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.

UPDATE: HHS released​ updated reporting requirements for recipients of PRF payments. With this announcement, HHS expands the amount of time providers will have to report information, aims to reduce burdens on smaller providers, and extends key deadlines for expending PRF payments for recipients who received payments after June 30, 2020. Read More​​
 

 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.

 

 

HRSA Releases ARP Rural Distributionhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/HRSA-Releases-ARP-Rural-Distribution.aspxHRSA Releases ARP Rural Distribution11/23/2021 5:00:00 AM<div>​The Health Resources and Services Administration (HRSA) began releasing the $7.5 billion American Rescue Plan (ARP) Rural Distribution this week. ARP Rural payments are being made to providers and suppliers who have served rural Medicaid, Children's Health Insurance Program (CHIP), and Medicare beneficiaries from January 1, 2019 through September 30, 2020. <br></div><div><br></div><div>Every eligible provider that served at least one rural Medicare, Medicaid, or CHIP beneficiary will receive funding. Eligibility for the Rural Distribution is based on the number of beneficiaries whose residency is designated as rural rather than the physical location of the provider. </div><div><br></div><div>Approximately 40,000 providers in 50 states, Washington, D.C., and six territories will receive ARP Rural payments. HRSA will begin distributing the Phase 4 $17 billion in mid-December.  </div><div><br></div><div><strong>ARP Rural Distribution Update </strong></div><div><strong><br></strong></div><div>HRSA is releasing the Rural Awards on a rolling basis. State-by-state total awards for all health care providers are available <a href="https://www.hrsa.gov/provider-relief/data/targeted-distribution/arp-rural" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">here</a>. The data is currently organized by total provider awards. Provider type (e.g., SNF and AL) specific amounts are not yet available. Provider specific awards may be <a href="https://data.cdc.gov/Global-Health/American-Rescue-Plan-ARP-Rural-Payments/8v6a-z6zq" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">located</a> by provider name and zip code. <br></div><div><br></div><div>As with other awards, within 90 days of receiving a payment, recipients must sign an attestation confirming receipt of the funds and agreeing to the Terms and Conditions of payment by re-entering the <a href="https://cares.linkhealth.com/#/" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">Provider Relief Fund (PRF) Application and Attestation Portal</a>. If a recipient chooses to reject the funds, they must also complete the attestation to indicate this and return the funds within 15 calendar days.</div><div><br></div><div>If providers believe their Rural Award was made in error, HRSA’s calculation methodology is <a href="https://www.hrsa.gov/provider-relief/future-payments/phase-4-arp-rural/payment-methodology" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">available for review</a>. Questions about ARP Rural Awards should be directed to the Provider Support Line at 866-569-3522 (for TTY dial 711).<br></div><div><br></div><div><strong>Phase 4 Distribution Update</strong></div><div><strong><br></strong></div><div>HRSA continues to indicate it will begin releasing the $17 billion in Phase 4 awards on a rolling basis in mid-December. Many ARP Rural payment recipients will also be eligible for additional funding through the <a href="https://www.hhs.gov/about/news/2021/09/10/hhs-announces-the-availability-of-25-point-5-billion-in-covid-19-provider-funding.html" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">$17 billion PRF Phase 4</a> opportunity that was also made available during the same time period. Providers could apply for both opportunities through a single application.<br></div><div>​<br></div><div>HRSA expects to begin releasing PRF Phase 4 payments in December 2021. Similar to the ARP Rural payments, HRSA plans to send individual communications to providers when final payment determinations are made. Providers with questions about the Phase 4 and ARP Rural application process should contact the Provider Support Line at 866-569-3522 (for TTY dial 711).<br></div><div><br><br></div><p>​</p>The Health Resources and Services Administration (HRSA) began releasing the $7.5 billion American Rescue Plan (ARP) Rural Distribution today.
Important Updates: PRF Phase 4 and Rural Award Timelinehttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Important-Updates-PRF-Phase-4-and-Rural-Award-Timeline-.aspxImportant Updates: PRF Phase 4 and Rural Award Timeline11/18/2021 5:00:00 AM<p>​​​<br></p><div>The Health Resources and Services Administration (HRSA) has <a href="https://cares.linkhealth.com/#/" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">posted an updated award timeline</a> in the now-closed Provider Relief Fund application web portal. <br></div><div><br></div><div>The agency had previously indicated that Rural awards would be made in mid-November and Phase 4 awards in mid-December. The newly posted information in the application portal notes, <em>“HRSA will begin making payments in December 2021 and continue through January 2022. HRSA will send individual communications to providers when final payment decisions are made and is not able to respond to requests for updates on application status at this time.” </em><br></div><div><br></div><div>Rural payments are still on track for November, while this update impacts Phase 4.<br></div><div><br></div><div>Earlier this week, providers, including those who have submitted Reporting Period 1 reports, received email notifications indicating they would not receive Phase 4 awards if their reports were not submitted by November 30, 2021. November 30 is the end of the 60-day reporting grace period. <br></div><div><br></div><div>Providers who had submitted reports also received these notifications. The Agency indicated that notifications sent to providers who had reported were sent in error. Providers who have submitted reports and would like to document HRSA’s verbal response to AHCA may contact the Provider Support Line at (866) 569-3522 and request a call ticket number and operator identification number to document the call.  </div><div><br></div><div>Providers who have not yet reported will continue to receive reminders from HRSA noting such providers will be out of compliance with PRF <a href="https://www.hrsa.gov/provider-relief/past-payments/terms-conditions" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">Terms and Conditions​</a> if Reporting Period 1 reports are not submitted by November 30.  <br></div><div><br></div><div>Please <a href="mailto:ProviderReliefContact@hrsa.gov" data-feathr-click-track="true" style="text-decoration:underline;">contact HRSA directly</a> with any technical questions regarding your application, including portal challenges and questions. </div><div><br><br></div><p>​</p>The Health Resources and Services Administration (HRSA) has posted an updated award timeline in the now-closed Provider Relief Fund application web portal.
GAO Releases New Report on Provider Relief Fundshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/GAO-Releases-New-Report-on-Provider-Relief-Funds.aspxGAO Releases New Report on Provider Relief Funds11/3/2021 4:00:00 AM<div>In a <a href="https://www.gao.gov/products/gao-22-105051?utm_campaign=usgao_email&utm_content=daybook&utm_medium=email&utm_source=govdelivery" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">report recently released</a>, the Government Accountability Office (GAO) called for the U.S. Department of Health and Human Services (HHS) to establish more concrete plans for post-payment reviews and recovery of overpayments in the Provider Relief Fund (PRF). GAO also provided important updates regarding remaining balances in the fund.</div><div><br></div><div>As many tracking the fund are aware, HHS announced <a href="https://www.hrsa.gov/provider-relief/future-payments" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">it intends to allocate $17 billion of that remaining funds</a> through a new application-based round of funding known as “Phase 4.” In the report, GAO indicates that HHS noted “the remaining unallocated funds are reserved for future contingencies and emerging needs.” The GAO report <a href="https://files.gao.gov/reports/GAO-22-105051/index.html#d518e3a2334_1634634931184" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">also includes a chart</a> that spells out the total amount allocated and disbursed with each round of funding, going back to April 2020. (Search for “Provider Relief Fund: Summary of Allocations and Disbursements, as of August 31, 2021).” </div><div><br></div><div>PRF Resources: <br></div><div><ul><li><a href="https://www.gao.gov/products/gao-22-105051?utm_campaign=usgao_email&utm_content=daybook&utm_medium=email&utm_source=govdelivery" data-feathr-click-track="true" target="_blank" style="text-decoration:underline;">GAO Report</a><br></li><li><a href="https://www.hrsa.gov/provider-relief/" data-feathr-click-track="true" style="text-decoration:underline;">HHS Provider Relief Fund website​</a>​​</li><li><a href="/Reimbursement/Pages/COVID-19-Funding.aspx" data-feathr-click-track="true" target="_blank" style="font-size:11pt;text-decoration:underline;">AHCA/NCAL PRF Resource Page</a><span style="font-size:11pt;"> </span></li></ul></div><p><br><br></p>In a report recently released, the Government Accountability Office (GAO) called for the U.S. Department of Health and Human Services
AHCA/NCAL Summary of HRSA Phase 4 and Rural Documentation Webinarhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/AHCANCAL-Summary-of-HRSA-Phase-4-and-Rural-Documentation-Webinar-.aspxAHCA/NCAL Summary of HRSA Phase 4 and Rural Documentation Webinar10/18/2021 4:00:00 AM<p></p><div>Last week, Health Resources & Services Administration (HRSA) held its third Phase 4 and Rural distribution webinar focusing on documentation needed for the single application. HRSA also released detailed guidance on submitting Phase 3 Reconsideration Applications. </div><div><br></div><div>Highlights from the October 13 webinar include: <br><br></div><div><ul><li>General application instructions, including documentation guidance, are located in the <a href="https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/phase4-arp-application-instructions.pdf?cm_ven=ExactTarget&cm_cat=COVID-19+Update+%23214&cm_pla=All+Subscribers&cm_ite=Phase+4+General+Distribution+and+ARP+Rural+Payments+Application+Instructions.&cm_lm=1343767647&cm_ainfo=&&&&&" data-feathr-click-track="true" target="_blank">Phase 4 General Distribution and ARP Rural Payments Application Instructions.</a> </li><li>HRSA emphasis on, <strong><em>“Failure to submit the correct supporting documentation may result in HRSA deeming your application ineligible for payment.” </em></strong></li><li>Review of five scenarios which health care providers have tax requirements, use financial documentation, and/or have organizational structures which fall outside of their standard application documentation requirements. </li></ul></div><div>As part of this discussion, HRSA noted guidance on <em><a href="https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/prf-parent-subsidiary-reporting-fact-sheet.pdf?cm_ven=ExactTarget&cm_cat=COVID-19+Update+%23214&cm_pla=All+Subscribers&cm_ite=parent-subsidiary+relationships&cm_lm=1343767647&cm_ainfo=&&&&&" data-feathr-click-track="true" target="_blank">parent-subsidiary relationships</a></em> contained in its reporting guidance. Additionally, in an October 15 transmittal, HRSA outlined Phase 3 Reconsideration Application key steps. Phase 3 Reconsideration detail is located <a href="https://www.hrsa.gov/provider-relief/payment-reconsideration?cm_ven=ExactTarget&cm_cat=COVID-19+Update+%23214&cm_pla=All+Subscribers&cm_ite=here.&cm_lm=1343767647&cm_ainfo=&&&&&" data-feathr-click-track="true" target="_blank">here</a>. </div><div><br></div><div>AHCA/NCAL has also provided a <a href="/Survey-Regulatory-Legal/Emergency-Preparedness/MemberOnlyDocs/COVID19/Phase%204%20and%20Rural%20Distirubtion%20Documentation%20Webinar%20Summary%2010.18.21.pdf?cm_ven=ExactTarget&cm_cat=COVID-19+Update+%23214&cm_pla=All+Subscribers&cm_ite=summary&cm_lm=1343767647&cm_ainfo=&&&&&" data-feathr-click-track="true" target="_blank">summary</a> of last week's webinar for members to easily reference.</div><div><br><br></div><p>​</p>Last week, Health Resources & Services Administration (HRSA) held its third Phase 4 and Rural distribution webinar focusing on documentation needed for the single application.

 Questions?
Please contact us with any questions you have regarding PRF or QIP.

 Additional Resources