The Department of Health and Human Services, through the Health Resources and Services Administration, is releasing an additional $25 billion from the Provider Relief Fund to Medicaid, Children’s Health Insurance Program providers and to safety net hospitals.
HHS said it expects to distribute approximately $15 billion to eligible Medicaid and CHIP providers that have yet to receive a payment from the Provider Relief Fund General Allocation.
The payment to each provider will be at least 2% of reported gross revenue from patient care. The final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients they serve.
HHS has also announced the launch of an enhanced Provider Relief Fund Payment Portal that will allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their Provider Relief Fund payment.
The $10 billion to safety net hospitals is expected to be distributed this week via direct deposit.
On Monday, June 8, HHS sent communications to all hospitals asking them to update information on their COVID-19-positive inpatient admissions for the period January 1 through June 10.
This information will be used to determine a second round of funding to hospitals in COVID-19 hotspots to ensure they are equitably supported in the battle against this pandemic.
To determine their eligibility for funding under this $10 billion distribution, hospitals must submit their information by June 15.
Qualifying hospitals will have: a Medicare Disproportionate Payment Percentage of 20.2% or greater; average uncompensated care per bed of $25,000 or more; and profitability of 3% or less.
WHY THIS MATTERS
HHS said it recognizes the incredibly thin margins on which hospitals serving vulnerable populations operate.
The funding will supply relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID-19.
This includes pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities, and other home and community-based services providers.
To be eligible for the funding, healthcare providers must not have received payments from the $50 billion Provider Relief Fund general distribution from the Coronavirus Aid, Relief and Economic Security Act. Also, these providers must have either directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31.
Close to one million providers may be eligible for funding, HHS said.
Recipients will receive a minimum distribution of $5 million and a maximum distribution of $50 million.
HHS is working on an additional allocation to distribute relief broadly to dentists.
THE LARGER TREND
Congress earmarked $175 billion in COVID-19 relief funds to hospitals and other providers, first through $100 billion in CARES Act funding and then another $75 billion through the Paycheck Protection Program and Health Care Enhancement Act.
Hospitals got $50 billion in CARES Act funds in two general allocations. Another $50 billion was distributed as targeted allocations for hot spot areas, Tribal Health Services, rural providers, skilled nursing facilities and to help cover the cost of uninsured care.
With the distribution of $25 billion announced on Wednesday, HHS still has a significant amount needing to be allocated.
The initial general distribution provided payments to approximately 62% of all providers participating in state Medicaid and CHIP programs.
The Medicaid and CHIP targeted distribution will make the Provider Relief Fund available to the remaining 38%.
REACTION: ON THE RECORD
Rick Pollack President and CEO, American Hospital Association said “The AHA is pleased that HHS will be distributing additional funds from the CARES Act emergency relief fund to hospitals serving high numbers of Medicaid and uninsured patients, as we have suggested. While we appreciate the emergency funds released by HHS to date, the AHA continues to urge the department to distribute substantial additional funds to hospitals and health systems in an expedited manner as the COVID-19 virus continues to spread, hospitalizations continue to occur, and many Americans continue to forgo care, including primary care and other specialty care visits.”
Dr. Bruce Siegel, president and CEO of America’s Essential Hospitals said, “Today’s announcement of $10 billion in additional funding for hospitals that provide safety-net care, as well as a future allocation of $10 billion for providers in COVID-19 hot spots, will help ease the financial pain this public health emergency has inflicted on these caregivers. We appreciate that the administration has recognized the severe pressures on front-line providers.”
“Healthcare providers who focus on treating the most vulnerable Americans, including low-income and minority patients, are absolutely essential to our fight against COVID-19,” said HHS Secretary Alex Azar. “HHS is using funds from Congress, secured by President Trump, to provide new targeted help for America’s safety-net providers and clinicians who treat millions of Medicaid beneficiaries.”
Historically, healthcare was something done to patients, says Dr. Carl Nohr of the Canadian Medical Association. In 2016, Nohr said the system needed to move to an era where healthcare is something done with patients. But even that doesn’t go far enough. “My role is not so much directing care,” he said, “but finding out what people value.” For more on this topic, click here to watch the complimentary webinar “Health System Transformation: Improving Population Health After COVID-19,” on June 16 at 11 a.m. CT.