A recent extension of the federal public health emergency through January 14, 2022, will continue to provide much needed help for the state, hospitals and providers, and patients during the COVID emergency. Impacts include:
Extension of enhanced federal match rate. The extension provides financial support to states and providers by continuing the enhanced federal match rate for Medicaid services through March 2022. This will result in enhanced Medicaid payment in cases where payment is influenced by changes to the federal match rate. In other cases where hospitals and providers are paid a fixed rate or fee schedule, the enhanced match rate provides the state with budget relief in the current fiscal year and allows the state to conserve funds to be used in areas of need. The enhanced federal match rate also helps states bear the additional costs due to expanded Medicaid enrollment due to disruption of work during the COVID emergency.
Extension of payment provisions and insurer mandates. The extension of the emergency period extends certain payment provisions and carrier mandates at both the federal level. Generally, state mandates by the governor or insurance commissioner have mirrored federal extensions of the federal emergency.
- COVID payment provisions, including continuation of the 20 percent enhancement for Medicare and Medicaid COVID inpatient services. This is critical for hospitals since both Medicare and Medicaid’s standard payment is significantly less than the cost of care for these services.
- Covid Provider Relief Funding. While it is unclear if Congress will provide additional funding beyond what has been already appropriated, the extension may provide additional flexibility in provider’s use of existing funding.
- Extension of carrier payment mandates protecting patients from unexpected COVID costs. These include prohibitions on cost-sharing and balance billing for many COVID testing and treatment services, as well as coverage and payment for vaccine counseling, telehealth, and other services. A listing of current OIC emergency orders is here. (Andrew Busz, AndrewB@wsha.org)
