DHS COVID-19 PROVIDER GUIDANCE // OLTL
Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Funding for Office of Long-Term Living (OLTL) Nursing Facility Providers
Issued: July 6, 2020
Governor Wolf recently signed Act 24 of 2020, which allocates funding from the federal Coronavirus Aid, Relief, and Economic Security Act – also known as the CARES Act. Funding from Act 24 must to be used to cover necessary COVID-19 related costs incurred between March 1, 2020 and November 30, 2020. Act 24 includes $457 million of COVID-19 relief funds for providers of long-term living programs. To qualify for the one-time payment, a person or entity must be in operation as of March 31, 2020. This funding includes the following payments to providers of ventilator or tracheostomy nursing facility services:
- COVID-19 Vent/Trach Payment
The total funds available for a one-time payment to Qualified Ventilator or Tracheostomy Non-Public and County NFs pursuant to Act 24 (COVID-19 Vent/Trach Payment) is $8 million. Non-Public and county nursing facilities qualify for the COVID-19 Vent/Trach Payment if, based upon the Supplemental Ventilator Care and Tracheostomy Care Payments for December 2019, the NF had: (a) ten or more Medical Assistance (MA) residents who received medically necessary ventilator care or tracheostomy care, and (b) at least 17 percent of the facility’s MA residents received medically necessary ventilator or tracheostomy care.
For each Qualified nursing facility, the Qualified NF’s number of MA residents who received necessary ventilator care or tracheostomy care for the third quarter of calendar year 2019 is divided by the sum of all Qualified NFs’ MA residents who received necessary ventilator care or tracheostomy care for the third quarter of calendar year 2019 to obtain an NF specific quotient. Each NF’s quotient is multiplied by $8 million to determine their payment amount.
OLTL is preparing the distribution of the funds as one-time gross adjustment for NFs currently enrolled as MA providers with the Department. Providers should expect to see the payment appear as a gross adjustment transaction/lump sum payment on a PROMISe remittance advice with payment issuance occurring nine days after the transaction appears on their remittance. OLTL’s intention is to distribute the payments in July. Payment information will be posted to the Department’s website.
Act 24 of 2020 requires these funds to be expended by November 30, 2020 or returned to the commonwealth. Additionally, these funds must be used for COVID-19 related expenses incurred between March 1, 2020 and November 30, 2020. Providers must keep documentation to prove that these funds were used for their response to the COVID-19 pandemic in case of an audit. Any person or entity accepting a COVID-19 payment agrees to provide documentation to the Department, upon request, for purposes of determining compliance with Act 24 requirements. Instructions on expenditure reporting will be provided in the future.
Providers are advised to review guidance for eligible expenses on the U.S. Department of Treasury website:
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