Dentists are now able to receive funds from the U.S. Department of Health and Human Services’ Provider Relief Fund, as a result of the American Dental Association’s advocacy.
In a press release dated July 17, 2020, the U.S. Department of Health and Human Services (HHS) extended the deadline to apply for the funds to August 3, 2020, “to ensure eligible Medicaid and CHIP programs, including dentists, have the opportunity to apply.” Eligible dental providers can now apply through the Enhanced Provider Relief Fund Payment Portal and receive reimbursement up to 2% of their annual reported patient revenue.
To be eligible, dental providers must not have received payment from the $50 billion in general distributions made to Medicare, Medicaid and CHIP providers, and must meet one of the following criteria:
- Directly billed (or owns a subsidiary that has directly billed) a state Medicaid or Children’s Health Insurance Program (CHIP) program or a Medicaid managed care plan for healthcare-related services during the period of January 1, 2018 to December 31, 2019.
- Directly billed (or owns a subsidiary that has directly billed) a health insurance company for oral healthcare-related services.
- Be a licensed dental service provider who does not accept insurance and has directly billed (or owns a subsidiary that does not accept insurance and has directly billed) patients for oral healthcare-related services.
In addition, the dental provider must have either (i) filed a federal income tax return for fiscal years 2017, 2018, or 2019 or (ii) be an entity exempt from the requirement to file a federal income tax return and have no beneficial owner that is required to file a federal income tax return, such as a state-owned hospital or health clinic.
Finally, eligible providers must:
- Have provided patient dental care after January 31, 2020;
- Have not permanently ceased providing dental patient care, whether directly or through a subsidiary (pandemic closures excluded); and
- If the applicant is an individual, he/she has gross receipts or sales from providing dental patient care reported on Form 1040, Schedule C, Line 1, excluding W-2 income reported as an employee.
The full instructions for the distribution for Medicaid, CHIP, and Dental Providers via the Enhanced Provider Relief Fund Payment Portal, and a list of additional required documentation is found here. A copy of the application form is found here.
A useful fact sheet on eligibility for the distribution can be found here.
If you have any questions regarding Provider Relief Funds, including eligibility as a dental services provider, please do not hesitate to contact us. To subscribe to the Fox Health Care Law Matters Blog, click here.