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MGMA Washington Connection 12/17/2020

12/17/2020 8:13 AM | Rebekah Francis (Administrator)

HHS begins issuing Phase 3 Provider Relief Fund payments 

The Department of Health & Human Services (HHS) announced it is beginning distribution of Phase 3 Provider Relief Fund (PRF) payments on Dec. 16, which will continue through January. The Phase 3 distribution considers actual revenue losses and expenses attributable to COVID-19 and follows two earlier General Distributions to group practices and other healthcare entities.

While HHS has not published a formula for how it calculated Phase 3 payments, yesterday’s announcement indicated that this funding will meet “up to 88 percent of [a provider’s] reported losses” from COVID-19 in the first half of the year. Previous General Distributions endeavored to provide entities with a baseline payment of 2% of annual revenue from patient care. Practices that applied for Phase 3 should watch for payments and not be alarmed if payments result in amounts that exceed this 2% figure. MGMA will share updates with members as they are released. Additional information about Phase 3 includes:

  • Phase 3 funds are being distributed pursuant to applications submitted between Oct. 5 and Nov. 6. Payments are based in part on how many providers applied, which explains the delay in issuing funding.
  • HHS increased the amount of available Phase 3 funding from $20 billion to $24.5 billion.

Payments are being distributed to over 70,000 providers. Of these, it is estimated that 35,000 applicants will not receive an additional payment either because they experienced no change in revenues or net expenses or because they already received funds that equal or exceed reimbursement of 88% of reported losses.

MIPS hardship applications available for 2020 performance year

Group practices experiencing issues with meeting 2020 MIPS reporting requirements can apply for a hardship exception that, if approved, will re-weight any or all performance categories and hold clinicians harmless for non-reporting. There are two separate applications available:

  • The Extreme and Uncontrollable Circumstances Exception application allows a clinician, group practice, or APM entity to request reweighting for any or all performance categories if they experience circumstances beyond their control, such as the COVID-19 public health emergency. The deadline to apply for this exception is Feb. 1, 2021.
  • The MIPS Promoting Interoperability Performance Category Hardship Exception application is available to request reweighting for this category only. MIPS clinicians or group practices can submit an application by Dec. 31, 2020, citing one of the following reasons:
    • The group is a small practice
    • EHR technology is decertified
    • Insufficient internet connectivity
    • Lack control over the availability of CEHRT

Extreme and uncontrollable circumstances

MGMA calls on Congress to mitigate HIPAA fines for medical groups

MGMA joined six other leading healthcare organizations, including the American Medical Association and American Hospital Association, urging Senate leaders to support H.R. 7898. Specifically, this legislation would require the HHS Office for Civil Rights (OCR) to consider use of recognized security best practices by a medical group when assessing fines and audits related to HIPAA. The legislation gives much-needed protection to medical groups who follow recognized security practices to fend off cyberattacks by acknowledging that organizations who have been acting in good faith should not be penalized by OCR. Earlier this month, the House of Representatives passed the legislation on a voice vote. Access MGMA cybersecurity resources here.


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