Hospitals and providers treating uninsured patients for COVID-19 have received little reimbursement from the federal government despite a program that aims to ensure uninsured Americans’ don’t face large COVID-19-related bills, according to the Kaiser Family Foundation.
In April, the Trump administration said it would take money from the Coronavirus Aid, Relief, and Economic Security Act to reimburse providers who treat uninsured COVID-19 patients. To date, HHS has paid about $881 million to about 8,000 providers under the program.
Previous estimates from the foundation suggest payments to hospitals for treating uninsured COVID-19 patients could range from $13.9 billion to $41.8 billion.
One reason reimbursement under the HHS program may be limited is a guidance that ties reimbursement to a primary diagnosis of COVID-19. For example, coding protocols require providers to code a patient with sepsis caused by COVID-19 with a primary diagnosis of sepsis, not COVID-19. Providers also aren’t required to participate in the reimbursement program for uninsured COVID-19 patients.
Reimbursement from the program is also contingent on available funds. About $31.1 billion in federal funding is still available for providers, according to the study. HHS has not said how much of those funds will be used to cover treatment for uninsured COVID-19 patients.
It’s “unclear how many uninsured COVID-19 patients are being billed for their care because their providers are unaware of this program or have chosen to not participate. While large hospitals are likely participating in the program, smaller providers may not be aware of this source of funding or they may face administrative barriers to submitting claims and getting reimbursed,” the report stated.
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