By Julie RovnerKaiser Health NewsEditor’s Note: Such articles initially appeared on Kaiser Health News.Casa de Salud, a nonprofit clinic in Albuquerque, New Mexico, provisions primary medical care, opioid craving services and non-Western regimen, including acupuncture and reiki, to a largely low-income population.And, like so many other health care providers that serve as a safety net, its revenue — and its future — are threatened by the COVID-1 9 epidemic.“I’ve been working for the past six weeks to figure out how to keep the doors open, ” said the clinic’s executive director, Dr. Anjali Taneja. “We’ve seen probably an 80% drop in patient care, which has completely impacted our bottom line.”In March, Congress allowed $100 billion for health care providers, both to compensate them for the extra costs associated with caring for cases with COVID-1 9 and for the revenue that’s not coming in from regular charge. They have been required to stop specifying most nonemergency services, and countless patients are afraid to visit health care facilities.But more than half that fund has been allocated by the Department of Health and Human Work, and a majority of the members of it still further has are going to hospices, doctors and other facilities that serve Medicare cases. Officials said at the time that was an efficient way to get the money beginning to move to countless providers. That, however, leaves out a large swath of the health system infrastructure that responds to the low-income Medicaid population and children. Casa de Salud, for example, professes Medicaid but not Medicare.State Medicaid conductors say that without immediate funding, many of the health facilities that serve Medicaid cases could close permanently. More than a month ago, bipartisan Medicaid chiefs wrote the federal government departments asking questions immediate authority to clear “retainer” pays — not is attributable to specific care for cases — to keep their health providers in business.“If we wait, core components of the Medicaid delivery system could neglect during, or soon after, this pandemic, ” wrote the National Association of Medicaid Directors.So far, the Trump administration has not answered, although in early April it said it was “working rapidly on added targeted distributions” for other providers, including those who predominately dish Medicaid patients.In an email, the Center for Medicare& Medicaid Business said officials there will “continue to work with territories as they seek to ensure continued access to care for Medicaid recipients through and beyond the public health emergency.”CMS noted that states have several ways of improving pays for Medicaid providers, but did not directly answer the question about the retainer payments that states are seeking the authority to procreate. Nor did it say when the funds would start to flowing to Medicaid providers who do not likewise get funding from Medicare.The delay is forestalling Medicaid advocates.“This needs to be addressed urgently, ” said Joan Alker, executive director of Georgetown University’s Center for Children and Families in Washington, D.C. “We are concerned about the infrastructure and how quickly it could evaporate.”In the administration’s explanation of how it is distributing the succour stores, Medicaid providers are included in a catchall category at the unusually foot of the schedule, under the heading “additional allocations.”“To not saw something substantive coming from the federal degree simply computes revile to gash, ” said Todd Goodwin.He fees the John F. Murphy Homes in Auburn, Maine, which provides residential and day services to hundreds of children and adults with developmental and academic disabilities. He said his organization — which has already furloughed roughly 300 workers and spent more than $ 200,000 on COVID-related expenses including buys of indispensable gear such as disguises and protective equipment that will not be reimbursable — has still not been eligible for any of the various aid platforms passed by Congress. It get most of its funding from Medicaid and public school systems.The make-up has tapped a line of credit to stay afloat. “But if we’re not here providing these services, there’s no Plan B, ” he said.Even providers who principally help privately insured cases are facing monetary distress. Dr. Sandy Chung is CEO of Trusted Doctors, which has about 50 specialists in 13 offices in the Northern Virginia suburbs around Washington, D.C. She said about 15% of its fund comes from Medicaid, but the drop off in private and Medicaid cases has left the group “really struggling.”“We’ve had to furlough faculty, had to curtail hours, and we may have to close some locations, ” she said.Of special concern are children because Medicaid cover-ups nearly 40% of them across the county. Chung, who also heads the Virginia chapter of the American Academy of Pediatrics, said that vaccination proportions are off 30% for babies and 75% for adolescents, putting them and others at risk for preventable illnesses.The biggest rub, she contributed, is that with their own economies in free fall, more people will qualify for Medicaid coverage in the coming weeks and months.“But if you don’t have providers around anymore, then you will have a significant mismatch, ” she said.Back in Albuquerque, Taneja is working to find whatever sources of funding she can to keep the clinic open. She fastened a federal loan to help cover her payroll for a couple of months, but worries what will happen after that. “It would kill me if we’ve lived 15 times in this health care system, precisely to not make it through COVID, ” she said.KHN elderly reporter Phil Galewitz contributed to this story.
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