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U.S Code last checked for updates: Nov 26, 2024
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Title 42
Chapter 7
Subchapter XI
Part A
§ 1320b-25. Reporting to law enf...
Part B - Peer Review of Utilizat...
§ 1320b-25. Reporting to law enf...
Part B - Peer Review of Utilizat...
U.S. Code
§ 1320b–26.
Funding for providers relating to COVID–19
(a)
Funding
(b)
Application requirement
To be eligible for a payment under this section, an eligible health care provider shall submit to the Secretary an application in such form and manner as the Secretary shall prescribe. Such application shall contain the following:
(1)
A statement justifying the need of the provider for the payment, including documentation of the health care related expenses attributable to COVID–19 and lost revenues attributable to COVID–19.
(2)
The tax identification number of the provider.
(3)
Such assurances as the Secretary determines appropriate that the eligible health care provider will maintain and make available such documentation and submit such reports (at such time, in such form, and containing such information as the Secretary shall prescribe) as the Secretary determines is necessary to ensure compliance with any conditions imposed by the Secretary under this section.
(4)
Any other information determined appropriate by the Secretary.
(c)
Limitation
Payments made to an eligible health care provider under this section may not be used to reimburse any expense or loss that—
(1)
has been reimbursed from another source; or
(2)
another source is obligated to reimburse.
(d)
Application of requirements, rules, and procedures
(e)
Definitions
In this section:
(1)
Eligible health care provider
The term “eligible health care provider” means—
(A)
a provider of services (as defined in
section 1395x(u) of this title
) or a supplier (as defined in
section 1395x(d) of this title
) that—
(i)
is enrolled in the Medicare program under subchapter XVIII under
section 1395cc(j) of this title
(including temporarily enrolled during the emergency period described in
section 1320b–5(g)(1)(B) of this title
for such period);
(ii)
provides diagnoses, testing, or care for individuals with possible or actual cases of COVID–19; and
(iii)
is a rural provider or supplier; or
(B)
a provider or supplier that—
(i)
is enrolled with a State Medicaid plan under subchapter XIX (or a waiver of such plan) in accordance with subsections (a)(77) and (kk) of
section 1396a of this title
(including enrolled pursuant to section 1396a(a)(78) or
section 1396u–2(d)(6) of this title
) or enrolled with a State child health plan under subchapter XXI (or a waiver of such plan) in accordance with subparagraph (G) of
section 1397gg(e)(1) of this title
(including enrolled pursuant to subparagraph (D) or (Q) of such section);
(ii)
provides diagnoses, testing, or care for individuals with possible or actual cases of COVID–19; and
(iii)
is a rural provider or supplier.
(2)
Health care related expenses attributable to COVID–19
(3)
Lost revenue attributable to COVID–19
(4)
Payment
(5)
Rural provider or supplier
The term “rural provider or supplier” means—
(A)
a—
(i)
provider or supplier located in a rural area (as defined in
section 1395ww(d)(2)(D) of this title
); or
(ii)
provider treated as located in a rural area pursuant to
section 1395ww(d)(8)(E) of this title
;
(B)
a provider or supplier located in any other area that serves rural patients (as defined by the Secretary), which may include, but is not required to include, a metropolitan statistical area with a population of less than 500,000 (determined based on the most recently available data);
(C)
a rural health clinic (as defined in
section 1395x(aa)(2) of this title
);
(D)
a provider or supplier that furnishes home health, hospice, or long-term services and supports in an individual’s home located in a rural area (as defined in
section 1395ww(d)(2)(D) of this title
); or
(E)
any other rural provider or supplier (as defined by the Secretary).
(
Aug. 14, 1935, ch. 531
, title XI, § 1150C, as added
Pub. L. 117–2, title IX, § 9911
,
Mar. 11, 2021
,
135 Stat. 236
.)
cite as:
42 USC 1320b-26
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