On June 9, 2020, the U.S. Department of Health and Human Services (HHS) announced that it will make additional distributions from the Provider Relief Fund to eligible Medicaid and Children's Health Insurance Program (CHIP) providers.
HHS announced that it expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Allocation.
Examples of providers who may potentially be eligible for the Medicaid/CHIP targeted distribution include: pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities and other home and community-based services providers, who treat Medicaid/CHIP patients.
HHS launched an enhanced Provider Relief Fund Payment Portal that will allow 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.
According to the June 9th HHS announcement, the provider payments under this targeted distribution will be at least 2 percent (2%) of reported gross revenue from patient care. The final amount will be determined after the data is submitted by the provider, including information about the number of Medicaid patients served.
As with the earlier general fund distributions, this funding will supply relief to eligible providers to compensate for lost revenues or increased expenses due to COVID-19.
To be eligible for this funding, healthcare providers must not have received payments from the $50 billion Provider Relief Fund 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. Providers must attest to the information in the application they submit and agree to the applicable Terms and Conditions. HHS estimates that close to 1,000,000 healthcare providers may be eligible for this funding.
The Enhanced Provider Relief Portal and Application and may be accessed here.
More information on the Medicaid/CHIP targeted distribution and the application process is available from HHS here.
Updated information and data on the Provider Relief Fund may be accessed here.
If you are a provider with questions about this legal alert, please contact Grace Mack or any member of the Health Law team.
Tags: Coronavirus (COVID-19) • CARES Act • Provider Relief Fund • Medicaid • Children's Health Insurance Program (CHIP)