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Pediatric Primary Care - Coronavirus Relief and Response

Medicaid Pediatric Primary Care Rate Supplement

Program Overview

In July of 2020, EOHHS and OHIC implemented the Pediatric Primary Care Relief Program, which issued one-time grant payments to pediatric primary care providers to support system resiliency to improve immunization rates following COVID-19 related disruptions in care and practice cashflow. While pediatric primary care offices have re-opened following initial closures, social distancing and COVID-19 prevention measures have constrained practice capacity and created barriers for members to access care (e.g., transportation, perceptions of safety). These barriers are anticipated to persist as the state continues to respond and adapt to the COVID-19 pandemic. As such, EOHHS is implementing the Medicaid Pediatric Primary Care Rate Supplement through the end of calendar year 2020, to provide monthly financial incentives to pediatric primary care practices to ensure all children are up to date with the full array of essential, preventive healthcare services by overcoming COVID-19 related barriers to access.

Pediatric primary care has been deferred for many families because of the COVID-19 Public Health Emergency. During April of 2020, pediatric claims filed were down 44% compared to April of 2019. While utilization has increased slightly, claims filed were still 10% lower during June 2020 compared to June 2019. It is critical that the state supports Pediatric Primary Care Providers to encourage patient participation for care that was deferred during the Spring virus surge and continue to build capacity throughout the phases of reopening to ensure all Medicaid covered children have access to these critical preventive services. As such, Medicaid Pediatric Primary Care Rate Supplement payments will be contingent upon providers demonstrating measurable improvement in access to care. 

The Medicaid Pediatric Primary Care Rate Supplement will provide monthly payments to pediatric practices, family medicine practices, or any other such primary care practice that provides primary care to Rhode Island Medicaid covered children by an MD, DO, PA, or NP with a subspecialty in pediatrics or family medicine. Non-FQHC practices located in Rhode Island are eligible to apply. Payments will be calculated based on the number of Rhode Island Medicaid covered children served by the practice, and contingent on demonstrating performance improvement on a standardized measure of primary care access. Detailed information on quality benchmarks and reporting schedule is included within the program guidance document. 

Program Timeline

  • Online applications will go live Tuesday 8/27/20 at 10am EST.
  • Applications are due Thursday 9/10/20 by 5pm EST. Applications received after 9/10/20 may be considered and processed subject to available funds.
  • EOHHS will make every effort to disburse payments to qualifying providers by 9/30/20 (and the end of the month following each subsequent report). Payments will coincide with Medicaid fee-for-service payment cycles.
  • EOHHS will make reporting templates available to applicants for each subsequent monthly report, which will be due on the first of each month through the remainder of 2020 (October, November, December).

Program Application

  • Application is closed

Program Documents

Please email OHHS.PediRelief@ohhs.ri.gov if you have additional questions that are not addressed in the program’s guidance or application instructions.

Medicaid Pediatric Primary Care Relief Program

Program Overview

In June 2020, Governor Raimondo announced that the state would be providing financial relief payments to pediatric primary care providers. These one-time grant payments are meant to support system resiliency and response to public health concerns brought on by COVID-19 related disruptions in primary care as well as to offset costs of business interruption and expenses incurred due to the COVID-19 public health emergency.

Pediatric primary care has been deferred for many families because of the COVID-19 Public Health Emergency, resulting in a 33% reduction in vaccines administered between March and May of 2020 compared to the same period in 2019. Delayed vaccinations have been an unfortunate and nationally documented second-order effect of the public health emergency. As such, distribution of these funds will be tied to expectations that pediatric providers will take targeted actions to ensure patients are caught up on immunizations.

The Pediatric Primary Care Relief Program will provide payments to Rhode Island practices that provide primary care services to children. Payment size will be based on the practice’s panel in a manner proportional to the number of children under 18 years of age that receive primary care services from the practice. Non-FQHC practices located in Rhode Island are eligible to apply. Out-of-state practices will not be eligible to apply.

Program Timeline

  • Applications will go live Thursday 7/2/20 at 10am EST. Please complete the application in its entirety here: (APPLICATION CLOSED)
  • Applications are due Wednesday, 7/15/20 by 5pm EST. Applications received after 7/16/20 may be considered and processed subject to available funds.
  • EOHHS will make every effort to disburse payments to qualifying providers by 7/31/20. Payments will coincide with Medicaid fee-for-service payment cycles.

Program Documents

Please email OHHS.PediRelief@ohhs.ri.gov if you have additional questions that are not addressed in the program’s guidance or application instructions.

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