Pediatricians are elated over a new coronavirus relief package announced Tuesday for healthcare providers serving Medicaid patients, saying they had largely been left out of the Trump administration’s prior payment programs.
“After months of uncertainty and financial instability throughout the COVID-19 pandemic, the American Academy of Pediatrics finally received the news we’ve been waiting for: Many pediatricians are now eligible for financial relief from the federal government,” said Dr. Sally Goza, a Georgia pediatrician who is president of the American Academy of Pediatrics.
The U.S. Department of Health and Human Services (HHS) said it will send $15 billion to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers — doctors, dentists and some clinics — who had not yet received payments.
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HHS also announced a distribution of $10 billion to safety net hospitals across the country.
“Healthcare providers who focus on treating the most vulnerable Americans, including low-income and minority patients, are absolutely essential to our fight against COVID-19,” said HHS Secretary Alex Azar, when announcing the payments.
The announcement came a week after a bi-partisan group of U.S. House and Senate leaders of committees that oversee Medicaid sent a letter to Azar saying healthcare providers serving low-income patients had been left out and needed assistance immediately from the Public Health and Social Services Emergency Fund.
Dr. Terri McFadden, president of the Georgia chapter of the American Academy of Pediatrics, said the announcement of the federal aid made Wednesday an “exciting day” for pediatricians and the families they serve.
“COVID has really devastated pediatric practices throughout the state,” McFadden said. Patient visits have dropped by 60 to 70 percent at many practices, she said, forcing furloughs and layoffs of staff, and leaving some pediatricians worried about being able to recover, she said.
As schools closed and Gov. Brian Kemp ordered Georgians to shelter in place, families were afraid to take their kids to a medical office for check-ups or other types of care. The federal aid “is going to make the difference, in some practices, in their ability to survive the pandemic,” she said.
"COVID has really devastated pediatric practices throughout the state." —Dr. Terri McFadden, president of the Georgia chapter of the American Academy of Pediatrics
However, Goza, who practices in Fayetteville, said that questions remain about whether the funding will provide the breadth and scope of relief that pediatricians need.
About 60 percent of babies born in Georgia are eligible for Medicaid coverage, according to the Georgia chapter of the American Academy of Pediatrics, leaving most Georgia pediatricians heavily dependent on the health plan for low-income families. Previous relief payments have been tied to Medicare, the federal health plan that covers seniors and disabled people. Pediatricians rarely see patients covered by Medicare.
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HHS said the payment to each provider will be at least 2 percent of reported gross revenue from patient care.
Between 33 and 36 hospitals are likely to qualify for more than $400 million of the $10 billion in new funding for safety-net hospitals, the Georgia Hospital Association said. Grady Memorial Hospital said it expected to receive aid but didn't know how much. In earlier rounds of federal relief payments, it has received $55 million.
America’s Essential Hospitals, an organization that represents the safety-net hospitals, said it was still studying the eligibility requirements to determine which of its members would get the extra help. To get a slice of the money, hospitals must serve a large share of patients who are uninsured or on Medicaid. They must also a profit margin of no more than 3 percent. Those hospitals that qualify will receive between $5 million to $50 million each.
“Our preliminary analysis indicates this will help many of our members, including those in COVID-19 hot spots,” said Beth Feldpush, the organization’s senior vice president of policy and advocacy. “But we believe more targeted funding is needed, as some essential hospitals are still unlikely to meet all the HHS criteria.”
The federal government previously has disbursed more than $1.5 billion to Georgia medical providers.