HHS on Tuesday announced new grant distributions to Medicaid providers, safety net hospitals, and hospitals in COVID-19 hot spots.
The agency in recent days faced pressure from a bipartisan group of lawmakers to send more of Congress' $175 billion provider relief fund to Medicaid-dependent providers.
HHS said that $15 billion will be sent to Medicaid providers that did not already receive a grant from the department's initial $50 billion general grant distribution, which was open to providers that billed Medicare fee-for-service in 2019.
Around 38% of Medicaid providers were left out of the initial general fund distribution. The funds to Medicaid providers were delayed nearly two months compared with Medicare distributions because the agency had issues gathering data from states, a senior HHS official said.
Providers have to report their annual patient revenue through an online portal starting Wednesday, and payments will be at least 2% of reported gross revenue from patient care.
A senior HHS official said that providers who submit revenue information could expect to see funds as soon as 10 days after submission. HHS backed off a similar timeline estimate the department gave to Medicare providers during the general distribution tranche. After a month of that portal being open, only 23% of available funds had been sent to providers that submitted paperwork.
"On April 22, HHS committed to getting Medicare providers roughly 2% of their revenue. On June 9, HHS committed to getting Medicaid providers roughly 2% of their revenue. While the timing and process may not have been appreciated, the equity is," McDermottPlus Consulting vice president Rodney Whitlock said.
HHS said providers such as pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities, and other home and community-based services providers may be eligible for the $15 billion funding pot.
Manatt Health managing director Jocelyn Guyer said a cohesive outreach strategy will be needed to ensure community-based Medicaid providers know how to access to the portal.
"So far, its been more of a spit and duct tape feeling to how they have been running the fund," Guyer said.
Georgetown University research professor Edwin Park said it's possible that providers that received a de minimis amount of aid under prior distributions could be excluded.
Another $10 billion will go to safety-net hospitals this week, HHS said in a statement. Requirements for the safety net distribution are a Medicare disproportionate payment percentage of 20.2% or greater, average uncompensated care per bed of $25,000 or more, and profitability of 3% or less, as reported the most recent available cost report. The minimum distribution is $5 million and the maximum is $50 million.
The American Hospital Association praised the allocation, but said more funds need to be sent to hospitals and health systems. America's Essential Hospitals, which represents safety-net hospitals, said the distributions will "ease the financial pain" of the pandemic for its members.
HHS on Tuesday said the agency will distribute an additional $10 billion in grant money to hospitals in COVID-19 hot spots and asked them to submit data about COVID-19 positive inpatient admissions.
The federal health department previously sent $12 billion to nearly 400 hospital facilities that had treated at least 100 COVID-19 patients between January and April. The new distribution may have a different patient threshold, and data submissions are due June 15.
"HHS' allocation methodology will be determined after fully analyzing the collective data submitted by hospitals," an updated guidance document states.
The distribution will come from the $175 billion provider relief fund lawmakers created to help healthcare providers offset lost revenue and coronavirus-related expenses.
HHS emailed hospitals Tuesday asking them to submit information about their COVID-19 positive inpatient admissions between January 1 and June 10 using the TeleTracking platform by 9 p.m. ET.
Updated guidance states that funds from the prior hot spot distribution will be factored into the second round of grants, but providers who already received money may still be eligible for further funds.
The first round of high-impact grants was distributed based on a fixed amount per COVID-19 inpatient admission with an add-on payment based on each hospital's proportion of disproportionate-share hospital payments and Medicare uncompensated care payments.
