COVID-19 Funding

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The U.S. Department of Health and Human Services (HHS) has provided much-needed funding to many long term care facilities through the CARES Act Provider Relief Fund (PRF) and Quality Incentive Program (QIP). These funds support American families, workers, and the heroic health care providers in the battle against the COVID-19 outbreak.

AHCA/NCAL is helping our skilled nursing and assisted living​ member providers address PRF and QIP issues through work with Capitol Hill and the Administration. In partnership with our state affiliates, AHCA/NCAL is collecting outstanding funding concerns our members are facing. Contact COVID19@ahca.org with any questions.
 

 Provider Relief Fund

The Provider Relief Fund​ (PRF) supports health care providers in the battle against the COVID-19 pandemic. This funding is provided through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act.​

 PRF Resources

Update: Provider Relief Fund FAQs
HHS recently updated the ​Provider Relief Fund (PRF) FAQs to clarify Ownership Structures and Financial Relationships between “parent” and “subsidiary” entities that received PRF funding (General and Targeted).

Provider Relief Fund Questions
There are several resources to assist with PRF questions. Contact the CARES Act Fund Hotline at (866) 569-3522 (for TTY dial 711). You can also review the HHS Frequently Asked Questions, which includes information about using the PRF for vaccine administration​.​

WebEx: Provider Relief Fund Reporting Requirements
This WebEx recording includes registration details, registration FAQs, recommended terms and conditions compliance controls, and a PRF reporting update overview.

U.S. Government Accountability Office (GAO) Report
The January 28th GAO report – Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal Attention (GAO-21-265) – made several recommendations (focused around areas like COVID-19 testing, vaccines and therapeutics, and the medical supply chain) to federal agencies to improve the ongoing response and recovery efforts in the areas of public health and the economy. It is important to note that there is a summary of the PRF allocations and disbursements as of 12/31/20 on page 54.

This document offers detail on u​se of funds for health care related expenses and transfer of funds to higher need buildings. 

 Quality Incentive Payments

AHCA/NCAL is advocating on behalf of our members to provide the necessary resources regarding the Quality Incentive Payments (QIP), as well as promoting a fairer incentive program. This step-by-step chart is available to help providers correct any previously made errors when filling out NHSN data. 

Entering this data is valuable in determining how cases are spreading throughout facilities.

With the distribution of December QIP payments on Friday, February 12, it appears that this will be the last payment that HHS will make for this program. Although HHS previously stated there would be an aggregate payment, the running total through December is $2 billion – which is the total allocated for the program.

The county population and county case rate are factored in the methodology, as well as the resident occupancy level and resident case rate. The vast majority of facilities with at least 1 infection will not receive payment. The number of facilities paid per month decreased from around 10,000 in September to 6,000 in December due to the increasing number of cases in the later months of the program. Additionally, since all of the factors varied in each month, the payment you may have received can also vary widely.

 

 

Important QIP HHS FAQshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Important-QIP-HHS-FAQs.aspxImportant QIP HHS FAQs4/12/2021 4:00:00 AM<div><span style="font-size:14.6667px;">​​​AHCA is flagging two ​U.S. Department of Health and Human Services (HHS) <a href="https://www.hhs.gov/sites/default/files/provider-relief-fund-general-distribution-faqs.pdf">FAQs</a> relating to the Quality Incentive Program (QIP). Be sure to also check out the AHCA/NCAL <a href="/Reimbursement/Pages/COVID-19-Funding.aspx">provider relief fund and QIP website</a> that has helpful information and resources.</span></div><div><span style="font-size:14.6667px;"> </span></div><div><ul><li><span style="font-size:14.6667px;"><strong>​Will HHS allow providers to make corrections to the data used to determine Targeted Distribution eligibility and payment amounts?</strong> (Added 10/28/2020) Going forward, HHS will allow providers that submitted data as part of the COVID-19 High Impact Area Distribution and/or the Nursing Home Infection Control/Quality Incentive Payment Distribution, a limited opportunity to submit corrected data for up to 5 business days after the submission deadline. HHS will only accept corrections within the 5-day time period that are accompanied by a justification for why the provider erred in the initial data submission. HHS will review each request for correction on a case-by-case basis and may determine that a previous payment be amended to align with the updated data. Providers who submit updated data may have their payments delayed for up to 90 days from the date of submission pending review and adjudication. All HHS decisions are final and there is no appeals process.<br><br></span></li><li><strong>​How is the infection gateway calculated for determining eligibility for Quality Incentive Program payments under the Nursing Home Infection Control Distribution? </strong>(Added 12/28/2020) The infection gateway criterion specifically excludes facilities that are found to have an infection rate exceeding the estimated infection rate in their county during the performance period. County infection rates are measured using daily COVID-19 community profile reports (CPRs) disseminated under the HHS Protect data program. CPRs contain information on the rate of COVID-19 infections for all residents in each county. <span style="text-decoration:underline;">County infection rates are not the same as county positivity rates.</span>​</li></ul></div>AHCA is flagging two HHS FAQs relating to the Quality Incentive Program.
PRF Use – A Refresher and Preparing for Reportinghttps://www.ahcancal.org/News-and-Communications/Blog/Pages/PRF-Use-–-A-Refresher-and-Preparing-for-Reporting.aspxPRF Use – A Refresher and Preparing for Reporting4/8/2021 4:00:00 AM<p></p><div>All recipients of Provider Relief Fund (PRF) payments must comply with the reporting requirements described in the <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html#terms-and-conditions" target="_blank">Terms and Conditions</a> and specified in directions issued by the U.S. Department of Health and Human Services (HHS) Secretary. Recipients of PRF payments exceeding $10,000 in aggregate must register in the <a href="https://prfreporting.hrsa.gov/s/" target="_blank">Provider Relief Fund Reporting Portal</a>. At present, there is no deadline for completing registration in the portal. Recipients will later receive a notification about when they should complete the second step of submitting reporting requirements information on the use of funds. The Health Resources and Services Administration (HRSA) will send a broadcast email to the email address you provide during the registration process. The registration process will take at least 20 minutes to complete and must be completed in one session. You cannot save a partially complete registration.  Make sure you have all of the information required to register before you begin.  </div><div><br></div><div>It is important to note that, as of now, PRF must be expended no later than June 30, 2021. HHS will provide directions in the future about how to return unused funds. HHS reserves the right to audit PRF recipients now or in the future, and is authorized to collect any PRF amounts that were overpaid or not used in a manner consistent with program requirements or applicable law. All payment recipients must attest to the Terms and Conditions, which require the submission of documentation to substantiate that these funds were used for health care-related expenses or lost revenue attributable to coronavirus. </div><div><br></div><div>More details on the reporting requirements can be found on the <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/reporting-auditing/index.html" target="_blank">HHS webpage</a>. AHCA/NCAL also has a <a href="https://educate.ahcancal.org/products/prf-reporting-requirements-updated-january-25th" target="_blank">pre-recorded webex</a> available on the January 15, 2021 PRF reporting registration instructions as well as the updated reporting guidance for members. The recording includes detail on registration, important registration FAQs, recommended terms and conditions, compliance controls, and a PRF reporting update overview. Finally, AHCA/NCAL has a dedicated <a href="/Reimbursement/Pages/COVID-19-Funding.aspx" target="_blank">PRF webpage</a> with resources and information you might find of assistance – including an AHCA/NCAL document that offers detail on use of funds for health care related expenses and transfer of funds to higher need buildings. Please send any PRF related questions to <a href="mailto:COVID19@ahca.org" target="_blank">COVID19@ahca.org</a>.<br></div>All recipients of PRF payments must comply with the reporting requirements described in the Terms and Conditions and specified in directions issued by the HHS Secretary.
HHS Provides Data Visualizations and Tables of COVID-19 Fundinghttps://www.ahcancal.org/News-and-Communications/Blog/Pages/HHS-Provides-Data-Visualizations-and-Tables-of-COVID-19-Funding.aspxHHS Provides Data Visualizations and Tables of COVID-19 Funding3/26/2021 4:00:00 AM<p>​​​​​​​On HHS' COVID-19 <a href="https://taggs.hhs.gov/Coronavirus/Providers" target="_blank">funding page​</a>, there are now​​ data visualizations and tables that represent the list of providers that received a payment from the General Distribution, High Impact Targeted Allocation, Rural Targeted Allocation and/or the Skilled Nursing Facility Targeted Allocation of the Provider Relief Fund (PRF). The PRF webpage also includes who has attested to receiving one or more payments and agreed to the terms and conditions.​</p>There are now​​ data visualizations and tables that represent the list of providers that received a payment from various allocations of the PRF.
MACPAC Publishes Provider Relief Funding Reporthttps://www.ahcancal.org/News-and-Communications/Blog/Pages/MACPAC-Publishes-Provider-Relief-Funding-Report.aspxMACPAC Publishes Provider Relief Funding Report3/10/2021 5:00:00 AM<p></p><div>Last month, MACPAC published an <a href="https://www.macpac.gov/wp-content/uploads/2021/02/COVID-Relief-Funding-for-Medicaid-Providers.pdf" target="_blank">issue brief</a> on the distribution of provider relief funds (PRF) to Medicaid and State Children’s Health Insurance Program (CHIP) providers based on a review of applications submitted as of November 26, 2020. This date was after the deadline for the most recent general distribution of relief funds. In addition, MACPAC interviewed Medicaid officials in five states and representatives from national provider organizations to learn more about the barriers experienced by Medicaid providers applying for PRF. The 12-page <a href="https://www.macpac.gov/wp-content/uploads/2021/02/COVID-Relief-Funding-for-Medicaid-Providers.pdf" target="_blank">issue brief</a> also includes these MACPAC findings.       <br></div><div><span style="font-size:11pt;"><br>Congress created MACPAC to advise both Congress and the Executive Branch on issues impacting both Medicaid and CHIP. Recommendations issued by the Commission are non-binding.</span></div>Last month, MACPAC published an issue brief on the distribution of PRF to Medicaid and State CHIP providers based on a review of applications submitted as of November 26, 2020.