HHS Slates $15 Billion for Clinicians With Patients in CHIP, Medicaid

Kerry Dooley Young

June 10, 2020

WASHINGTON — Federal officials are preparing to distribute $15 billion in financial aid to pediatricians and other healthcare professionals who see patients enrolled in Medicaid and the State Children's Health Insurance (CHIP) program.

This approach is intended to aid clinicians who serve younger patient populations as they manage the business disruptions and demands of the COVID-19 pandemic. These new funds are intended for healthcare professionals who have not yet received money from the federal Provider Relief Fund General Allocation, the Department of Health and Human Services (HHS) said Tuesday.

Applicants for this tranche of funds also need to have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services from January 1, 2018, to May 31, 2020, HHS said in a news release.

This new share of financial aid likely will serve pediatricians, obstetrician-gynecologists, dentists, and healthcare professionals who deliver opioid treatment and behavioral services, HHS said. The department will require eligible clinicians to report their annual patient revenue, which will be used as a factor in determining payments. The payments are intended to amount to at least 2% of reported gross revenue from patient care.

HHS relied on Medicare payments to guide financial aid in an initial tranche of $50 billion, released in April. That approach resulted in payments to more than 1 million clinicians, including about 450,000 clinicians who also care for people in the Medicaid and CHIP programs, HHS officials said on a call with reporters on Tuesday.

The new $15 billion is intended to provide aid to about 275,000 clinicians who care for people enrolled in Medicaid and CHIP who did not receive aid earlier from the $50 billion distribution.

Expedient Delivery Requested

In a statement to Medscape Medical News, the American Medical Association (AMA) on Tuesday said it was "pleased" by this announcement.

AMA is among the medical organizations that have been pressing for wider distribution of federal aid. HHS used records of Medicare payment to quickly move earlier payments to clinicians, who have struggled financially because of the coronavirus pandemic.

That approach largely left out certain specialties that serve younger populations, which is not what Congress intended in passing recent laws with financial aid for the medical community, wrote Maureen G. Phipps, MD, MPH, chief executive officer of the American College of Obstetricians and Gynecologists (ACOG), in a June 4 letter to HHS Secretary Alex Azar.

"This inequitable method of distributing funds is not reflective of congressional intent," Phipps wrote.

In the letter, Phipps told HHS that obstetrics and gynecology practices have said they might close in the coming weeks because of significant financial strain.

On Tuesday, ACOG issued a statement thanking HHS for the new tranche of funds. In it, Eva Chalas, MD, ACOG's president, noted that nearly half of US births are covered by Medicaid, adding that obstetrician-gynecologists accept more new Medicaid patients than almost any other specialty.

"Although the creation of a dedicated relief funds portal is a welcome first step to support clinicians who accept Medicaid, we urge HHS to ensure that payments are delivered expediently so that these physicians receive needed relief quickly," she said.

The American Academy of Pediatrics (AAP) also has been pressing for financial aid for its members, who have lost revenue and have seen certain expenses rise because of the pandemic.

In a statement, Sally Goza, MD, AAP president, said her organization will work to prevent its members from being "needlessly excluded, especially those who have been left out of past rounds of funding or may have received negligible amounts from the fund.

"While today's announcement brings a measure of relief to pediatricians worried about their financial viability in the short term, important questions remain about whether this funding will offer the breadth and scope of relief our members so desperately need," Goza said.

HHS also on Tuesday announced plans to distribute $10 billion in Provider Relief Funds to safety-net hospitals.

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