HRSA Begins Phase 4 Payments & Payment Reconsideration Updates

COVID-19; Reimbursement; Provider Relief Fund

The Health Resources and Services Administration (HRSA) today announced the distribution of approximately $9 billion in Provider Relief Fund (PRF) Phase 4 payments to health care providers who have experienced revenue losses and expenses related to the COVID-19 pandemic. HRSA reports a total of $17 billion for release in Phase 4.  

Of the $9 billion released today, HRSA states the average payment for small providers is $58,000, $289,000 for medium providers, and $1.7 million for large providers. More than 69,000 providers in all 50 states, Washington, D.C., and eight territories will receive Phase 4 payments. Payments will start to be made later this week, and the Phase 4 payment methodology is available here.   

The PRF Phase 4 payments are in addition to the $7.5 billion in American Rescue Plan (ARP) Rural payments to providers and suppliers who serve rural Medicaid, Children's Health Insurance Program, and Medicare beneficiaries.  

HRSA will make Phase 4 awards on a rolling basis. More details on HRSA’s recent update on Phase 4 roll out, status of outstanding ARP Rural Payments, and how to complete Period 1 Reporting if you were unable to report were shared in a recent AHCA/NCAL update.  

Additional HRSA resources are available, including the HHS press release and a state-by-state breakdown of Phase 4 payments. AHCA/NCAL will continue to provide updates as more information becomes available. 

Payment Reconsideration Updates 
HRSA has also updated its payment reconsideration webpage, a process intended for providers who believe their payment was not correctly calculated. The update provides preliminary information on how to request a Phase 4 or ARP Rural Reconsideration. 
  • ​Providers will not have an opportunity to submit an application if they missed a deadline. 
  • Providers will not be able to revise or correct their original application - e.g., elect to be considered for ARP Rural payment after their Phase 4/ARP Rural application was submitted. 
  • HRSA will not consider reconsideration requests that would require a change to payment methodology or policy. 
HRSA notes providers may appeal their awards, but the payment methodology will not change.  
Updates by payments include:  
  • ARP Rural and Phase 4 Payment Reconsideration: The reconsideration window for ARP Rural and Phase 4 payments will open February 1, 2022. Providers will be able to request reconsideration of their ARP Rural and/or Phase 4 payments. Details regarding the application process will be provided on this website by February 1, 2022. At a minimum, providers will need to provide in their reconsideration application information confirming their eligibility for ARP Rural and/or Phase 4 payment reconsideration, as well as information necessary to enable HRSA to link the reconsideration request with the original ARP Rural and Phase 4 application. This information is expected to include: a copy of the email or letter the provider received from HRSA communicating the ARP Rural and/or Phase 4 payment determination the provider would like HRSA to reconsider, as well as the taxpayer identification number, DocuSign envelope ID for the ARP Rural/Phase 4 application, and contact information from the original application.  The PRF Phase 4 and ARP Rural Reconsiderations FAQ is available here.  
  • Phase 3 Payment Reconsideration: The Phase 3 Payment Reconsideration period closed on November 12, 2021. HRSA is processing the requests that were received, including reviewing providers’ original submitted applications again based on the established PRF Phase 3 Payment Methodology. Given the volume of requests received and the complexity of the reviews, HRSA anticipates that review of requests will occur over an extended period of time. 
If you have questions about a Phase 3 Reconsideration Request, contact the Provider Support Line at 866-569-3522 (for TTY, dial 711) for assistance. Providers should have the following information available when calling: 
  • The recipient's or applicant's Tax Identification Number (TIN). 
  • The name of the recipient or applicant as it appears on the most recent tax filing. 
  • The mailing address for the recipient or applicant as it appears on the most recent tax filing.