As of midnight March 22, 2022, providers are no longer able to submit claims to the COVID-19 Uninsured Program for tests and treatment for uninsured patients. Claims for vaccination claims for uninsured patients will stop being accepted at midnight on April 5, 2022.
According to a White House Fact Sheet, the fund that reimburses doctors and other medical providers for caring for uninsured individuals will start to be scaled back this month and end completely in early April because Congress refused to pass an emergency funding bill to provide the necessary resources.
“Specifically, one week from today – March 22 — the Uninsured Program will stop accepting new claims for testing and treatment due to lack of sufficient funds,” the White House says. “Providers will no longer be able to submit claims for providing these services to uninsured individuals, forcing providers to either absorb the cost or turn away people who are uninsured, increasing the disparity in access to critically needed health care and putting additional burdens on safety net providers. Three weeks from today—April 5—the Uninsured Program will also stop accepting vaccination claims due to a lack of sufficient funds.”
The Uninsured Program began in 2020 shortly after the pandemic began. Approximately $4.8 billion was allocated from the American Rescue Plan, along with another $2 billing from Families First Coronavirus Response Act (FFCRA) Relief Fund, to provide COVID-19 testing for the uninsured. As well, money from the $178 billion provider relief fund was earmarked for health care providers and facilities for testing, treatment, and vaccine administration for the uninsured. More than 50,000 clinics, hospitals, physician groups, and other providers are listed as recipients in the program, according to data from the Health Resources and Services Administration.
Since February 4, 2020, providers could request claims reimbursement through the program electronically and were reimbursed at Medicare rates, “subject to available funding.” It’s that last phrase that’s causing trouble now, according to the Department of Health and Human Services (HHS). While technically there is still money in the account, most is waiting to be distributed for claims already submitted.
“The bulk of that is because while we make an announcement for a distribution, [Health Resources and Services Administration] goes through their due diligence validating those claims,” said Norris Cochran, acting assistant secretary for financial resources for HHS, during a recent press conference. “Money that reflects as un-obligated is actually fully committed in most cases.”
HHS Secretary Xavier Becerra is concerned the funds may already fall short of the claims they’ve received.
“We want to be responsible,” he said. “We don’t want to give any provider this unrealistic expectation. We don’t want them to believe that if they apply and have a legitimate claim that we are still going to have money to provide them with a reimbursement.”
In addition to the COVID-19 Uninsured Program, the White House says the following initiatives also will be affected if Congress does not provide additional funding:
- Sufficient booster doses and variant specific vaccines may not be available, if needed.
- The federal government will no longer be able to purchase monoclonal antibody treatments and will have to scale back state/territory Allocations.
- Critical testing, vaccine, and treatment efforts will be halted, including
- the purchase of additional oral antiviral pills beyond the 20 million already secured.
- the pre-purchase of promising new antivirals.
- the accelerated creation of a next-generation, pan-COVID vaccine that would provide broad protection against a range of variants.
- maintaining our domestic testing capacity beyond June.
- Planned purchases of preventive treatments for immunocompromised patients will be scaled back.
- The ability to rapidly identify and assess emerging variants will be hindered.
- Global vaccination and COVID-19 treatment efforts will be damaged.
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