Sept. 21, 2021, 5:02 p.m. News Staff ― HHS announced on Sept. 10 that a new round of COVID-19 relief funding for physicians and other health care professionals and facilities is on the horizon. The agency is making available a total of $25.5 billion across two different programs ― $17 billion for Phase 4 of the COVID-19 Provider Relief Fund and $8.5 billion in American Rescue Plan resources for those who serve rural areas ― to entities that have suffered financial setbacks due to the pandemic.
Health care entities that can document revenue losses and excess operating expenses caused by the pandemic between July 1, 2020, and March 31, 2021, are eligible to receive PRF Phase 4 funds, as outlined in the Coronavirus Response and Relief Supplemental Appropriations Act of 2020.
To promote health equity and deliver support where the need is greatest, the Health Resources and Services Administration, which is distributing the funds, will provide relief funds to smaller practices ― which frequently serve vulnerable communities and are more likely to operate on thin margins — at a higher rate than larger practices. In addition, HRSA will issue PRF bonus payments based on the volume of services provided to Medicaid, CHIP and Medicare patients, priced at the typically higher Medicare rates.
Similarly, HRSA will distribute ARP funds to physicians and other health care entities in rural areas based on the amount of Medicaid, CHIP and/or Medicare services they provide. Recognizing that these entities normally serve a disproportionate number of Medicaid and CHIP patients ― who tend to have more complex medical needs ― in communities that have been particularly hard-hit by the pandemic, these payments will also be based on generally higher Medicare rates.
“This funding critically helps health care providers who have endured demanding workloads and significant financial strains amidst the pandemic,” said HHS Secretary Xavier Becerra in the Sept. 10 news release. “The funding will be distributed with an eye towards equity, to ensure providers who serve our most vulnerable communities will receive the support they need.”
Note that to ensure fund recipients use the relief payments for patient care, HRSA will require them to notify HHS of any merger with or acquisition of another health care entity during the period in which they can use the payments. Those who report a merger or acquisition may be more likely to be audited to confirm the funds were used for pandemic-imposed costs.
The application period for these funds opens Sept. 29. To streamline the process, physicians and other health care entities will apply for both programs using a single application, and HRSA will utilize existing Medicaid/CHIP and Medicare claims data to calculate portions of the payments. Further information about the two programs is available from the HRSA website.
Finally, HHS also stated in its release that although the Sept. 30 deadline to report on funds received during the first PRF payment period (April 10-June 30, 2020) has not changed, because of ongoing COVID-19 disease spread linked to the delta variant, as well as the ill effects of several recent natural disasters, the agency is granting a 60-day grace period to allow physicians and others to come into compliance with their PRF reporting requirements if they fail to meet that deadline.
It’s worth noting that this development follows recent AAFP advocacy calling on HRSA to revise its PRF reporting requirements, which the Academy said have proven burdensome for many family medicine practices. “AAFP members who have contacted us about the PRF reporting activity and its associated portal have uniformly expressed frustration with the experience and time involved,” the Academy told HRSA in an Aug. 18 letter.
“Part of the problem may be that HRSA’s current reporting requirements and associated portal assume a level of reporting capability and resource support that does not exist in many of the solo, small group and rural practices in which so many of our members serve their patients,” the letter, signed by AAFP Board Chair Gary LeRoy, M.D., of Dayton, Ohio, noted.
Visit the HRSA website for details about PRF reporting requirements, deadlines and related information, including how to access the reporting portal.