Provider Relief Fund Payments for Medicare & CHIP Providers and Safety Net Hospitals

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CARES Act, Paycheck Protection Program, and Health Care Enhancement Act Support for Healthcare Providers

By Jennifer Allen, CPA

As states reopen, some medical professionals continue to receive much-needed assistance through the CARES Act Provider Relief Fund and Paycheck Protection and Health Care Enhancement Act.

On June 9, 2020, the U.S. Department of Health and Human Services (HHS) announced its plans to distribute approximately $15 billion to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that have not received payment(s) from the Provider Relief Fund General Allocation.  HHS also announced an additional $10 billion for safety-net hospitals.

With the launch of an enhanced Provider Relief Fund Payment Portal, eligible Medicaid, CHIP, and home and community-based service (HCBS) providers can report their annual revenue data and apply for a payment equal to at least two percent of reported gross revenues from patient care, given they:

  • did not previously receive payment from the $50 billion ($30B followed by $20B) Provider Relief Fund General Distribution and
  • they billed Medicaid for healthcare-related services between January 1, 2018, and December 31, 2019.

You must apply by July 20, 2020, for payment.  Once payment has been allocated, you must confirm receipt of the funds and agree to the terms and conditions within 90 days of receiving payment.

I already received a Provider Relief Fund payment.  Why can’t I apply for this, too?

The original payments provided relief to approximately 62 percent of providers participating in state Medicaid and CHIP.  This round of payments targeted at Medicare and CHIP providers is intended to provide payments to the remaining 38 percent.

Safety Net Hospitals

Given their incredibly thin financial margins, $10 billion in Provider Relief Fund payments is available to safety net hospitals serving some of the most vulnerable citizens and populations in the country.  These payments are being automatically direct deposited to hospitals serving a disproportionate quantity of Medicaid patients and those that provide a high amount of uncompensated care.

Hospitals that qualify have:

  • A Medicare Disproportionate Payment Percentage (DPP) of at least 20.2 percent
  • An average uncompensated care per bed of at least $25,000
  • Profitability of 3 percent or less (as reported in its most recently filed cost report to the Centers for Medicare & Medicaid Services)

We will continue to update you as guidance is issued.  Please contact us at any time for information or assistance.

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