AOA urges greater support as HHS issues Medicaid, CHIP relief funds

Medicaid and Children's Health Insurance Program (CHIP) participating doctors of optometry who missed out on coronavirus-related relief funds may be eligible to collect payments, but even so, the AOA continues to push for greater support and review of federal crisis relief measures.

On June 9, the U.S. Department of Health and Human Services (HHS) announced disbursement of an additional $15 billion in Provider Relief Funds to eligible Medicaid and CHIP providers, roughly 38% of whom did not previously receive a relief payment under the $50 billion Provider Relief Fund General Distribution provided for under the Coronavirus Aid, Relief and Economic Security (CARES) Act.  

Additionally, HHS launched an enhanced Provider Relief Fund Payment Portal for eligible Medicaid and CHIP providers who have not previously received any disbursements from the Provider Relief Fund, to report their annual patient revenue, used to determine payment, HHS says. These payments will be at least 2% of reported gross revenue from patient care, while a final amount will be determined after data is submitted.  

But even as doctors of optometry begin applying for the Medicaid/CHIP Provider Relief Fund, the AOA expressed concerns to HHS that some doctors could still be missed during an especially critical time for optometry practices' reactivation of routine, comprehensive eye and vision care.  

AOA urges further relief from HHS, CMS  

In a June 15 letter to HHS Secretary Alex Azar and Centers for Medicare & Medicaid Services Administrator Seema Verma, the AOA thanked the agencies' expediency in distributing much-needed funds to doctors of optometry struggling in the current public health emergency but also stressed wariness over the most recent disbursement based on concerns from the initial General Distribution. Specifically, the AOA noted some Medicare doctors of optometry with significant 2019 Medicare billing who still hadn't received relief funds.  

While both individual doctors and the AOA have contacted the United Healthcare-operated CARES Provider Relief line to determine the status of these funds, operators haven't been able to provide any information about when doctors could expect a further explanation or funding. Hence, the AOA requests HHS to provide assurances that qualifying physicians will receive their funding.  

"Uncertainty in this program is deeply destabilizing for the physicians it was meant to support, as they continue to struggle every day to keep their practices open and preserve their ability to care for patients now and in the future," reads the letter, signed by AOA President Barbara L. Horn, O.D.  

Considering these providers already have been waiting for their relief funding, the AOA sought to proactively address potential pitfalls in the system. Primarily, the AOA noted that some states' Medicaid eye health and vision care services are paid by a managed care plan that then subcontracts with a vision care plan. With so many layers, HHS may not receive a complete list of doctors of optometry providing Medicaid care in a timely fashion and the AOA stands ready to assist.  

Additionally, as future Public Health and Social Services Emergency Funds are considered, the AOA urged HHS to consider doctors of optometry who may not generally bill public programs as a large share of their practice. Nearly 90% of AOA doctors of optometry are enrolled in and provide care to Medicaid patients with doctors of optometry located in more than 10,000 communities nationwide.  

"Across the U.S., doctors of optometry are working hard to get their practices back to some version of normal and to meet the pent-up need for care," the AOA letter reads.  

"However, in order to protect both their patients and their staff, these doctors are facing a 'normal' that includes increased time per patient, fewer patients per day, increased cleaning, and significantly increased use of personal protective equipment, all of which strain the resources and efficiency of practices, especially small ones. Even if funding from the Public Health and Social Services Emergency Fund has reached almost all qualifying providers so far, for those who have been missed, the financial blow may be devastating."

How to apply

To be eligible for the Medicaid and CHIP Provider Relief Fund, providers must not have received general distribution relief funds and either have directly billed their state Medicaid or CHIP program, or Medicaid managed care plans, for health care-related services between Jan. 1, 2018, and May 31, 2020. The AOA advises doctors to read the full instructions and application before entering the portal.  

In addition to advocating for needed additional HHS provider relief, the AOA will continue providing updates and information regarding changes to the Paycheck Protection Program (PPP). The AOA will host an #AskAOA webinar to complement previous PPP webinars once clarifying information is obtained from the Small business administration. In the meantime, please send questions or feedback to AskAOA@aoa.org.  

Find the latest information for optometry on the coronavirus public health emergency at the AOA COVID-19 Crisis Response page.