Today, the U.S. Department of Health and Human Services (HHS) announced it will be releasing Phase 4 of the Provider Relief Fund (PRF). Phase 4 consists of $17 billion for providers who can document revenue loss and expenses associated with the pandemic. HHS has also created an option for reconsideration of Phase 3 awards and extended the due date for the first PRF Reports, formerly due on September 30, 2021, by 60 days. It is also possible rural SNFs and assisted living communities may be eligible for the $8.5 for rural providers.
Consistent with the requirements included in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020, PRF Phase 4 payments will:
- Be based on providers’ lost revenues and coronavirus-related expenditures between July 1, 2020, and March 31, 2021.
- Reimburse smaller providers—who tend to operate on thin margins and often serve vulnerable or isolated communities—for their lost revenues and COVID-19 expenses at a higher rate compared to larger providers.
- Also include bonus payments for providers who serve Medicaid, CHIP and Medicare patients, who tend to be lower income and have greater and more complex medical needs.
- HRSA will price these bonus payments at the generally higher Medicare rates for Medicaid and CHIP patients to ensure equity for those serving low-income children, pregnant women, people with disabilities, and seniors.
Similarly, HRSA will make American Rescue Plan (ARP) rural payments to providers based on the amount of Medicaid, CHIP and Medicare services they provide to patients who live in rural areas as defined by the
HHS Federal Office of Rural Health Policy. Accordingly, ARP rural payments will also generally be based on Medicare reimbursement rates.
Applications
The application portal will open on September 29, 2021. Virtually, all health care providers should be eligible to apply for funding in this distribution. Even providers who received funding previously may be newly eligible for consideration. In order to expedite and streamline the application process, providers will apply for both programs in a single application. HRSA will use existing Medicaid, CHIP, and Medicare claims data in calculating payments. To help ensure that these provider relief funds are used for patient care, PRF recipients will be required to notify the HHS Secretary of any merger with or acquisition of another health care provider during the period in which they can use the payments. Providers who report a merger or acquisition may more likely be audited to confirm their funds were used for coronavirus-related costs, consistent with an overall risk-based audit strategy.
To promote transparency in the PRF program, HHS is also releasing
detailed information about the methodology utilized to calculate PRF Phase 3 payments. Providers who believe their PRF Phase 3 payment was not calculated correctly according to this methodology will now have an opportunity to request a reconsideration. Further details on PRF Phase 3 reconsideration process are forthcoming.
September 30 Report Due Date Delayed
In light of the challenges providers across the country are facing due to recent natural disasters and the Delta variant, HHS announced today a 60-day grace period to help providers come into compliance with their PRF
reporting obligations if they fail to meet the September 30, 2021 deadline for the first PRF Reporting Time Period. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate recoupment or similar enforcement actions for noncompliant providers during this grace period.
Additional Phase 4 Information
AHCA will have more detail on the Phase 4 award methodology available next week, including possible rural SNF and ALC eligibility for the $8.5 billion aimed at rural providers. For now, additional resources and information can be found at the PRF Phase 4 announcement
webpage, at the PRF Reporting
webpage, or by calling the Provider Support Line at (866) 569-3522, for TTY dial 711. Hours of operation are 8 AM to 10 PM CT, Monday through Friday.