Answering the call from many lawmakers to support the public health safety net system (e.g., here and here), the U.S. Department of Health and Human Services (HHS) announced an additional distribution of $25 billion from the COVID-19 Provider Relief Fund, aimed at safety net hospitals and Medicaid and CHIP providers. Details on the distributions follow.
- Medicaid and CHIP Providers – $15 billion: HHS is launching an “enhanced Provider Relief Fund Payment Portal” that will now allow Medicaid and CHIP providers to report their annual patient revenues. These amounts will in turn determine how much money providers receive from this next tranche of funding. HHS states this funding will be made available to the 38 percent of all Medicaid and CHIP providers that did not receive funding from the initial General Distribution out of the Provider Relief Fund. HHS anticipates payment to each provider will equal approximately 2 percent of reported gross revenue from patient care, totaling to an expected $15 billion in funding across all eligible providers.Providers will be eligible to receive this next wave of funding if they did not receive payment from the previous $50 billion General Distribution and if they have directly billed their state Medicaid and CHIP programs or Medicaid managed care plans between Jan. 1, 2018 and May 31, 2020. HHS anticipates close to 1 million providers will be eligible for this funding. Additional details, including application information, are available here.Information on the terms and conditions for providers accepting this funding are here and here (for safety net hospitals and Medicaid/CHIP providers, respectively). These conditions are similar to those agreed to by providers who have already received Provider Relief Fund disbursements (including certain patient protection agreements that, e.g., prohibit providers from “balance billing” patients receiving COVID-19 related treatment).
HHS states it will launch the enhanced Provider Relief Fund Payment Portal on Wednesday, June 10.
- Safety Net Hospitals – $10 billion: HHS states it will be sending a total of $10 billion to safety net hospitals through direct deposit. Qualifying hospitals will receive a maximum of $50 million and a minimum of $5 million. Qualifying hospitals include those who have:
- A Medicare Disproportionate Payment Percentage of 20.2 percent or more;
- An average uncompensated care per bed of $25,000 or more;
- Three percent or less profitability per the hospital’s most recently filed Cost Report to the Centers for Medicare and Medicaid Services (CMS).
HHS states the safety net distribution will occur this week.
For reference, a breakdown of the announced Provider Relief Fund disbursements to date follows in the table below.
|Relief Fund Distribution (amount)||WHG Summary||Provider Recipients|
|First General Allocation ($30 b)||Here||All Medicare-billing providers|
|Second General Allocation ($20 b)||Here||All Medicare-billing providers|
|High Impact Allocation ($12 b)||Here||Hospitals with at least 100 COVID-19-related admissions|
|Rural Allocation ($10 b)||Here||Rural acute general hospitals, CAHs, RHCs, and rural CHCs|
|Nursing Homes ($4.9 b)||Here||SNFs|
|Indian Health Service Support
|Here||Tribal hospitals, clinics, and urban health centers|
|Safety Net ($25 b)||N/A||Medicaid and CHIP Providers, Safety Net Hospitals|
As such, HHS has dispersed or announced disbursement of approximately $102 billion of the total $175 billion appropriated to the Provider Relief Fund. This leaves approximately $73 billion for subsequent funding tranches. Along those lines, HHS stated it is developing a forthcoming targeted distribution to dentists. HHS is also requesting COVID-related admissions data from hospitals to begin developing a second round of funding for hospitals in to-be-determined “hotspot” areas. HHS requests this data from hospitals by June 15. 2020.