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Financial and Additional Resources

HHS Announces Additional $3 Billion to Safety Net Hospitals

HHS has announced an additional $3 billion in CARES Act Provider Relief Fund payments to safety net hospitals to supplement the $10 billion distribution that was announced on June 9. HHS has expanded the criterion for payment qualification so that certain acute care hospitals meeting the revised profitability threshold of less than of 3 percent averaged consecutively over two or more of the last five cost reporting periods, as reported to the Centers for Medicare and Medicaid Services (CMS) in its Cost Report filings, will now be eligible for payment. HHS expects to distribute over $3 billion across 215 acute care facilities, bringing the total payments for safety net hospitals from the Provider Relief Fund to $12.8 billion to 959 facilities.  State-by-state breakdown - PDF

HHS Announces $1 Billion to Certain Rural Providers and Other Providers from Small Metropolitan Areas

HHS has announced $1 billion in CARES Act Provider Relief Funding for providers in rural areas and in small metropolitan areas.  In May, HHS announced $10 billion in funding to almost 4,000 rural health care providers. HHS is now expanding the existing payment formula to include certain special rural Medicare designation hospitals in urban areas as well as others that provide care in smaller non-rural communities. These may include some suburban hospitals that are not considered rural but serve rural populations and operate with smaller profit margins and limited resources than larger hospitals. HHS estimates the new funding will provide relief to 500 of these hospitals with payments ranging from $100,000 to $4,500,000 for rural designated providers and $100,000 to $2,000,000 for the other providers. State-by-state breakdown - PDF

CARES Act Provider Relief Funding Allocated to Date

As of July 7, 2020, HHS has distributed the following tranches of CARES Act Provider Relief Funding:

  • $50 billion in general distributions
  • $12 billion targeted distribution to high-impact hospitals
  • $10 billion targeted distribution to safety net hospitals
  • $10 billion targeted distribution to rural providers
  • $4.9 billion targeted distribution to Skilled Nursing Facilities
  • $500 million targeted distribution to tribal hospitals, clinics and urban health centers   

For more information about this funding, visit the HHS CARES Act Provider Relief Fund Webpage.  For terms and conditions applicable to each tranche of funding, visit the HHS CARES Act Provider Relief Fund Provider Webpage.

Forthcoming CARES Act Provider Relief Funding

CMS is planning an approximately $15 billion targeted distribution for Medicaid and CHIP providers that did not receive any payments through the General Distributions (see CMS Fact Sheet for additional criteria). The payment to each provider will equal approximately 2% of reported gross revenue from all payer sources from patient care for CY 2017, 2018 or 2019, as selected by the applicant and with accompanying submitted tax documentation. Permissible uses of the funds include health-related expenses to prevent, prepare for, and respond to coronavirus, as well as lost revenues that are attributable to coronavirus (see FAQs for more information). Applications are due by July 20, 2020, via the CARES Act Provider Relief Fund Portal.  Detailed application instructions can be found here. CMS has indicated that these payments will be disbursed on a rolling basis and should received by providers by the end of August.

Other announced distributions of Provider Relief Funding include a forthcoming second tranche of funding for high-impact hospitals based on data that was submitted by June 15. Additionally, a portion of the federal funding will be distributed to healthcare providers that have provided treatment for uninsured COVID-19 patients on or after February 4, 2020; providers may request claims reimbursement via the COVID-19 Uninsured Program Portal and will be reimbursed at Medicare rates, subject to available funding.

Additional Financial Resources

AzHHA has created a series of documents which provide an overview of funding opportunities available to hospitals at a state and federal level. Click on the links below to access the documents.

Federal funding opportunities for hospitals
Automatic Federal Fiscal Relief
State Fiscal Relief

Additional Resources and Guidance

Arizona Department of Health Services

Surge Line

The Arizona Surge Line facilitates the interfacility transfer of patients during an emergency hospital or healthcare facility surge. It was created to optimize Arizona’s patient management through the COVID-19 pandemic, but could be applied to any threat that would lead to a healthcare surge.

Four Key Components of the Surge Line

  • Expedite transfer to a higher level of care (e.g. ICU)
  • Expedite transfer to a lower level of care (e.g. step-down units, post-acute care facilities)
  • Assist with interfacility transport when resources are scarce
  • Provide real-time clinical consultation when resources are scarce

For more information about the Surge Line, visit the ADHS website.

Surveillance toolkit for EMResource

In response to Gov. Ducey’s Executive Order expanding data that hospitals must report to EMResource, the Arizona Department of Health Services (ADHS) published a toolkit. As a reminder, hospitals should be updating EMResource daily by 12 p.m. For any questions or assistance, please email [email protected].

ADHS Posts Staffing and Triage Crisis Standards of Care Guidance

The Arizona Department of Health Services (ADHS) has convened the State Disaster Medical Advisory Committee (SDMAC) to discuss staffing and triage crisis standards of care. The Committee approved guidance for (1) crisis staffing in short-term acute care facilities, (2) pre-hospital triage and (3) identification and appointment of triage officers and clinical care directors in acute care facilities. The specific recommendations are as follows:

Acute Care Facilities should identify Triage Officer(s) and a Clinical Care Director.  Job Action sheets can be found in the Arizona Crisis Standards of Care Plan.   

EMS should communicate contingency status, changes in transportation, and consider changes in deployment strategies.

Facilities should develop and implement expanded staffing plans.

More information on the SDMAC and all adopted guidance can be found on the ADHS website for SDMAC.

COVID-19 Provider Resources - Information on the state’s COVID-19 response efforts, including links to FAQs and clinical guidance from the Arizona Department of Health Services, as well as links to the Centers for Disease Control and Prevention guidance.

FAQs relating to public health emergencies and hospital licensing requirements - General guidance to assist hospitals with understanding Arizona’s hospital regulations as they apply to medical surge, capacity and capabilities during a public health emergency prior to a state declaration.

State Public Health Emergency Declaration Playbook - The health emergency declaration playbook provides an overview of the state emergency and state public health emergency declaration processes, including legal authorities.

Local Public Health Department Resources

Federal Resources

CMS releases virtual toolkit

CMS released a virtual toolkit to help states respond to health care workforce shortages by leveraging new emergency flexibilities offered during the public health emergency. The toolkits also contain best practices for states and localities to reference as they implement changes in their respective areas.

COVID-19 Resources - Obtain COVID-19 resources for healthcare professionals, public health, businesses and the general public.


Federal Agency Announcements and Guidance

CMS grants exceptions and extensions to Medicare quality reporting

CMS non-emergent, elective medical services, and treatment recommendations

Updated CMS COVID 19 Coverage and Coding FAQs

Updated CMS COVID 19 Coverage and Payment Fact Sheet

Medicare Provider Enrollment Relief FAQ

Updated CDC Guidance on Discharging COVID 19 Patients

Updated CDC Guidance for Collecting, Handling and Testing Specimens

CDC Hospital Resources for Preparing for COVID 19 Patients

CDC PPE Burn Rate Calculator

Updated Evaluating and Testing Persons for COVID 19

CDC Interim Infection Control Recommendations for COVID 19 Patients in a Healthcare Setting

Quick Guide: FEMA Reimbursement for acute Care Hospitals