State Medicaid directors Monday sent a letter to the CMS and the Office of Management and Budget asking both agencies to allow states to make retainer payments to essential Medicaid providers during the COVID-19 outbreak.
"Many of the providers who serve our 72 million members are at risk of closing their doors in a matter of days or weeks due to extraordinary costs (e.g., staffing, PPE) and loss of typical visit volume," wrote the National Association of Medicaid Directors.
Officials are concerned that providers won't be able to get small business loans available under the Coronavirus Aid, Relief, and. Economic Security Act, or CARES Act, fast enough because lenders are swamped with applications.
"It may take months for dollars to flow. It is also unclear when — and even if — the $100 billion in provider financial assistance, also from the CARES Act, will reach small, essential Medicaid providers," NAMD said.
States could get the money out the door and ensure that the funds are well-spent by directing them to substance use disorder specialists, long-term care providers and other providers that rely heavily on Medicaid, according to the association. They could also audit the payments and claw back the money if states determine the payments were improper. States could force providers to promise that they won't cut staff, salaries or wages.
The HHS secretary has the power to waive specific Medicaid and CHIP rules if they are "likely to assist in promoting the objectives of the program," according to the Social Security Act. Helping Medicaid providers keep their doors open to preserve beneficiaries' access to care likely meets the standard.
The CMS and Office of Management and Budget did not respond to requests for comment.