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$15B in relief to be distributed to Medicaid providers, HHS announces

Eligible Medi-Cal Dental providers can apply by Sept. 13 to receive CARES Act funds

July 07, 2020 12489

Dentists who provide care for Medicaid patients (known as Medi-Cal in California) may be eligible to receive financial relief from the Department of Health and Human Services’ Provider Relief Fund established by the Coronavirus Aid, Relief, and Economic Security Act.

Article originally published June 10 and updated July 17 to include the following information and links and to communicate the new Aug. 3 application deadline.

Dentists who provide care for Medicaid patients (known as Medi-Cal in California) may be eligible to receive financial relief from the Department of Health and Human Services’ Provider Relief Fund established by the Coronavirus Aid, Relief, and Economic Security Act.

The HHS announced June 9 that it will distribute approximately $15 billion to providers who participate in state Medicaid programs and have not yet received a payment from the Provider Relief Fund General Allocation. The department stated that it expects the additional funds to reach “close to one million” more providers on top of the more than 1 million providers who have already received relief through the fund. And there are already indications that additional distributions are in the works.

The CARES Act and the Paycheck Protection Program and Health Care Enhancement Act together allocated $175 billion in relief funds to hospitals and other health care providers, including those disproportionately impacted by this pandemic.

Dentists were largely left out of the funds disbursed in April and May, which went to Medicare providers, hospitals, safety-net clinics and rural and Indian Health Services providers.

The current round of funding is targeted to several types of providers who do not have significant Medicare involvement, such as pediatricians, OB-GYNs, dentists, opioid treatment and behavioral health providers, assisted living facilities and other home and community-based providers. 

CDA has advocated for dentists’ access to the provider relief funds to help compensate for economic losses caused by the pandemic.  

Reporting annual patient revenue, determining provider payments

California dentists will be eligible to receive the funds if they have billed the Medi-Cal Dental Program (also known as Denti-Cal) or a Medi-Cal managed care plan for health care-related services between Jan. 1, 2018, and May 31, 2020. The HHS will use providers’ total annual patient revenue as one factor when determining a provider’s payment.

According to the HHS’ June 9 press release :

  • Providers will report by the Aug. 3 deadline (originally July 20) their annual patient revenue through the HHS’ enhanced Provider Relief Fund Payment Portal.
  • The payment to each provider will be at least 2% of reported gross revenue from patient care.
  • The final distribution each provider receives will be determined after the data is submitted, including information about the number of Medi-Cal Dental patients the provider serves.

HHS stated it will engage in “significant anti-fraud monitoring” of funds distribution. The Health Resources & Services Administration is responsible for distributing the funds.

Alex Azar, HHS secretary, has indicated in interviews that the department is “working on an additional allocation to distribute relief broadly to dentists” for those who have been affected by COVID-19 but do not participate in federal Medicare or Medicaid programs. 

For more information, see the provider relief fund fact sheet and the HHS’ CARES Act Provider Relief Fund webpage. On the webpage, users will find a link to a recorded webinar about the provider application process. The HHS will continue to update the FAQ with more information, including about the distribution timeline, specific terms and conditions and more.