On June 9, 2020, the U.S. Department of Health and Human Services (HHS) announced that it will distribute approximately $15 billion from the Provider Relief Fund to eligible Medicaid and Children's Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Allocation. Additionally, $10 billion in Provider Relief Funds will be distributed to Safety Net Hospitals.
Medicaid and Children's Health Insurance Program (CHIP) providers
While the initial Provider Relief Fund General Distribution provided payments to approximately 62 percent of all providers participating in state Medicaid and CHIP programs, this distribution will make the fund available to the remaining 38 percent.
To be eligible for the funding providers must not have received payments from the General Distribution and either have directly billed their state Medicaid, CHIP programs or Medicaid managed care plans for services between January 1, 2018, to May 31, 2020. It is believed that close to one million providers may be eligible for this funding.
Eligible providers will need to report their annual patient revenue on the HHS Enhanced Provider Relief Fund Payment Portal. This information will be used 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.
Clinicians that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations who have not yet received funding are also eligible to receive a distribution equal to at least 2 percent of reported gross revenues from patient care. They will need to submit their annual patient revenue information to the Portal to receive these funds.
Safety Net Hospitals
Hospitals that serve a disproportionate number of Medicaid patients or provide large amounts of uncompensated care will receive payment designated for Safety Net Hospitals. Qualifying hospitals will have all of the following:
- A Medicare Disproportionate Payment Percentage (DPP) of 20.2 percent or greater;
- Average Uncompensated Care per bed of $25,000 or more;
- Profitability of 3 percent or less,
All of the above are taken from the latest filed Medicare cost report
Recipients will receive a minimum distribution of $5 million and a maximum distribution of $50 million.
Additional Provider Relief Funds
HHS is working on a second round of funding to hospitals in COVID-19 hotspots to ensure they are equitably supported. Communications were sent out on June 8, 2020 to all hospitals requesting updated information on their COVID-19 positive inpatient admissions for the period January 1, 2020, through June 10, 2020. The information will be used to determine funding. Information must be submitted by June 15, 2020 at 9:00 PM EST.
The Rybar Group is available to assist you with any questions or with any reporting needs that you may have.