NYAPRS Note: Here’s some analysis and next steps from the National Council
HHS Announcement
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HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs that have not received a payment from the Provider Relief Fund General Allocation
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To be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020.
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If you received Medicare payments you are currently excluded from this new Provider Relief funding stream.
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HHS will launch a Payment Portal that 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.
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The payment to each provider will be at least 2 percent of reported gross revenue; the final amount each provider receivers can only be determined after the data is submitted.
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The initial General Distribution provided payment 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%.
Strategy/Targets for Advocacy
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Data collection and getting a clear understanding which providers received what from the Provider Relief Fund.
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ASK: $38.5 billion for behavioral health providers. This is a step in the right direction but more must be done to make them whole to respond to the present and growing demand for mental health and addiction services.
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We look to the slate of Senators running for reelection in 2020 including: Senators Cassidy (LA), Collins (ME), Cornyn (TX), Daines (MT), Ernst (IA), Gardner (CO), Sullivan (AK), and Tillis (NC). In addition, Democratic Senators like Senators Peters (MI), Smith (MN) and Warner (VA).
NYAPRS will support a call in action to the above Senators in the coming days
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FOR IMMEDIATE RELEASE
Tuesday, June 9, 2020
HHS Announces Enhanced Provider Portal, Relief Fund Payments for Safety Net Hospitals, Medicaid & CHIP Providers
Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs. HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution.
HHS is also announcing the distribution of $10 billion in Provider Relief Funds to safety net hospitals that serve our most vulnerable citizens. The safety net distribution will occur this week.
“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.”
HHS is providing support to healthcare providers fighting the COVID-19 pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers, including those disproportionately impacted by this pandemic.
ENHANCED PROVIDER RELIEF FUND PORTAL
On Wednesday, HHS is launching 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 payment to each provider will be at least 2 percent 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 providers serve.
The initial General Distribution provided payments to approximately 62 percent 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 percent. HHS has already provided relief funding to over one million providers, and today’s announcement is expected to reach several hundred thousand more providers, many of whom are safety net providers operating on thin margins.
Clinicians that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations who have not yet received General Distribution funding may submit their annual patient revenue information to the enhanced Provider Relief Fund Portal to receive a distribution equal to at least 2 percent of reported gross revenues from patient care.
This funding will supply relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID-19. Examples of providers serving Medicaid/CHIP beneficiaries possibly eligible for this funding, include 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 this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020. Close to one million health care providers may be eligible for this funding.
More information about eligibility and the application process is available at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/general-information/index.html
$10 BILLION ALLOCATION FOR SAFETY NET HOSPITALS
HHS is announcing the distribution of $10 billion in Provider Relief Funds to safety net hospitals that serve our most vulnerable citizens, recognizing the incredibly thin margins these hospitals operate on. This payment is being sent directly to these hospitals via direct deposit.
This payment is going to hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care. Qualifying hospitals will have:
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A Medicare Disproportionate Payment Percentage (DPP) of 20.2 percent or greater;
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Average Uncompensated Care per bed of $25,000 or more. For example, a hospital with 100 beds would need to provide $2,500,000 in Uncompensated Care in a year to meet this requirement;
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Profitability of 3 percent or less, as reported to CMS in its most recently filed Cost Report.
Recipients will receive a minimum distribution of $5 million and a maximum distribution of $50 million.
ADDITIONAL PROVIDER RELIEF FUND UPDATES
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On Monday, June 8, 2020, HHS sent communications to all hospitals asking them to update information on their COVID-19 positive-inpatient admissions for the period January 1, 2020, through June 10, 2020. 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, 2020 at 9:00 PM ET.
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HHS is working on an additional allocation to distribute relief broadly to dentists.
For updated information and data on the Provider Relief Fund, visit hhs.gov/providerrelief