On September 10, 2021, through the Health Resources and Services Administration (HRSA), the Department of Health and Human Services announced additional funding will be made available to providers impacted by the COVID-19 pandemic. In addition, the HRSA also announced a 60-day grace period for Reporting Period 1 in light of recent natural disasters and the Delta variant.
These decisions are the latest in COVID-19 relief effort that aims to support providers with revenue loss through the pandemic, including SNFs. The relief fund will also enable providers to continue providing quality care to the most vulnerable populations.
1. What’s the new funding and when will it be available?
The new funding totals $25.5 billion, which includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.
Eligible health care providers will be able to apply for this funding starting September 29, 2021. In order to minimize administrative burden and streamline the process, providers will be able to use the same application for both of these programs. The HRSA will use existing Medicaid/CHIP and Medicare claims data in calculating portions of these payments.
2. Who is eligible for this funding?
The Phase 4 General Distribution of the PRF payment will be calculated based on providers’ lost revenues and changes in operating expenses from July 1, 2020 to March 31, 2021. To be eligible for General Distribution, a provider must have billed Medicare fee-for-service in 2019, be a known Medicaid and CHIP or dental provider and provide or provided after January 31, 2020 diagnoses, testing, or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19. Learn more about PRF eligibility here.
PRF Phase 4 will reimburse smaller providers – who tend to serve vulnerable or isolated communities and operate on a thinner margin – for lost revenue and expense at a higher rate than larger providers. The new distributions will also provide “bonus” payments based on the amount of services they provide to Medicaid, CHIP, and Medicare patients, priced at the generally higher Medicare rates.
ARP payments will be available to Providers who serve Medicaid, CHIP, and Medicare patients who live in rural communities. Refer to the Rural Health Grants Eligibility Analyzer to see what areas qualify as “rural” for the ARP rural payments.
3. How to prepare your applications
Accuracy, clarity and timeliness is key to a successful application for these additional funding. The HRSA recommends these steps to prepare your application for PRF and ARP funding:
– Identify your eligibility for this funding. The Rural Health Grants Eligibility Analyzer can determine if your areas of service qualify as rural.
– Gather supporting documents to show lost revenues and expenses. Examples of supporting documents can be most recent tax documents, financial statements for the second half of calendar year (CY) 2020 and financial documents of first quarter of CY 2021.
More information on the new PRF and ARP funding will be available prior to September 29, 2021. We will continue to monitor for additional information and updates you as we receive them. Timely (and early) filing is likely to be key to securing this much needed round of payment.