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Medicaid, CHIP Providers, Safety Net Hospitals Next up for CARES Act Provider Relief Funds

Medicaid, CHIP Providers, Safety Net Hospitals Next up for CARES Act Provider Relief Funds

Medicaid and CHIP providers, along with safety net hospitals that serve our most vulnerable citizens, will finally get their portion of the CARES Act Provider Relief Fund. Earlier this week, the Department of Health and Human Services (HHS) announced the planned distribution of approximately $15 billion to eligible Medicaid and CHIP providers who have not previously received payment from the CARES Act Provider Relief Fund General Allocation. HHS also announced the distribution of $10 billion in Provider Relief Funds to safety net hospitals.

Medicaid and CHIP Providers

To be eligible for a portion of the $15 billion, Medicaid and CHIP providers must:

  • not have received payments from the $50 billion Provider Relief Fund General Distribution, and
  • have directly billed either their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020. 

To access the funds, Medicaid and CHIP providers must report their annual patient revenue on HHS’s enhanced Provider Relief Fund Payment Portal, which was expected to be released on Wednesday, June 10. This information will be used as a factor in determining their Provider Relief Fund payment, which will be at least 2 percent of their reported gross revenue from patient care and possibly more based on how many patients they serve.

Approximately 62 percent of all providers participating in state Medicaid and CHIP programs have already received payment relief, according to HHS, and the agency hopes to reach the remaining 38 percent in this round of distribution. HHS estimates that as many as one million health care providers may be eligible.

Safety Net Hospitals

To be eligible for a portion of the $10 billion, hospitals must have the following:

  • 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 CMS in its most recently filed Cost Report.

Eligible hospitals will receive a minimum distribution of $5 million and a maximum distribution of $50 million. These safety net distributions will occur this week via direct deposit.

Additional Funding for Hospitals in COVID-19 Hotspots

Additionally, HHS is asking all hospitals for information about their COVID-19 positive-inpatient admissions for the period of January 1, 2020, through June 10, 2020. This information will be used to determine a second round of funding to hospitals in COVID-19 hotspots to ensure they are equitably supported in the battle against COVID-19. 

Hospitals must submit that information based on the instructions received from HHS by June 15, 2020, at 9 PM EDT in order to be considered for funding under this additional $10 billion distribution.

As with other Provider Relief Fund payments, recipients of these new distributions must attest to receipt of the payment and accept the terms and conditions within 90 days of receiving the money.

More Information

To learn more about this latest distribution of CARES Act Provider Relief Funds, check out the following resources:

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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