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New PRF Phase 4 & rural distribution application information released

Patti Cullen
By Patti Cullen, CAE  |  October 1, 2021  |  All members

On Monday, September 27, 2021, the Health Resources & Services Administration (HRSA) released additional information on the $17 Billion Phase 4 and the $8.5 Billion Rural Distribution application. Applicants will be able to apply for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) rural payments during the application process. PRF Phase 4 is open to a broad range of providers with changes in operating revenues and expenses. ARP rural is open to providers who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). See a detailed list of eligible provider types here.  

HRSA will be hosting webinar sessions for Phase 4 and ARP Rural applicants, featuring guidance on how to navigate the application portal. The next webinar session will be held on Tuesday, October 5, 2021, from 2:00–3:00 PM CT—register here to attend. Two additional webinars during the weeks of October 11th and 18th (dates, times, and registration details forthcoming).

HHS recently hosted a briefing session to provide information about these upcoming funding opportunities—view the video here

Beginning on September 29, 2021, healthcare providers will be able to apply for $25.5 billion in relief funds, including $8.5 billion in ARP resources for providers who serve rural patients covered by Medicare, Medicaid, or CHIP and $17 billion for PRF Phase 4 for a broad range of providers with changes in operating revenues and expenses. The application will be open for a period of four weeks. Providers must submit their completed application by the final deadline of October 26 at 11:59 PM ET. Providers who have previously created an account in the Provider Relief Fund Application and Attestation Portal and have not logged in for more than 90 days will need to first reset their password before starting a new application.

In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application and HRSA will use existing Medicaid, CHIP, and Medicare claims data in calculating portions of these payments.

  • Phase 4 General Distribution—$17 billion based on providers’ changes in operating revenues and expenses from July 1, 2020–March 31, 2021
    • To promote equity and to support providers with the most need, HRSA will:
      • reimburse smaller providers for changes in operating revenues and expenditures at a higher percentage compared to larger providers; and
      • provide "bonus" payments based on the amount of services they provide to Medicaid, CHIP, and Medicare patients, priced at the generally higher Medicare rates
  • American Rescue Plan (ARP) rural—$8.5 billion based on the amount of services providers furnish to Medicaid/CHIP and Medicare beneficiaries living in Federal Office of Rural Health Policy (FORHP)-defined rural areas
    • To promote equity, HRSA will price payments at the generally higher Medicare rates for Medicaid/CHIP patients

In HRSA’s announcement, the agency notes supporting documentation and information needed to complete an application will include the following:
  • Applicant tax identification number (TIN) and TINs for any subsidiaries
  • Internally-generated financial statements that substantiate operating revenues and expenses from patient care in 2019 Q1, Q3, and Q4; 2020 Q3 and Q4; and 2021 Q1 
  • Federal income tax return, audited financial statements, or internally-generated financial statements submitted in their entirety

ARP rural payments will be determined based on the location of the patients, not the provider. You do not need to verify whether your patients live in an area that meets the definition of rural. Simply select whether your organization (including any subsidiaries) would like to be considered for ARP Rural payments during the application process. HRSA will base payments on data already available to us on the amount and type of Medicare, Medicaid, and CHIP services provided to rural patients. HRSA will use the Federal Office of Rural Health Policy definition of rural.  

Patti Cullen, CAE  |  President/CEO  |  |  952-851-2487



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