Medicaid Providers Fear Delay in Getting Promised Relief Aid

June 11, 2020, 5:21 PM

Medicaid providers hit hard by the pandemic are hailing the HHS’s announcement that long-awaited relief aid is on the way, but they’re worried it will take too long for the funds to arrive.

The Department of Health and Human Services said Tuesday it was directing $15 billion in provider relief funds to Medicaid and Children’s Health Insurance Program providers who haven’t yet received aid. The agency also plans to distribute $10 billion to safety-net hospitals.

Non-hospital providers eligible for the funding will be required to submit revenue information through a new online provider portal and await validation of their claims before seeing any money.

Some industry groups say the process could delay the distribution of funds to eligible providers, which primarily treat low-income and uninsured patients.

Providers are already reporting that the portal is “confusing and cumbersome,” according to Sean Luechtefeld, spokesman for the American Network of Community Options and Resources, which represents providers of services to the disabled.

“We have a lot of concerns about how well this will function,” said Chuck Ingoglia, president and CEO of the National Council for Behavioral Health. “A lot of our members have anticipatory anxiety about how stable it will be when a lot of providers are trying to access it.”

An HHS spokesman declined to say how quickly the money would reach providers, but said the funds would be distributed “on a rolling basis, as information is validated.”

The process may include some back and forth between the HHS and providers, some of whom may be asked to provide additional information, the spokesman said.

‘Intimidating’ Data Request

The new portal went live on Wednesday, according to an HHS frequently-asked-questions document.

Providers will have to submit federal tax returns for 2017-2019, the first quarter federal tax return for 2020, a federal unemployment tax return, a worksheet for calculating the provider’s number of full-time employees, and a worksheet for calculating gross revenue.

Interacting with the portal could be daunting for some smaller providers, Diane Ung, a partner and health-care business attorney with Foley & Lardner LLP in Los Angeles, said.

“Many smaller providers have less experience with reporting this kind of data,” she said. “We’re talking about pediatricians and dentists here, they haven’t been required to do much of this, and they could find it intimidating.”

There are also questions about how providers will be notified of their eligibility to participate, according to Susan Feigin Harris, a partner and health-care attorney at Morgan Lewis & Bockius LLP in Houston.

“The notifications have been coming in in weird ways,” she said. “They seem to come in to some random person, whoever happened to make the last submission to HHS. One of my clients even thought it was spam at first, but luckily gave it a closer look.”

Two Percent

Medicaid providers are also concerned about the amount of funding they will receive, which the HHS said will be around 2% of a provider’s gross revenues.

Many behavioral health providers have suffered much more significant losses during the Covid-19 crisis than 2%, Ingoglia said.

An April survey of community behavioral health providers, many of whom heavily rely on Medicaid revenues, showed that nearly 62% had canceled at least one program, nearly all had reduced operations, and around half had plans to lay off or furlough employees.

Many were also in danger of going under, with more than 60% reporting they could last just three months or less under the conditions of the Covid-19 crisis, according to the survey by the National Council for Behavioral Health.

Luechtefeld said more relief funding will be needed for providers serving the disabled, many of whom have only enough cash on hand to last a month if revenue streams are disrupted.

“The cuts these programs and providers have been making, we’re not just talking here about trimming the fat,” Harris said. “It’s getting to the bone, and the amount that has been allocated so far is probably not going to be enough.”

To contact the reporter on this story: Christopher Brown in St. Louis at ChrisBrown@bloomberglaw.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloomberglaw.com; Alexis Kramer at akramer@bloomberglaw.com

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