This announcement solicits applications for the Ryan White HIV/AIDS Program (RWHAP) Part F Dental Reimbursement Program (DRP) to improve access to HIV oral health services for low-income, underinsured, and underserved people living with HIV (PLWH) and to support related education and training for the
delivery of dental care to PLWH. The DRP defrays a portion of unreimbursed dental care costs for low-income, underinsured, and underserved PLWH incurred by accredited dental or dental hygiene education programs recognized by the Commission on Dental Accreditation.
This funding opportunity is open to accredited dental education institutions eligible to receive RWHAP Part F funding under section 2692(b)(1)(B) of the Public Health Service (PHS) Act. This program will reimburse certain costs incurred by eligible entities that have provided uncompensated or partially uncompensated oral health care to PLWH from July 1, 2014 through June 30, 201 5. General Recipient Expectations Patient Payment for Services: Applicants must have consistent and equitable policies and procedures related to verification of patients’ financial status, implementation of a sliding fee scale, and ensuring a cap on patient charges for HIV-related services. Program Income:
Programs are required to maximize the service reimbursement available from private insurance, Medicaid, Medicare, and other third-party sources for reimbursable services provided. Programs are required to track and report all sources of service reimbursement as program income on the annual Dental Services Report. All program income earned must be used to improve access to oral health care services for low-income, underinsured, and underserved PLWH and to train dental and hygiene students and dental residents to deliver dental care to PLWH. All program income generated as a result of awarded funds must be used in an “additive” manner for the purposes for which the award is made, and may only be used for allowable costs under the award. Please see PCN #15-03 Clarifications Regarding the Ryan White HIV/AIDS Program and Program Income (http://hab.hrsa.gov/manageyourgrant/policiesletters.html) for additional information.
The RWHAP is the payer of last resort, except for programs administered by or providing the services of the Indian Health Service. Please note that direct or indirect grant funds such as RWHAP Parts A, B, C, and D programs are not program income.
Services provided under Part F DRP cannot also be billed to RWHAP Parts A, B, C, or D.
Other Financial Management Issues: Programs must have appropriate financial systems in place that provide for internal controls, safeguarding assets, ensuring stewardship of federal funds, and maintaining adequate cash flow to meet daily operations. Programs are required to monitor subrecipients under the grant to ensure they adhere to the requirements of the program including the use of funds.
Funds received from DRP must be allocated to the accredited dental education program that provided oral health services to low-income, underinsured, and underserved PLWH. It is the expectation that these reimbursement funds will provide expanded access to oral health care for PLWH. Applicants must ensure that Medicaid billable services are billed to Medicaid. RWHAP funds should be used when payment cannot be expected to be made, i.e., after billing Medicaid, Children’s Health Insurance Program (CHIP), other public/private health insurance resources, and after billing clients for allowable costs using a sliding fee scale. Because the RWHAP is the payer of last resort and funds for the DRP are limited, applicants must report unreimbursed costs for oral health services not paid for by Medicaid, CHIP, or other public/private health insurance. DRP programs must provide a system to discount patient payment for charges by developing and utilizing a sliding discounted fee schedule that is published and made readily available. While the fee schedule may be based on the patient’s income or household size and income, the organization must track the patient’s income and charges imposed. Each program is responsible for creating its own sliding fee scale in accordance with the most recent Federal Poverty Level guidelines. Federal Poverty Guidelines are updated each year in early spring, and are available on the web at https://aspe.hhs.gov/poverty-research.