Transparency Sought on COVID-19 Relief Funds

May 5, 2020


Craig Wilson, JD, MPA
Director, Health Policy

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In an April 27 letter to Secretary of Health and Human Services Alex Azar, the National Association of Medicaid Directors (NAMD) urged more transparency regarding COVID-19 funding distribution to healthcare providers. The association asked the U.S. Department of Health and Human Services (HHS) to share with states provider-specific amounts distributed so that states can better target their own fiscal relief efforts to Medicaid providers. As noted in the NAMD letter, “aggregated funding amounts by state that are currently available are not sufficient for state planning purposes and may inadvertently lead states to duplicate funds” from other sources.

In a post yesterday, we noted that $326 million in grant funding from the Coronavirus Aid, Relief, and Economic Security (CARES) Act had been distributed to 2,905 Arkansas healthcare providers. News accounts have provided self-reported amounts received by healthcare providers, but HHS has offered no provider-specific information, although HHS has indicated the agency is in the process of developing a publicly available database to track funds.

The NAMD letter and the broader push for more transparency come as HHS begins to distribute an additional $40 billion in CARES Act funds to healthcare providers. Some smaller hospitals with 500 or fewer employees have applied for and received funds from the Paycheck Protection Program (PPP) as well, although the Small Business Administration has not yet indicated that it will  release details about the recipients of those funds.

The most recent stimulus bill — the Paycheck Protection Program and Health Care Enhancement Act —adds $310 billion to the PPP and allocates $100 billion to hospitals and other healthcare providers to purchase personal protective equipment, ventilators, and testing equipment. This massive federal funding flow comes as states and philanthropies open up their coffers as well. For example, Arkansas has allocated $75 million in direct funding to assist healthcare providers and has applied for a $116 million waiver for additional support through Medicaid. The Northwest Arkansas Council recently announced that $3 million in funds it has raised from local businesses would be available to Northwest Arkansas hospitals.

There is no question that a number of Arkansas hospitals — even before the COVID-19 pandemic — were financially vulnerable, as shown in our hospital profiles dashboard. Although as of April 27 the state has permitted elective procedures to resume in limited fashion, the short-term financial impact of COVID-19 on hospitals and other healthcare providers is evident, with many hospitals having furloughed hundreds of staff.

As the long-term effects of COVID-19 on the state’s healthcare system begin to materialize, a more detailed look into federal funding bursts from March and April will be critical to ensure that the impact on the state’s safety net providers — including non-hospital-based providers such as school-based, behavioral health, and home- and community-based service providers — is not overlooked.

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