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Letter to the HHS Secretary Following Up on CARES Act Distribution

In this letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, MACPAC follows up on a previous letter to Centers for Medicare & Medicaid Services Administrator Seema Verma. The Commission restates its concern that Coronavirus Aid, Relief, and Economic Security Act (CARES Act, P.L. 116-136) funds are not providing sufficient assistance to health care providers focused on serving Medicaid beneficiaries, and that lack of attention to these providers may do permanent damage to the nation’s health care safety net.

The Commission expresses three concerns stemming from HHS’s April 22, 2020 modification in the CARES Act distribution formula:

  • The change not only has little effect on the likely share of funds going to hospitals that serve a high share of Medicaid and low-income patients, but also favors providers with a higher share of patients with commercial insurance whose rates are higher than those paid by Medicaid.
  • Other providers serving vulnerable Medicaid beneficiaries—including dentists, providers of home- and community-based services, and many non-hospital-based behavioral health providers—continue to be ineligible to receive funds under the new distribution formula.
  • There is a lack of transparency regarding which providers have already received funding and the methodology and amount of funds that will be used to make future payments. Making such information available would help assuage providers’ concerns that help is on the way as well as assist states as they assess how best to meet the health care needs of their residents at this time of crisis.

The letter concludes by urging the Secretary to act quickly to speed relief to many providers who are the primary source of health care for tens of millions of Medicaid beneficiaries.