Medicaid Enhanced Provider Payment Strategies and COVID-19: Questions and Answers
Anne Karl, Manatt Health
As the COVID-19 pandemic continues to progress, providers across the continuum of care are experiencing significant changes in utilization resulting in declining revenue and jeopardizing access to care. The federal government has acknowledged the financial challenges facing providers through supplemental funding included in the three federal stimulus bills enacted to date–the Coronavirus Aid, Relief, and Economic Security Act (CARES Act); the Families First Coronavirus Response Act; and the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020. In addition, several states have submitted Section 1115 waivers requesting CMS approval to establish “disaster relief funds,” paid for with Medicaid dollars, to further assist providers.
While it will take some time for waiver requests to be reviewed and for the new federal funds to be released, more immediately available tools can help ensure payments continue flowing to providers despite substantial utilization changes. This Q&A provides a moment-in-time update in response to questions SHVS has received regarding the April 9 Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 CrisisWebinar and corresponding Toolkit.
This expert perspective reviews key considerations for states exploring Marketplace insurance subsidies and highlights the experiences in the five states that have established state-based subsidies that supplement the ACA’s premium tax credit and cost-sharing reductions.
The United States is in the midst of an unprecedented national effort to manufacture, distribute, and ultimately administer COVID-19 vaccines to all Americans. While the federal government is coordinating distribution of vaccines from manufacturers to states, individual states (and certain municipalities) are responsible for coordinating the various components of infrastructure and operational logistics needed to take the vaccine from federal distribution channels to the arms of Americans. This expert perspective outlines four recommendations for states to engage their managed care plans to assist in efforts to successfully and rapidly vaccinate the Medicaid population.