HHS Advisor Clarifies Provider Relief Fund Questions

Regulation | June 12, 2020 | by Nicole Fallon

Senior Advisor to Health and Human Services Secretary Alex Azar, Nick Uehlecke, clarified many aspects of the new Medicaid Distribution and other distributions made to date from the Provider Relief Fund on the June 12 LeadingAge Member Update call. 

With the recent announcement of an application portal for Medicaid and CHIP providers to apply for a Targeted Medicaid distribution from the Provider Relief Fund, LeadingAge sought to clear up the confusion around this particular distribution. First, there were several issues identified regarding which providers are eligible to apply for the funds. Uehlecke clarified, consistent with the Medicaid Distribution announcement, that providers who bill either Medicaid Fee-For-Service and/or Medicaid Managed Care (and meet all other eligibility criteria) are eligible to apply for the Medicaid Distribution and data on both of these revenue sources will be collected through the portal. In addition, all adult day health providers, including those who had to close their physical location, are eligible to apply. HHS views that the action of closing the physical location as an action to prevent COVID-19 and as such should apply for the Medicaid Distribution. Assisted living providers who bill Medicaid are also eligible to apply but HHS is also looking at a future Provider Relief distribution to address the needs of assisted living providers who are private pay as well. This will likely require a dual authentication factor that HHS is working to outline right now. Finally, Nick clarified that at present PACE programs are not eligible at this time but HHS is exploring this issue further as both PACE programs and some Institutional Special Needs Plans(ISNPs) serve dual roles of provider and payer. HHS had made a commitment to Congress that as a general rule the Provider Relief Funds would not go to payers. He acknowledged that PACE and ISNPs may prove to be an exception at some point and that the application portal includes PACE providers in one of the fields. For now, PACE programs cannot apply but HHS is taking a second look at this issue and new guidance may be forthcoming.

LeadingAge also raised the concerns expressed by a number of members who serve Medicaid beneficiaries but happen to be under the same Tax Identification Number(TIN) as an organization that received a General Distribution payment, which disqualifies them from applying for a Medicaid distribution. Uehlecke noted that HHS is looking into this issue and trying to understand these circumstances better. HHS is willing to review specific cases where the General Distribution payments have not been shared out with the Medicaid providers under the TIN. LeadingAge can provide those names to HHS for follow up. A thread throughout the interview with Uehlecke is that HHS is striving to get these funds to providers who need them to ensure their survival but also seek to balance those efforts with good stewardship and accountability.

It has been confirmed that providers will have until July 20 to apply for the Medicaid Distribution. Previously, some communications had suggested July 3 but HHS made a decision to extend the application deadline to the July 20. This decision to extend was made after reflecting that the earlier date did not give Medicaid providers a comparable time to apply in comparison to the time given for prior distributions. Similarly, providers can expect more clarity to come regarding when a provider had to be billing for Medicaid services in order to be eligible to apply for the Medicaid Distribution. Essentially, Uehlecke indicated that HHS is trying to assure that providers have been in existence and providing care and aren’t setting up a new organization solely for the purpose of taking advantage of Provider Relief Funds. 

When asked about payments being Distributed through the Targeted SNF Distribution, Uehlecke stressed that HHS continues to send out payments to the remaining nursing homes as it is able to verify data. HHS is still missing addresses,and/or other key information for some of these nursing homes but outreach from HHS will continue next week to obtain this information so payments can be sent. HHS will be sharing the current list of providers it is still trying to verify with LeadingAge so we can identify those nursing homes who are our members so these issues can be resolved and payments sent. Medicaid-only nursing homes who have not received a payment from the Provider Relief Fund by the end of next week(June 19) should reach out to LeadingAge who can gather their information and submit this to HHS for resolution. HHS also noted that Medicaid-only SNFs who have not yet received a payment can apply through the new Enhanced Provider Relief Fund Payment Portal for the Medicaid Distribution.

For all providers who receive Provider Relief Funds, the first report to HHS will be due July 10. Uehlecke indicated that getting further guidance out on this topic is a top priority for him and should be posted very soon. Providers should also watch for the HHS FAQs to be updated. Uehlecke confirmed there are additional FAQs coming out in the next few days. He specifically noted that at least one FAQ will address the issue of which expenses can be reported by a provider organization, such as Life Plan Communities, who has multiple service lines. He hinted that they are likely to take a broad view recognizing that lost revenue in one building may impact, for example, the health care side of the business as those dollars are not available to pay for certain expenses such as PPE.

Additional Provider Relief Fund resources:

HHS FAQs

Enhanced Provider Relief Fund Payment Portal for Apply for Medicaid Distribution 

Application Instructions for the Medicaid Distribution