In the month of March alone, the U.S. government made history when Congress passed the $3 trillion CARES act to provide relief to virtually everyone on the U.S. economic ladder amid the coronavirus pandemic. In April, Congress passed another $100 billion for healthcare providers, to compensate them for the extra costs associated with caring for patients with COVID-19. The $100 billion also went to floating nonprofits and healthcare providers without the revenue from regular care, since most non-emergency services have been halted and many patients are afraid to visit healthcare facilities.
Where is the $100 billion going?
- As announced in early April, a portion of the $100 billion Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured. Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through the program and will be reimbursed at Medicare rates, subject to available funding. Steps will involve: enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit.
- $10 billion will be allocated for a targeted distribution to hospitals in areas that have been particularly impacted by the COVID-19 outbreak.
- $50 billion of the Provider Relief Fund is allocated for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers’ 2018 net patient revenue.
- $400 million will be allocated for Indian Health Service facilities.
- $10 billion will be allocated for rural health clinics and hospitals.
In the administration’s explanation of how it is distributing the relief funds, Medicaid providers are included in a catchall category at the very bottom of the list, under the heading “additional allocations.”
Medicaid left out
But more than half that money has been allocated by the Department of Health and Human Services, and the majority of it so far has gone to hospitals, doctors, and other facilities that serve Medicare patients. Officials said at the time that was an efficient way to get the money moving to many providers. That, however, leaves out a large swath of the health system infrastructure that serves the low-income Medicaid population and children.
State Medicaid directors say that without immediate funding, many of the health facilities that serve Medicaid patients could close permanently.
One of many healthcare providers at risk
Casa de Salud, a nonprofit clinic in Albuquerque, New Mexico, provides primary medical care, opioid addiction services, and non-Western therapies, including acupuncture and reiki, to a largely low-income population. Like so many other healthcare providers that serve as a safety net, Casa de Salud’s revenue is threatened by the COVID-19 epidemic because they only accept Medicaid, not Medicare.
“I’ve been working for the past six weeks to figure out how to keep the doors open,” said the clinic’s executive director, Dr. Anjali Taneja. “We’ve seen probably an 80% drop in patient care, which has completely impacted our bottom line.
Taneja is working to find whatever sources of funding she can to keep the clinic open. She secured a federal loan to help cover her payroll for a couple of months, but continues to worry what will happen when it runs out. “It would kill me if we’ve survived 15 years in this health care system, just to not make it through COVID,” she said.
Over a month ago, bipartisan Medicaid chiefs wrote to the federal government asking for immediate authority to make “retainer” payments in order to keep their health providers in business and have received no response.
“If we wait, core components of the Medicaid delivery system could fail during, or soon after, this pandemic,” wrote the National Association of Medicaid Directors.
“This needs to be addressed urgently,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families in Washington, D.C. “We are concerned about the infrastructure and how quickly it could evaporate.”
The Trump administration has yet to respond, although in early April they said that they were “working rapidly on additional targeted distributions” for other providers, including those who predominantly serve Medicaid patients.That has yet to be seen. If Nancy Pelosi’s Heroes Act is passed, there might be hope for Medicaid aid.
The Centers for Medicare and Medicaid Services said that their officials will “continue to work with states as they seek to ensure continued access to care for Medicaid beneficiaries through and beyond the public health emergency.”