Targeted Payments for Medicaid/CHIP Providers
Targeted Payments for Medicaid/CHIP Providers

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Additional CARES Act Provider Relief Funding

Targeted Payments for Medicaid/CHIP Providers

On June 9, 2020, The U.S. Department of Health and Human Services (HHS) announced additional distributions from the CARES Act Provider Relief Fund, targeted for eligible providers that participate in the Medicaid and Children’s Health Insurance Programs (CHIP). Approximately $15 Billion in Provider Relief Funds will be distributed to healthcare providers who provide services to low-income and indigent patients.

As a background, the HHS Provider Relief Fund represents federal funding for eligible health care providers to provide financial relief during the COVID-19 pandemic. The program is funded through a combination of larger federal COVID-19 Relief Programs: The CARES Act and the Paycheck Protection Program. The disbursement of these funds is contingent upon compliance with the HHS terms and conditions, which include future reporting requirements and documentation of proper use. Specifically, the funds are to be used for increased health care-related expenses attributable to COVID-19, and lost revenues associated with the COVID-19 pandemic.

To be eligible for this funding, providers must meet all of the following requirements:

  • Must not have received payment from the $50 Billion Provider Relief Fund General Distribution.
  • Must have directly billed Medicaid for healthcare-related services during the period of January 1, 2018, to December 31, 2019, or own (on the application date) an included subsidiary that has billed Medicaid for healthcare-related services during the period of January 1, 2018, to December 31, 2019.
  • Must have either have filed a federal income tax return for fiscal years 2017, 2018 or 2019 or be an entity exempt from the requirement to file a federal income tax return and have no beneficial owner that is required to file a federal income tax return. (e.g. a state-owned hospital or healthcare clinic).
  • Must have provided patient care after January 31, 2020.
  • Must not have permanently ceased providing patient care directly, or indirectly through included subsidiaries.
  • If the applicant is an individual, they must have gross receipts or sales from providing patient care reported on Form 1040, Schedule C, Line 1, excluding income reported on a W-2 as an employee.

Payment Amounts:
Eligible Medicaid and CHIP providers can expect to receive at least 2 percent of their reported gross revenue from patient care. The final amount each provider receives will be based on the data providers submit through the enhanced Provider Relief Fund Payment Portal. For context, gross revenue includes revenue across all payer types – not Medicaid specific revenues.

HHS has recently updated their Provider Relief Fund Website to include an enhanced Provider Relief Fund Payment Portal that will serve as an application tool to submit the required documentation. This website also includes a set of instructions for providers, as well as an application form for completion. The deadline to submit an application for this funding is July 20, 2020.

Helpful Links:
Provider Relief Fund Web site
Provider Relief Funds—FAQ
Enhanced Provider Relief Fund Portal
Medicaid/CHIP Provider Relief Fund Application Instructions
Medicaid/CHIP Provider Relief Fund Application

Critical Considerations for Assisted Living Providers:
NC Assisted Living providers enrolled for Medicaid Personal Care Services (PCS) will most certainly qualify for this targeted allocation of Provider Relief Funds. Providers need to act timely to apply for the funds and submit the required documentation. As you plan your application process for these funds, there are several areas to consider including:

  • HHS Reporting Requirements.
  • Tracking and Documentation of Proper Use.
  • Financial Statement & Tax implications.
  • “Double Dipping” with other CARES Act funding such as PPP/SBA Loans.

Please contact Andy Page at Dixon Hughes Goodman LLP if you have questions or need any assistance with the Provider Relief Fund application or documentation process.

Andy Page, CPA | Partner - DHG Healthcare
Dixon Hughes Goodman LLP
(919) 526-1836

North Carolina Assisted Living Association

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