More pandemic relief available from the HHS Provider Relief Fund

Rebecca Farrington.

Additional funds will be available under the American Rescue Plan (ARP) for providers serving rural patients. Both aspects of the current distribution will be available through a single request process.

Distribution of PRF phase IV

The distribution of phase IV will be based on the evolution of a supplier’s operating income and expenses from July 1, 2020 to March 31, 2021. However, funds can be used to replace lost income and / or expenses incurred. over the three-year period. January 1, 2020 to December 31, 2022. Providers are eligible if they charge Medicare (both Traditional and Advantage), Medicaid, and / or CHIP, and whether or not they have previously received PRF grants. The application period ends on October 26, 2021 at midnight.

HHS will determine the amount of base payments and supplements after analyzing the data of all claims received to ensure they are on budget and funds are distributed fairly. HRSA expects Phase IV payments to be distributed in mid-December 2021. According to the Health Resources and Services Administration (HRSA) website, funds will be allocated to:

  • Large vendors will receive a minimum payout amount based on a percentage of their changes in operating income and expenses.
  • Medium and small providers will receive a base payment plus a supplement, with smaller providers receiving the highest supplement, as smaller providers tend to operate on low margins and often serve vulnerable or isolated communities.
  • Bonus payments will be based on the amount and type of services provided to Medicaid, CHIP, and Medicare patients. HHS will rate Medicaid and CHIP claim data at Medicare rates, with some exceptions for certain services provided primarily in Medicaid and CHIP.

ARP rural distribution

Providers serving patients who live in rural communities are eligible to apply for funds under this part of the distribution program. Payment will be based on the amount and type of Medicare, Medicaid, and CHIP services provided to rural patients during the period January 1, 2019 to September 30, 2020.

Similar to Phase IV payments, HHS will determine the payment amount after analyzing data from all claims received to ensure they are on budget and funds are distributed fairly. HRSA expects rural ARP payments to be distributed in late November 2021.

It is important to note here that rural ARP payments will be determined based on the location of the patients, not the provider. Applicants do not need to verify whether their patients live in an area that meets the definition of rural; HRSA will base payments on data already available using the Federal Office for Rural Health Policy definition of rural. HRSA said there is no penalty for applying in any case.

According to ARSH websiteClaims, Medicaid and CHIP data will be billed at Medicare rates, with some exceptions for certain services provided primarily in Medicaid and CHIP. Providers who serve patients living in rural areas defined by the Federal Office of Rural Health Policy with Medicaid, CHIP or Medicare coverage, and who otherwise meet eligibility criteria, will receive a minimum payment.

How and when to apply

Both programs can be claimed in a single application, and HRSA will use existing Medicaid, CHIP, and Medicare claim data to calculate a portion of the payments. The application will be available on the HRSA PRF application and attestation portal from September 29 to October 26, 2021. This is the same portal that was used to apply to the previous phases of the PRF distributions and to report on the use of these funds. If you have not yet created an account on the portal, a separate registration process is required first.

It is not recommended to wait until the last minute to file the application; start the application relatively early even if you don’t plan to finalize it before the deadline. The first step (validation of the taxpayer’s identity) can take up to four working days, even if the firm has already used the portal for the request and / or the attestation of a PRF grant.

Also, some time should be set aside in case you don’t have all the requested data on hand while you are working on the app. Firms that have received a Phase III grant must certify receipt, terms and conditions of that grant prior to proceeding to the Phase IV application.

HRSA states that the information needed to complete the application is as follows:

  • Tax identification number (TIN) of the firm and its subsidiaries
  • Financial statements that support patient care operating revenues and expenses in 2019 (quarters 1, 3 and 4), 2020 (quarters 3 and 4) and 2021 (quarter 1)
  • The firm’s federal income tax return, audited financial statements or internally generated financial statements for download in their entirety

The firm’s total annual income is entered from one of the documents described above. In addition, the amount of net patient care income must be entered separately. In certain circumstances When the amounts entered are not directly supported by the tax return or uploaded financial statement, additional spreadsheets may be required to reconcile the discrepancy.

A sample application form and detailed instructions can be downloaded for viewing before using the portal. HRSA also presented a online seminar which describes in detail the application process and answers many questions.

Conclusion

In order to determine whether to apply for Phase 4 or ARP Rural funds, the practice should examine its COVID-related income and expenses by quarter from January 1, 2019 to date. Since grant funds can be used until the end of 2022, they should also consider a projection of future income and expenses.

If the methodology used in the first phase report applies to these grants, then each quarter will be compared to the same quarter in the base period of 2019; however, HRSA has not announced the reports and methodology that will be used to support the use of these funds.

There is little risk in applying for Phase IV distribution, including ARP Rural funding. Once the decision is made, the cabinet can decide whether or not to accept the grant funds. Since the funds can be used to cover expenses and income as early as January 1, 2020, the three-year period until the end of 2022 provides ample opportunity to justify the use of the funds, if necessary. If for some reason the firm is unable to use the funds for their intended purpose, then HHS will recover the funds.

HRSA fact sheet contains detailed information on grants and the application process. We will continue to monitor and report any new information available on this and other similar programs.

Rebecca Farrington is the Chief Recipe Officer of Administrative partners in health. She has over 20 years of experience in healthcare sales and management roles, focusing on managing the revenue cycle of hospitals and physicians.

Comments and observations expressed are those of the author and do not necessarily reflect the opinions of AuntMinnie.com.

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