A new update from the Department of Health and Human Services explains how hospitals receiving Medicaid disproportionate share hospital (DSH) payments can use Provider Relief Fund (PRF) general and targeted distribution payments.
Through the Coronavirus Aid, Relief, and Economic Security Act, Congress allocated funding for PRF payments to health care providers. Under the PRF terms and conditions, hospitals must limit use of these payments to reimburse for health care expenses and lost revenue related to COVID-19 that are not reimbursed from other sources. As such, if a DSH payment was received for uncompensated costs of providing inpatient or outpatient hospital services to Medicaid beneficiaries and patients without insurance, those expenses would be considered reimbursed and not be eligible for PRF general or targeted distribution payment.
According to previously released guidance, PRF funds received through the general and targeted distributions are not included in the calculation of a hospital-specific DSH cap. However, if a hospital receives funding for uninsured COVID testing and treatment costs through the PRF uninsured program, those funds are included in the hospital-specific DSH cap.
For more information on PRF reporting and auditing, see our PRF reporting resource page.
Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.
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