On June 9, the U.S. Department of Health and Human Services (HHS) announced targeted financial help for individual providers who participate in Medicaid and the Children’s Health Insurance Program (CHIP). AGD, in partnership with the Organized Dentistry Coalition, successfully advocated for the inclusion of dentists.
The program is an enhancement of the Provider Relief Fund, which was established as part of the Coronavirus Aid, Relief, and Economic Security (CARES) and Health Care Enhancement acts, with $173 billion allocated by Congress. HHS plans to distribute about $13 billion through the Medicaid/CHIP provider program. Payment is based on a percentage of reported gross revenue from patient care, and data can be submitted through the Provider Relief Fund Program Portal. The portal provides detailed instructions for submission.
The program is being administered by UnitedHealth Group and requires that applicants create an Optum ID, verify tax identification information and submit specific documentation of revenues.
To be eligible for relief funds, applicants must meet all of the following requirements:
- Must not have received payment from the $50 billion General Distribution. This includes providers who have billed Medicare on a fee-for-service basis [Parts A or B] in 2019.
- Must have directly billed Medicaid for health care-related services during the period of Jan. 1, 2018, to Dec. 31, 2019, or own an included subsidiary that has billed Medicaid for health care-related services during the period of Jan. 1, 2018 to Dec. 31, 2019.
- Must either have filed a federal income tax return for fiscal years 2017, 2018 or 2019 or be an entity exempt from the federal income tax return filing requirement and have no beneficial owner who is required to file a federal income tax return (e.g. a state-owned hospital or health care clinic).
- Must have provided patient care after Jan. 31, 2020.
- Must not have permanently ceased providing patient care directly, or indirectly through included subsidiaries.
- 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 a (statutory) employee if the applicant is filing as an individual.
Impact on General Dentistry: AGD recommends that eligible practices act promptly; eligible Medicaid and CHIP providers have until July 20 to apply for relief fund payments. Additionally, HHS has announced that it is working on an additional allocation to distribute relief broadly to dentists.