In a Press Release issued Tuesday afternoon, the U.S. Department of Health and Human Services (HHS) announced they will distribute approximately $15 billion to eligible providers that participate in state Medicaid and Children’s Health Insurance Program (CHIP) programs that have not received a payment from the Public Health and Social Services Emergency Fund (Provider Relief Funds) and $10 billion in Provider Relief Funds to safety net hospitals that serve the nation’s most vulnerable citizens.
PROVIDER RELIEF FUNDS FOR MEDICAID & CHIP PROVIDERS
HHS launched an enhanced Provider Relief Fund Payment Portal on Wednesday that allows 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% of reported gross revenue from patient care and will be dependent in part on the number of Medicaid patients.
Clinicians that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations who have not yet received Provider Relief Funds may submit their annual patient revenue information to the enhanced Provider Relief Fund Payment Portal to receive a distribution equal to at least 2% of reported gross revenues from patient care.
Examples of eligible providers, serving Medicaid/CHIP beneficiaries, include pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities and other home and community-based services providers.
Note that to be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Funds 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.
$10 BILLION ALLOCATION FOR SAFETY NET HOSPITALS
HHS will automatically distribute, through direct deposit, $10 billion in Provider Relief Funds to hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care. Qualifying hospitals will have:
- A Medicare Disproportionate Payment Percentage (DPP) of 20.2 percent or greater;
- 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; or
- Profitability of 3 percent or less, as reported to the Centers for Medicaid and Medicare Services (CMS) in its most recently filed Cost Report.
Qualifying hospital recipients will receive a minimum distribution of $5 million and a maximum distribution of $50 million.
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