The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), released $25.5 billion in funding for health care providers affected by the COVID-19 pandemic. The funding includes $8.5 billion in American Rescue Plan resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP) or Medicare beneficiaries, as well as $17 billion in Provider Relief Fund (PRF) Phase 4 payments for providers who can document revenue loss and expenses related to the pandemic.

PRF Phase 4 payments will reimburse smaller providers, who often serve vulnerable and isolated communities, for lost revenue and COVID-19 expenses at a higher rate compared with larger providers. In addition, PRF Phase 4 payments will include bonus payments for providers who serve Medicaid, CHIP and/or Medicare beneficiaries. Similarly, HRSA will make American Rescue Plan rural payments to providers based on the amount of Medicaid, CHIP and/or Medicare services they provide to patients who live in rural areas as defined by the HHS Federal Office of Rural Health Policy. Both PRF Phase 4 and American Rescue Plan rural payments will generally be based on Medicare reimbursement rates.

Providers will be able to apply for both programs in a single application, and HRSA will use existing claims data to calculate payments. View detailed information from HHS about the methodology used to calculate PRF Phase 3 payments here. Providers who believe Phase 3 payments were miscalculated will have an opportunity to request a reconsideration, with details on the reconsideration process expected in the coming weeks.

In addition, in light of challenges resulting from the Delta variant and natural disasters, HHS announced a delay in the final 60-day grace period for providers to comply with PRF Reporting requirements if they fail to meet the Sept. 30 deadline for the first PRF Reporting time period. Click here for information about eligibility requirements, application requirements and the application process for PRF Phase 4 payments and American Rescue Plan rural payments.

Read the full HHS press release.

Clinical Topics: COVID-19 Hub

Keywords: ACC Advocacy, SARS-CoV-2, Natural Disasters, Health Policy, Health Resources, Rural Population, Eligibility Determination, United States Health Resources and Services Administration, Medicare, Pandemics, Medicaid, Children's Health Insurance Program, COVID-19

< Back to Listings