United States: Healthcare providers to receive $ 25.5 billion in relief funds
To print this article, simply register or connect to Mondaq.com.
On September 10, the Biden-Harris administration, in conjunction with the Department of Health and Human Services (HHS), announced that $ 25.5 billion in relief funds will be distributed to healthcare providers by the through the Health Resources and Services Administration (HRSA). The American Rescue Plan (ARP) will provide $ 8.5 billion in funding and an additional $ 17 billion will be distributed as Phase 4 Provider Relief (PRF) funds.
HHS Secretary Xavier Becerra said “funding will be distributed on an equitable basis, to ensure that providers who serve our most vulnerable communities receive the support they need.” The distribution of funds will follow the guidelines of the Coronavirus Response and Relief Supplemental Appropriations Act of 2020 (CARES Act) on the distribution of lost income and expenses of providers between July 1, 2020 and March 31, 2021. Smaller providers that serving rural and vulnerable populations will be the key target group for these additional Phase 4 funds and will include bonuses for those serving Medicaid, CHIP and / or Medicare patients. All Phase 4 ARP and PRF distributions received between July 1, 2021 and December 31, 2021 must be used by December 31, 2022.
Request for ARP and PRF funds
ARP and PRF applicants will begin the application process through the same application and attestation portal used in the previous PRF distribution phases. Rural ARP providers can use the HRSA Rural Health Grant Eligibility Analyzer to determine their qualification as a rural provider. The application portal opens on September 29, and HRSA will use existing Medicaid, CHIP, and Medicare claim data to calculate payments in addition to bonus payments.
Phase 4 of the PRF distribution methodology
The Phase 4 distribution will allocate lost revenue and expenses related to COVID based on the following guidelines:
- 75% of the phase 4 allocation will be based on lost income and expenses related to COVID.
- Large vendors will receive a minimum payout amount based on a percentage of their lost revenue and COVID-related 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.
- HHS will determine the exact amount of base payments and supplements after analyzing data from all claims received to ensure that we are on budget and that funds are distributed fairly.
- No supplier will receive a Phase 4 payment in excess of 100% of their losses and expenses.
- HHS will continue to use risk mitigation and cost containment measures during Phase 4 to protect program integrity and preserve taxpayer dollars.
- 25% of the Phase 4 allocation will be used for bonus payments 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.
Rural health fund under the ARP
The Health Resources and Services Administration (HRSA) will facilitate PRF and ARP distributions. The $ 8.5 billion ARP funds will be available to rural Medicaid providers, CHIP and / or Medicare patients. Rural ARP distributions will be made to all providers serving patients who live in rural areas, as defined by the Federal Office of Rural Health Policy at HHS. The language of the ARP generally follows the PRF, which provides funding to providers for health care-related expenses and lost income attributable to COVID-19 but not reimbursed from another source.
FRP Phase 3 Compliance and Reviews
Any FRP beneficiary that has been the subject of a merger or acquisition must report to the Secretary of HHS and will likely need to be audited to confirm the proper use of funds for COVID-related costs. -19 which are compatible with an overall risk-based audit strategy. PRF Phase 3 suppliers who believe their Phase 3 payments were incorrect will now have the option to file a review. HRS provided a detailed methodology on how the Phase 3 payments were calculated.
Finally, HHS announced a 60 day final grace period (expiring 9/30/21) for any PRF vendor who must comply with PRF reporting requirements. This grace period does not affect reporting of PRF use or reporting requirements, but will remain any HHS enforcement or collection activity for non-compliant suppliers.
What it means for you
All providers who received PRF distributions in any of the other phases may be eligible to receive additional funding as part of the last phase 4 distributions. In addition, providers only need to serve patients. rural areas to be eligible for ARP payments. Husch Blackwell can help you determine your qualification and guide you through the PRF and ARP application process. Suppliers who have received Phase 3 PRF distributions and have questions about how they were reimbursed under the Phase 3 methodology or who believe their payment should be reconsidered can also contact Husch Blackwell for further assistance. help in solving these complex problems.
The content of this article is intended to provide a general guide on the subject. Specialist advice should be sought regarding your particular situation.
POPULAR ARTICLES ON: Food, Medicines, Health Care, Life Sciences of the United States