eligible for payments for the treatment of uninsured COVID patients, you must enroll as a participant in the program.  Enrollment must be done through an online portal that can be accessed at: http://www.coviduninsuredclaim.hrsa.gov.

Once my organization enrolls, when can we start submitting claims for reimbursement for treatment of uninsured COVID patients?

HHS has indicated that it will begin to accept claims for reimbursement for treatment of the uninsured on May 6, 2020.


COVID-19 Financial Impact Calculator

The American Ambulance Association is working nonstop on advocating for financial relief from the impact of the Coronavirus (COVID-19) for our members. Now that ground ambulance service providers and suppliers are receiving federal funding to help partially offset the negative financial impact of the Coronavirus (COVID-19), the Congress is asking for information to substantiate that additional funding is necessary. Instead of providing just anecdotal information on the increased costs and lost revenue from COVID-19, we need to provide more wide-ranging data demonstrating the dire financial situation facing our industry.

To this end, the American Ambulance Association has developed a Financial Impact Calculator to gather information from our members to help us make our case for additional financial relief. The Calculator is also designed for members to use in completing the application for more funding under the General Allocation second distribution of the Public Health and Social Services Emergency Fund.

Download the  Excel Version of the Financial Impact Calculator as a reference. The Instructions include definitions for fields in both the Excel and online calculators.

WE STRONGLY RECOMMEND USE OF THE CONVENIENT ONLINE CALCULATOR as this enables AAA to  synthesize data from ambulances across the country for use in advocacy efforts on behalf of mobile healthcare. Your data will be safely stored, and will  be shared only in aggregate.

Please DO NOT enter commas or dollar signs  when providing data. The system will format automatically. 

General Allocation Calculator & PPP Loan Estimator

2020 COVID-19 Financial Impact Calculator

Step 1 of 7

  • Contact Name

HHS Provider Relief Tranche 2 Calculator

Use the American Ambulance Association’s simple form to estimate relief you may receive from the second tranche of HHS COVID-19 funding. Please note that not all providers will receive funds.

More information about this program as well as access to the form you must complete in the General Allocation Portal can be found on the HHS website.

For-profit and non-profit non-governmental providers,  to determine your Net Patient Revenue for the portal, use the following information from your most recently filed tax return. (2019 if filed, otherwise use 2018 numbers).

Governmental providers,  enter your revenue generated for the last audited financial year. When completing the form in the portal,  select Tax Exempt Organization. When asked to upload a return at the end, upload your most recent audited financials.

Please do not enter commas or dollar signs. A negative number or zero in the Tranche 2 box indicates that you WILL NOT receive funding in tranche  2.

2020 HHS COVID-19 Funding Round 2 Calculator

  • Enter the amount your organization received as a direct deposit or check from the first tranche of COVID-19 funding.
  • If the number displayed is ZERO OR NEGATIVE, you will not receive Tranche 2 funding.

UPDATED: What to Do for Round 2 of HHS Provider Relief

UPDATED: HHS Opens Portal for Healthcare Providers and Suppliers to Apply for Second Tranche of CARES Act Provider Relief Funding

Updated April 24, 2020 at 9:40 pm | Register for AAA’s  4/27 webinar on this topic►

View a short video on this update from AAA Payment Reform Chair Asbel Montes at https://ems.zone/2004asbel2

At 5 p.m. on Friday, April 24, 2020, the Department of Health and Human Services opened the online portal that health care providers and suppliers must use to submit their revenue information. This is a requirement to access the second $20 billion tranche of general allocation funding. Access the online portal►

In order to provide the required information, you will need the following information/documentation:

  1. Your Tax Identification Number (TIN)
  2. The bank account to which the first tranche of provider relief funding
  3. You will need access to the email account that you are using to apply for funds (to accept and provide back a security verification code)
  4. A PDF copy of your most recent tax return

The portal will ask a series of questions to verify your identity and the identity of your organization. These include providing your TIN and the last six digits of the bank account to which the original tranche of relief funding was provided.

After completing the verification process, you will be asked to complete an attestation that you received the initial tranche of relief funding.

You will then be prompted to complete a short questionnaire that is used to apply for additional funding. The steps for completing that questionnaire are as follows:

  • Step 1: You will be asked to provide basic information about your organization. This information is similar to the information that you would use to complete a federal W-9 form.
  • Step 2: You will be asked to provide your gross receipts or sales as reported on your most recent tax filing.
  • Step 3: You will be asked to provide an estimate of your lost revenue for March 2020 and April 2020. Note: HHS provided little guidance on how you should go about estimating your lost revenues. The AAA believes that there are several possible approaches that you can use to provide these estimates. To help members answer this question, the AAA anticipates that it will be issuing a Financial Impact Calculator on Monday, April 27, 2020.
  • Step 4: The final step will be for you to upload a copy of your latest tax return.
Attention Governmental Providers

AAA is aware of an issue that may affect governmental EMS organizations. Specifically, those governmental agencies that do not file federal tax returns may not be able to complete the final stage of the application, which asks you to upload a copy of your most recent tax return. The AAA has reached out to HHS to request guidance on how governmental organizations should complete the form. We will update our members as soon as we know anything different.  Register for our May 4 COVID-19 Financial Resources for Governmental Providers webinar►

Targeted Allocation for Treatment of the Uninsured

HHS indicated that it will allocate an undisclosed portion of the $29.6 billion in otherwise unallocated relief funding to reimburse healthcare providers and suppliers for COVID-related treatment of the uninsured. Please note that this allocation is only available for the reimbursement of emergency and non-emergency ground ambulance transports. Reimbursement will be available for COVID-related care furnished with dates of service on or after February 4, 2020. Payments will be made at the Medicare rates, subject to available funding. As a condition to receipt of funding, you must agree to accept HHS’ payment as payment-in-full, i.e., you may not balance bill the uninsured patient.

Is there anything my organization needs to do to claim reimbursement for treatment of uninsured COVID patients?

Yes.  In order to be eligible for payments for the treatment of uninsured COVID patients, must enroll as a participant in the program.  Enrollment must be done through an online portal that will open starting on April 27, 2020.  Once open, the portal can be accessed at http://www.coviduninsuredclaim.hrsa.gov.

Once my organization enrolls, when can we start submitting claims for reimbursement for the treatment of uninsured COVID patients?

HHS has indicated that it will begin to accept claims for reimbursement for the treatment of the uninsured at some point in early May 2020.


The AAA strongly recommends that all members complete their enrollment form as soon as reasonably practicable, so that you are in a position to submit claims as soon as the claim submission window opens.

CMS Office Hours on COVID-19

CMS Office Hours on COVID-19

You are invited to CMS “Office Hours” on COVID-19, today, Thursday, April 16th from 5:00 – 6:00 PM Eastern, the next in a series of opportunities for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

  • Increase Hospital Capacity – CMS Hospitals Without Walls;
  • Rapidly Expand the Healthcare Workforce;
  • Put Patients Over Paperwork; and
  • Further Promote Telehealth in Medicare

Dial-in details below. Conference lines are limited, so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and membership.

Toll-Free Attendee Dial In: 833-614-0820

Event Plus Passcode: 6168487

Audio Webcast link

You can find a copy of the full press release and related materials HERE

To keep up with the important work the White House Task Force is doing in response to COVID-19, please click here: www.coronavirus.gov. For information specific to CMS, please visit the Current Emergencies Website.

Technical Resources from HHS/ASPR TRACIE to Assist First Responders and Healthcare Providers

Technical Resources from HHS/ASPR TRACIE to Assist First Responders and Healthcare Providers

HHS ASPR, the Technical Resources, Assistance Center, and Information Exchange (TRACIE) was created to meet the information and technical assistance needs of regional ASPR staff, healthcare coalitions, healthcare entities, healthcare providers, emergency managers, public health practitioners, and others working in disaster medicine, healthcare system preparedness, and public health emergency preparedness.

As we continue to work with each other through the COVID-19 response, we would like to share some resources to assist your efforts as first responders and healthcare providers in these challenging times. The documents listed below will serve to assist you and your colleagues should you ever need guidance on best practices and any issue related to the COVID-19 response.

Death of a Colleague During the COVID-19 Pandemic: Understanding and Managing Grief for Healthcare Workers and Leaders
Overview of recent federal guidance and resources to hospitals, inpatient and outpatient facilities, and alternate care strategy sites experiencing the loss of a fellow healthcare co-worker during COVID-19; Guidance for healthcare workers and leaders with strategies to address grief and facilitate emotional recovery in the workforce

Grief Following Patient Deaths During COVID-19: Tips for Healthcare Workers in Managing Grief
Grief Following Patient Deaths During COVID-19: Tips for Healthcare Workers in Managing Grief

Resources for Medication Assisted Treatment for Consumers with Substance Abuse Disorders During the COVID-19 Pandemic
Overview of recent federal guidance and resources to hospitals, inpatient and outpatient facilities, and alternate care strategy sites providing Medication-Assisted Treatment (MAT) for individuals with Substance Abuse Disorders (SUD); Guidance and resources intended to help ensure continuity of care and to help mitigate the potential surge of patients seeking in-hospital treatment

For additional resources, please find the hyperlinks to their corresponding documents below:

Should you have any questions, please contact ASPRStakholder@hhs.gov.

AAA Sends Letter to HHS on COVID-19 Response

On April 6, the AAA sent a letter to Health and Human Services Secretary Azar requesting that the Department distribute direct payments to all ambulance service providers and suppliers who are on the front lines of the COVID-19 pandemic. The AAA requested funding under the $100 Billion Public Health and Social Service Emergency Fund, established by the CARES Act, in the amount of $48,000 per ambulance registered as of April 1. The AAA estimates the payments would represent approximately $2.6 billion in desperately-needed relief for our industry. Read the letter HERE.

HHS Notice on Hoarding Supplies

Notice of Designation of Scarce Materials or Threatened Materials Subject to COVID-19 Hoarding Prevention Measures

The Department of Health and Human Services (HHS) announces the issuance of a Notice under Executive Order 13910 (Executive order) and section 102 of the Defense
Production Act of 1950 (the Act), as amended, designating health and medical resources necessary to respond to the spread of Coronavirus Disease 2019 (COVID-19) that are scarce or
the supply of which would be threatened by excessive accumulation. These designated materials are subject to the hoarding prevention measures authorized under the Executive order and the
Act. Download the PDF Now►