Grassley, Wyden Raise ‘Serious Concerns’ Over COVID-19 Relief Delays for Medicaid Providers

Lawmakers from the Senate Committee on Finance and the House Committee on Energy & Commerce called out the Department of Health and Human Services (HHS) for its delay on disbursing relief funds to Medicaid-dependent providers amid the COVID-19 pandemic, in a letter sent to HHS secretary Alex Azar this week.

“As the chairs and ranking members of the committees of jurisdiction over the Medicaid program, we are concerned that the delay in disbursing funds from the Public Health and Social Services Emergency Fund (PHSSEF) for Medicaid-dependent providers could result in long-term financial hardship for providers who serve some of our most vulnerable populations,” Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., and Reps. Frank Pallone, Jr., D-N.J., and Greg Walden, R-Ore., wrote to Azar on Monday.

The lawmakers are the chairs and ranking members of the committees of jurisdiction over the Medicaid program.

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With the passage of the CARES Act, Congress authorized and appropriated $100 billion for health care providers in the PHSSEF; HHS allocated $30 billion in funds based on 2019 Medicare reimbursements and supplemented this with $20 billion reflecting 2018 total reimbursements, the lawmakers noted.

In addition, the agency announced $4.9 billion for Medicare-enrolled skilled nursing facilities in late May.

But the providers who depend on Medicaid for large portions of their revenue haven’t “received a meaningful allocation from the PHSSSEF,” and many of them are under considerable strain from the effects of COVID-19, the lawmakers wrote.

“HHS has, thus far, relied on methodologies that favor providers that receive a larger share of their payments from Medicare or private insurance,” they said in the letter to Azar, which was also copied to Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma. “While HHS has made public statements regarding a commitment to develop a distribution for Medicaid providers who may not have Medicare claims, we have not yet seen public progress on such a commitment.”

Out of all nursing facility residents in the U.S, 62% depend on Medicaid as their primary payer source as of 2017, according to data from the Kaiser Family Foundation.

The lawmakers called on HHS to answer several questions by June 10 related to:

  1. HHS’s timeline for releasing “a dedicated tranche of funds for Medicaid-dependent providers.”
  2. How the department plans to release those funds to the providers.
  3. The level of funding HHS will dedicate to those providers “to ensure a meaningful and equitable distribution.”
  4. The factors that led to “HHS waiting until May 1 to request Medicaid-dependent provider information from states.”
  5. The factors contributing to delays in disbursing funds to those providers and how HHS is working to address them.

The delays in issuing those funds could “severely hamper” the ability of Medicaid-dependent providers to serve as essential players in the time of COVID-19 and beyond, they argued.

“We write regarding the need for a dedicated distribution from the PHSSEF for providers who rely on Medicaid and to share our serious concerns with the ongoing delay of funding,” they wrote.

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