HRSA Halts COVID-19 Claims Reimbursement for Uninsured Due to Lack of Funds

This week, the U.S. Health Resources and Services Administration (HRSA) announced it has stopped accepting claims for COVID-19 testing and treatment for uninsured individuals due to a lack of sufficient funds. No claims submitted to HRSA for testing or treatment after March 22, 2022, will be processed for adjudication or treatment, according to the agency. HRSA also indicates the Uninsured Program will stop accepting claims for vaccination on April 5, 2022, due to lack of sufficient funds.

Previously, the U.S. Department of Health and Human Services (HHS) had reimbursed providers delivering these services to uninsured and underinsured individuals. The Biden-Harris Administration indicated the wind-down of the program is an early consequence of Congress failing to provide an additional $15 billion in COVID-19 emergency funding requested by the Administration.

In light of the federal action, the California Department of Health Care Services (DHCS) announced it will accept claims for individuals enrolled in the COVID-19 Uninsured Group Program. Individuals must apply for the program through a Medi-Cal qualified provider (QP). QPs include providers of the following programs: Presumptive Eligibility for Pregnant Women, Breast and Cervical Cancer Treatment Program, Hospital Presumptive Eligibility, and Child Health and Disability Prevention. Providers must submit applications via the COVID-19 Uninsured Group Application Portal to be able to submit COVID-19 testing, testing-related, and treatment claims to DHCS for claims processing.

The COVID-19 Uninsured Group Program is authorized under the Families First Coronavirus Response Act which was enacted by Congress in March 2020. The program will end the last day of the calendar month in which the federal COVID-19 public health emergency ends.