HHS Announces new Medicaid/CHIP Distribution from Provider Relief Fund, Application Portal Opens 6/10/2020

Regulation | June 12, 2020 | by Nicole Fallon

Today, the U.S. Department of Health and Human Services announced it will be distributing roughly $15 billon in its next round of Provider Relief Funding to Medicaid and CHIP providers through a time-limited application process.

Who is eligible?

Medicaid and/or CHIP providers who:

  1. Did NOT receive a payment from the $50 billion General Distribution (these payments went to Medicare providers who may also provide Medicaid services) AND
  2. Billed Medicaid fee-for-service or Medicaid Managed Care plan between 1/1/2018 and 5/31/2020.

HHS explicitly identified the following providers as possibly eligible to receive a payment from this distribution: assisted living, home and community based services,  behavioral health, dentists, pediatricians. Specifically excluded from the list are PACE providers. LeadingAge has been told that this is because PACE is consider a payer like Medicare Advantage or Special Needs Plans who it has also deemed ineligible for Provider Relief Fund payments.  It is unclear, at this point, if a Medicaid provider whose parent organization received a General Distribution payment is still eligible for a payment under this Targeted Medicaid and/or CHIP Distribution. It may depend upon whether a provider is under the same Tax IDentification Number as the organization receiving the General Distribution. LeadingAge will be seeking clarification from HHS on this issue. 

How will providers get the payment?

Unlike prior Provider Relief Fund distributions,providers must apply for this distribution by submitting required information through a new “Enhanced Provider Relief Fund Payment Portal.” The portal is scheduled to go live Wed. June 10. HHS has said providers will need to submit: annual patient revenue and information on the number of Medicaid patients/beneficiaries served. The announcement did not indicate from which year the data will need to be reported.

How much will a provider receive?

HHS reports providers will be eligible to receive payments of at least 2% of reported gross revenue from patient care.

Providers are encouraged to apply as soon as possible once the portal goes live on June 10. The HHS website indicates applications will be accepted through the portal through July 20 . It is unclear how long it will take HHS to distribute the payment to providers following their application. More information is anticipated to be posted tomorrow (Wed. June 10) when the Enhanced Provider Relief Fund Payment Portal goes live.  The Terms and Conditions for the Medicaid distribution can be found here