MACPAC Expresses Concern Regarding Payments to High-Medicaid Providers During Coronavirus Pandemic

Foley Hoag LLP - Medicaid and the Law

Foley Hoag LLP - Medicaid and the Law

We haven’t posted on the blog in a while due to the rapid increase in our workload due to the coronavirus pandemic.  We’re preparing a longer post that will go through everything that’s happened in Medicaid legislatively and administratively in the past six weeks that will be up soon, but wanted to flag an important development in today’s post.

On March 27, President Trump signed the Coronavirus Aid, Relief, and Economic Stabilization (CARES) Act into law.  Among other provisions in CARES, section 5001 of the law created a Public Health and Social Services Emergency Fund that appropriated $100 billion to health care providers and suppliers that “provide diagnoses, testing, or care for individuals with possible or actual cases of COVID-19.”  The law is clear that these funds are to be made available to “Medicare or Medicaid enrolled suppliers and providers.”

So far, the Department of Health and Human Services (HHS) has announced two allocations of funding from the $100 billion.  The first allocation – equal to $30 billion – was based on a supplier’s or provider’s Medicare revenue in 2019 and was released on April 10.  The second allocation was announced on April 24 and is equal to $20 billion.  Allocations from that fund are to be based on the entity’s net patient revenue in 2018.  The remaining $50 billion has not yet been allocated, although HHS has issued an announcement explaining how they intend to allocate a portion of the remainder.

One question that health care providers and suppliers are starting to ask is:  what about Medicaid providers?  Although it is true that the second tranche of funding is intended to provide more benefit to providers that see fewer Medicare and more Medicaid patients, there has not yet been an allocation of funding focused solely on Medicaid revenues.  In part, that’s because it’s harder to identify Medicaid revenues since Medicaid is a jointly state and federal financed program.  Nevertheless, in the past week, both the National Association of Medicaid Directors and MACPAC sent a letter to HHS expressing concern over the lack of a funding allocation from the CARES package that is targeted explicitly at Medicaid providers and suppliers.

As MACPAC pointed out in its letter, “many providers serving vulnerable Medicaid beneficiaries are not eligible to receive funding under the first $50 billion allocation.”  This is an important issue that we’ll explore in more detail in our follow-up post.  Until then, please stay safe and healthy!

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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