The Department of Health and Human Services (HHS) announced a Phase 3 General Distribution of $20 billion from the Provider Relief Fund (PRF). The funds will be open to previously ineligible providers (e.g., those who began practicing in 2020) and will permit those who have already received funds through previous distributions to apply for additional funding that reflects financial losses and changes in operating expenses due to the pandemic. Providers can begin applying for funds on Monday, Oct. 5 and will have through Nov. 6, 2020 to apply.
The agency explained that the distribution is intended to give all applicants 2% of annual revenue from patient care, plus provide an additional amount to offset providers’ COVID-19 revenue losses and expenses. HHS notes that providers who have already received payments of 2% can submit more information to become eligible for the additional payment. The announcement suggests the Department will seek to provide all providers with 2% of annual revenue from patient care prior to determining the additional payments for lost revenue and expenses attributable to the coronavirus. Therefore, HHS recommends providers apply early, as the Health Resources and Services Administration (HRSA) will calculate add-on payments for providers using the remaining balance and taking the following information into account:
- A provider’s change in operating revenues from patient care;
- A provider’s change in operating expenses from patient care, including coronavirus-related expenses; and
- Payments previously received through prior PRF distributions.
Those eligible for the funding, include:
- Any provider who previously received, rejected, or accepted a General Distribution PRF payment;
- Behavioral health providers, including those that previously received funding as well as new providers; and
- Health care providers that began practicing between Jan. 1 and Mar. 31, 2020, including Medicare, Medicaid, CHIP, dentists, assisted living facilities, and behavioral health providers.
To date, HHS has allocated approximately $144 billion of the $175 billion in congressionally-appropriated Provider Relief funding. Some portion of the remaining funds will be distributed to providers who test or treat uninsured COVID-19 patients after Feb. 4, 2020. Providers have received and attested to roughly $1.4 billion for the treatment and testing of uninsured COVID-19 patients, as of Oct. 2, 2020.* Additionally, there is no set allocation amount for the dental distribution. The amount will be determined by the applications submitted through the dental portal.
For reference, a breakdown of the announced Provider Relief Fund allocations to date follows in the table below.
|Provider Relief Fund Allocation (amount)||WHG Summary||Recipients|
|Phase 1 General Allocation ($30B)||Here||All Medicare-billing providers|
|Phase 2 General Allocation ($20B)||Here||All Medicare-billing providers|
|High Impact Allocation ($12B)||Here||Hospitals with at least 100 COVID-related admissions; $2 billion was distributed to hospitals based on their Medicare DSH and uncompensated care payments|
|Second High Impact Allocation ($10B)||Here||Hospitals with over 161 COVID admissions between January 1 and June 10, 2020, or one admission per day, or experienced a disproportionate intensity of COVID admissions (exceeding the average ratio of COVID admissions/bed)|
|Rural Allocation ($10B)||Here||Rural acute general hospitals, CAHs, RHCs, and rural CHCs|
|Second Rural Allocation ($1B)||Here||Specialty rural Medicare designation hospitals in urban areas and hospitals in smaller non-rural communities|
|Nursing Homes ($4.9B)||Here||SNFs|
|Second Nursing Home Allocation ($5B)||Here||SNFs|
|Indian Health Service ($500M)||Here||Tribal hospitals, clinics, and urban health centers|
|Medicaid and CHIP Providers ($15B)||Here||Medicaid and CHIP Providers|
|Safety Net ($10B)||Here||Safety Net Hospitals|
|Second Safety Net Allocation ($3B)||Here||Acute care hospitals that have less than 3% profitability averaged over 2 or more of its last 5 cost report filings|
|Children’s Hospitals ($1.4B)||Here||Free-standing children’s hospitals|
|Phase 3 General Allocation ($20B)||Health care providers, including those who were previously ineligible|
|Uninsured ($1.4B*)||Providers testing or treating uninsured COVID patients|
|Dental (TBD)||Dental providers|
|Total Allocated: $144 billion (see more detail from HHS here)|