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COVID-19 Coverage Assistance Fund
> FAQs for The HRSA COVID-19 Coverage Assistance Fund
FAQs for The HRSA COVID-19 Coverage Assistance Fund
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General Questions
Eligibility Questions
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General Questions
What is the HRSA COVID-19 Coverage Assistance Fund?
Why did HRSA/HHS establish this program?
What constitutes “cost-sharing”?
How does the HRSA COVID-19 Coverage Assistance Fund differ from HRSA’s COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment and Vaccine Administration for the Uninsured (HRSA COVID-19 Uninsured Program)?
Who is administering the program?
Eligibility Questions
Can the Coverage Assistance Fund be used for Marketplace/Exchange Grace Period claims, where the pharmacy benefit is unable to return a Pended response, and RX billing windows are less than the 90 day plus grace period process?
Are Indian Health Service clinics eligible for reimbursement through the CAF? Are individuals who access care through the IHS system considered underinsured for the purpose of this program?
Who is eligible for reimbursement through this fund?
Who is ineligible to receive reimbursement from the HRSA COVID-19 Coverage Assistance Fund?
Who is an “underinsured individual” for purposes of requesting reimbursement for vaccine administration?
What services are eligible for reimbursement?
Which type of health care providers are eligible to receive reimbursement under this program? Are non-profit organizations or Federally Qualified Health Centers (FQHCs) eligible?
Are pharmacies/pharmacists that administer COVID-19 vaccines eligible providers for reimbursement under the program?
Do Health Center Program requirements restrict or limit health centers in submitting claims for reimbursement to the HRSA COVID-19 Coverage Assistance Fund?
If a vaccine is administered at a FEMA, State or Local Government sponsored vaccination site, can a health care provider submit a claim for reimbursement from the HRSA COVID-19 Coverage Assistance Fund?
Does the HRSA COVID-19 Coverage Assistance Fund reimburse providers who administer COVID-19 vaccines to patients who have Medicare Part A (hospital/facility care), but not Medicare Part B (medical/preventive services) coverage?
Payment Questions
How do eligible providers receive funding?
How are the reimbursement rates determined?
How do providers register to participate in the Coverage Assistance Fund?
How do providers submit a claim?
What type of unique identifiable identification information is required when submitting patient information?
Do providers need to obtain or provide a patient’s Social Security Number to submit the claim to the HRSA COVID-19 Coverage Assistance Fund?
Are claims subject to timely filing limits?
What if a provider submitted a claim to the HRSA COVID-19 Uninsured Program and the patient is actually underinsured, or vice versa?
How can a patient avoid being directly billed for receiving a COVID-19 vaccine?
Can health care providers submit claims for underinsured individuals who are undocumented?
How should providers account for these funds for purposes of cost reports and similar reports?
Do providers have to pay back the funding they received?
If a provider already received payment from an underinsured individual, are they required to reimburse that individual after receiving payment from the program?
Can providers submit a paper reimbursement request and/or request reimbursement via check?
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