WASHINGTON, D.C. (June 12, 2020)—The Department of Health and Human Services (HHS) has earmarked $15 billion in relief funding for health care providers serving patients under Medicaid and Children’s Health Insurance Program (CHIP) programs. In their release and in updated Provider Relief Fund FAQs, the agency stresses that this relief is only for health care providers who have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans between Jan. 1, 2018 and May 31, 2020, and have not received a payment from the Medicare-based $50 billion general distribution.

“Health care providers who focus on treating the most vulnerable Americans, including low-income and minority patients, are absolutely essential to our fight against COVID-19,” said HHS Secretary Alex Azar. “HHS is using funds from Congress… to provide new targeted help for America’s safety-net providers and clinicians who treat millions of Medicaid beneficiaries.”

AAHomecare recently encouraged HHS to make sure HME suppliers were included in any Medicaid-based relief distributions. There is no language in the current guidance on the Provider Relief Fund website or the related FAQs that indicates that HME suppliers will not be eligible for this round (just as HME suppliers were eligible in Medicare-based relief rounds).

Home health clinicians that participate in state Medicaid and CHIP programs and/or Medicaid and CHIP managed care organizations who have not yet received General Distribution funding may submit their annual patient revenue information to the enhanced Provider Relief Fund Portal to receive a distribution equal to at least 2% of reported gross revenues from patient care, reported the National Association for Home Care & Hospice. This funding will supply relief to Medicaid and CHIP providers experiencing lost revenues or increased expenses due to COVID-19. Examples of providers, serving Medicaid/CHIP beneficiaries, possibly eligible for this funding include pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities and other home and community-based services providers.

To be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020. Close to one million health care providers may be eligible for this funding.

Eligible providers will need to submit financial documentation in the new Targeted Distribution Provider Relief Fund Payment Portal by July 3, 2020. The application portal is expected to be available today (Wednesday, June 10), according to HHS.

The Medicaid Targeted Distribution methodology will be based upon 2% of gross revenues from patient care for CY 2017, 2018, or 2019, as selected by the applicant and with accompanying submitted tax documentation.

The new guidance related to the Medicaid/CHIP based relief can be found on pages 32-35 of the Provider Relief Fund FAQs.

More information about eligibility and the application process is available here.