***Update: Eligible providers that participate in Medicaid and CHIP programs must electronically submit an application for Provider Relief Funds through the Provider Relief Fund Portal by July 20, 2020. Note that such providers may select to use their gross revenues from patient care for CY 2017, or 2018 or 2019. The Instructions, Application and Terms and Conditions for Medicaid and CHIP Provider Relief Funds can be accessed here: Medicaid and CHIP Provider Relief Funds Instructions , Medicaid and CHIP Provider Relief Funds Application , Medicaid and CHIP Provider Relief Funds Terms and Conditions.
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.
For additional details on the $50 billion Provider Relief Funds general distribution, see the following Fox Rothschild Alerts: Details Regarding $30 Billion Distribution to Health Care Providers and HHS Begins Second Provider Relief Fund Distribution, Congress Adds $75 Billion in New Aid.
$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; and
- Profitability of 3 percent or less, as reported to the Centers for Medicaid and Medicare Services (CMS) in its most recently filed Cost Report.
*Note that Children’s Hospitals do not have to satisfy the uncompensated care per bed criteria to be considered a qualifying safety net hospital.
Qualifying hospital recipients will receive a minimum distribution of $5 million and a maximum distribution of $50 million.
If you have any questions regarding Provider Relief Funds, including eligibility as a Medicaid/CHIP provider or qualifying safety net hospital, please do not hesitate to contact us.