behavioral health providers who were not previously eligible. Most of the funding in this distribution was based on a share of providers’ losses during the first half of 2020 compared to providers’ revenue and expenses during the first half of 2019.6 In December 2020, the Consolidated Appropriations Act required HHS to distribute 85 percent of unspent provider relief funding appropriated under the CARES Act through a new general distribution that accounts for providers’ losses during the second half of 2020 and the first quarter of 2021. However, as of this writing, HHS has not announced the details of this funding distribution. Share of Eligible Providers Receiving Provider Relief Funding As of the week of January 11, 2021, approximately $120 billion in provider relief funds had been distributed to a total of 403,235 provider tax identification numbers (TINs) (HHS 2021a). A single provider organization may have multiple TINs for different components of its business (e.g., an inpatient hospital and its ambulatory surgery center may have separate TINs), so it is possible that fewer than 403,235 entities 3 received funds and estimates of potentially eligible TINs likely overstate the number of provider organizations that could apply. To understand the characteristics of providers that have received provider relief funding to date, we compared the TINs of provider organizations that received funds through the general distribution to TINs listed in the National Plan and Provider Enumeration System (NPPES). In this analysis, we excluded individual professionals registered in NPPES with a social security number (SSN) because most of these applied for funding using the TIN of their employer (e.g. employed physicians who applied for funding through their medical group). 7 We compared the list of organizations receiving funding to the HHS list of potentially eligible TINs, which was curated based on provider enrollment files from Medicare, state Medicaid and CHIP agencies, the Transformed Medicaid Statistical Information System (T-MSIS), and other sources. 8 This list of potentially eligible providers was intended to be broadly inclusive and thus includes some providers that did not directly bill Medicaid for services in 2018 or 2019 or meet other eligibility criteria. Overall, while 53.7 percent of potentially eligible provider organization TINs received relief payments through the general distribution, only 18.4 percent of potentially eligible Medicaid and CHIP-enrolled providers not enrolled in Medicare received funding (Table 1). A total of about $50.2 billion in relief payments were made through the general distribution based on providers’ patient care revenue, but only $2.6 billion of these payments went to Medicaid and CHIP-enrolled providers not enrolled in Medicare. Overall, less than 15 percent of the $18 billion initially allocated for the Phase 2 distribution was spent on Medicaid and CHIP providers (HHS 2021b). TABLE 1. Share of Potentially Eligible Provider Organization TINs Receiving Provider Relief Fund General Distribution Payments, 2020 Provider enrollment Total eligible provider organization TINs1 Number of TINs receiving funding Share of potentially eligible TINs receiving funding Total payments from the provider relief fund general distribution (billions)2 Total 600,019 322,182 53.7% $50.2 Medicare-enrolled providers 258,554 258,103 99.8% $47.0 Medicaid or CHIPenrolled providers not enrolled in Medicare 239,579 44,170 18.4% $2.6 Other eligible providers 101,886 19,909 19.5% $0.6 Notes: TIN is tax identification number. Analysis limited to TINs that could be matched to organizational national provider identifiers (NPIs) in the National Plan and Provider Enumeration System (NPPES). Analysis is based on applications submitted as of November 26, 2020. 1 Number of provider organizations potentially eligible for provider relief funding is based on a curated list of providers developed by the Health Resources and Services Administration (HRSA) using provider enrollment files from Medicare, state Medicaid and CHIP agencies, the Transformed Medicaid Statistical Enrollment System (T-MSIS), and other sources. Providers with potentially eligible TINs must meet other eligibility criteria to receive funding. 4 2 Total payments include payments from the Phases 1, 2, and 3 general distribution based on patient care revenue. Analysis excludes Phase 3 general distribution payments based on provider losses and targeted distribution payments, and it does not account for general distribution payments that have been returned by providers. Source: Acumen, 2021, analysis for MACPAC of NPPES and the HRSA curated list of providers potentially eligible for the provider relief fund general distribution. The subset of provider types that often serve Medicaid, but not Medicare beneficiaries also appear to have been less likely to receive provider relief funding (Figure 1). For example, Medicaid is the primary source of insurance coverage for more than one-third of children and Medicaid is the single largest payer for longterm care and behavioral health (MACPAC 2020). However, less than half of potentially eligible TINs for pediatric providers, HCBS-, and mental health providers received funding. In contrast, Medicare is the single largest payer for hospital care and virtually all hospitals are enrolled in Medicare and received