A new distribution of the Provider Relief Fund (PRF) is now open for applications until October 26th, 2021. $8.5 of the $25.5 billion dollars allocated for this phase will be directed towards rural providers, with the remaining $17 billion generally open to all providers who bill Medicare, Medicare Advantage, Medicaid, or CHIP. Distribution of PRF Phase 4 payments will be based on changes in operating revenues and expenses from July 1, 2020, to March 31, 2021, however, payments can be used for lost revenues or eligible expenses incurred from January 1, 2020, through December 31, 2022.
The $17 billion allotted for general distribution will be awarded under the following methodology:
- 75% of the Phase 4 allocation will be calculated based on revenue losses and COVID-related expenses.
- Large providers will receive a minimum payment amount that is based on a percentage of their lost revenues and COVID-related expenses.
- Medium and small providers will receive a base payment plus a supplement, with small providers receiving the highest supplement.
- HHS did not include the definition of ‘small’, ‘medium’, or ‘large’ providers with their initial announcement.
- No provider will receive a Phase 4 payment that exceeds 100% of their losses and expenses.
- 25% of the Phase 4 allocation will be put towards bonus payments that are based on the amount and type of services provided to Medicaid, CHIP, and Medicare patients.
- HHS will price Medicaid/CHIP claims data at Medicare rates, with some limited exceptions for some services provided predominantly in Medicaid/CHIP.
- Providers who serve any patients living in Federal Office of Rural Health Policy-defined rural areas with Medicaid, CHIP, or Medicare coverage, and who otherwise meet the eligibility criteria, will receive a minimum payment.
Applications for the Phase 4 distribution are to be submitted through the PRF attestation portal here: https://cares.linkhealth.com/#/.
HHS will host webinars on applying for this phase in the upcoming weeks. CLICK HERE to register or for additional resources on the Phase 4 distribution.
As a reminder, recipients of Provider Relief Funds are required to report on the use of funds as part of the terms and conditions of retaining the payment. HHS has granted a 60-day grace period for the first reporting deadline of September 30th, 2021. The grace period will end November 30th, 2021. More details are available here https://www.hrsa.gov/provider-relief/reporting-auditing
As always, ADVOCATE will continue to keep you informed on the issues impacting medical groups as they develop.
Manager, Regulatory Affairs