Provider Relief Funding Updates

The Department of Health and Human Services (HHS) and the Health Resources and Services Administration (HRSA) recently made available $25.5 billion in new Provider Relief Funding (PRF) for healthcare providers. The agencies also updated the application process and the deadline for application of the new funding. You may read the entire announcement here.

Your organization must submit your application by October 26, 2021, by 11:59 p.m. ET.

Here is how HHS is allocating the $25.5 billion:

$8.5 billion in American Rescue Plan (ARP) resources

This portion of funds is designated for providers serving rural Medicaid, Children's Health Insurance Program (CHIP) or Medicare patients.

$17 billion for Provider Relief Fund (PRF) Phase 4

This portion is available to providers with documentation of healthcare related revenue losses and expenses tied to the pandemic, specifically:

  • Providers’ healthcare related lost revenues and expenditures between July 1, 2020, and March 31, 2021.
  • Reimbursing smaller providers operating on thin margins while serving vulnerable and/or isolated communities.
  • Bonus payments for providers serving Medicaid, CHIP, and/or Medicare patients, to ensure equity for those serving low-income children, pregnant women, people with disabilities, and seniors.
How to Apply

HHS and HRSA are establishing a single application portal for providers to use to apply for both Provider Relief Fund (PRF) Phase 4 and ARP Rural. You may also access a sample application form here.

The following is an overview of the steps in the application process:

  • Determine if your organization is eligible for Provider Relief Fund Phase 4. The following providers will qualify:
    • Providers or suppliers who bill Medicare fee-for-service, Medicaid and/or CHIP as well as dental service providers, state-licensed or certified assisted living facilities, behavioral health providers, and others,
    • Providers that filed a tax return in 2018, 2019 or 2020 or were exempt from filing,
    • Providers that provided patient care after January 31, 2020
    • Providers that have not ceased operations.
  • Determine if your organization is eligible for ARP Rural Payments. The following heath care providers will qualify for the ARP distributions:
    • Rural health clinics
    • Providers treated as rural
    • Providers or suppliers that have directly billed Medicare fee-for-service, Medicaid and/or CHIP between January 1, 2019, and September 30, 2020
    • Operates or serves patients living in HHS Federal Office of Rural Health Policy’s (FORHP)
  • Documents needed for the application:
    • Listing of all billing TINs
    • Internally generated financial statements that support patient care revenues and expenses for Q1, Q3, and Q4 2019, Q3 and Q4 2020, and Q1 2021.
    • Federal income tax return audited financial statements or internally generated financial statements.
Application Review Process

After the application is submitted, HRSA will perform a review process to ensure the following

  • Applications are not duplicated
  • Identify all applicants that are new and provided patient care services for the first-time during January 1, 2019, through December 31, 2020
  • Pharmacy and Durable Medical Equipment Suppliers will be capped at 10% of their total annual revenues
  • The accuracy of financial information provided.
Payment Methodology

Provider Relief Fund Phase 4 will be allocated 75% as a base payment to providers based on lost revenues and expenses from patient care from July 1, 2020, through March 31, 2021. Smaller and medium providers will receive a higher percentage. The remaining 25% will be bonus payments to providers based on Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare participation. Payment percentages will be calculated by HRSA after all applications are received and reviewed. ARP Rural payment methodology has not been released by HRSA as they will depend on the volume of applications received.

How DHG Healthcare can help

Should you have questions regarding the application process or needsupport compiling required documentation, the professionals at DHG Healthcare stand ready to help you explore your options and navigate your next steps. We look forward to learning how we can help you.

ABOUT THE AUTHORS

Andy Page
Partner, DHG Healthcare
Andy.Page@dhg.com

Sabrina Preston
Senior Manager
sabrina.preston@dhg.com

Sarah Hereford
Manager
sarah.hereford@dhg.com

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