On September 10, 2021, the U.S. Department of Health and Human Services (HHS) offered updates regarding its Provider Relief Fund program, including $25.5 billion in new funding that will soon be made available to health care providers.

Here is what you need to know:

Additional $25.5 Billion in Funding

Starting September 29, 2021, health care providers can apply to receive additional funds to be disbursed as follows:

  • $8.5 Billion from the American Rescue Plan for providers in rural areas who serve individuals enrolled in the Medicaid, Medicare, and/or Children’s Health Insurance Program (CHIP).
  • $17 Billion from the Coronavirus Response and Relief Supplemental Appropriation Act of 2020. These “Phase 4” Funds will be distributed based on providers’ lost revenues and COVID-19 expenditures between July 1, 2020 and March 31, 2021, with a focus on getting funds to smaller providers who serve vulnerable or isolated communities. Bonus payments will be disbursed to providers who serve Medicaid, CHIP and/or Medicare patients, including low-income children, pregnant woman, people with disabilities and seniors.

The Health Resources and Services Administration (HRSA) will use existing claims data to calculate payments to providers.

Reconsideration of Phase 3 payments

HRSA has published the detailed payment calculation methodology utilized for Provider Relief Fund “Phase 3” disbursements. Providers who believe the payments they received under Phase 3 were incorrect can now review the specific methodology. Those providers who still believe the Phase 3 payment was incorrect will have the opportunity to request a reconsideration.

Details regarding how to request a reconsideration are forthcoming.

Grace Period for First Reporting Deadline

The September 30, 2021 deadline remains for providers to demonstrate that Provider Relief Funds received between April 10, 2020 and June 30, 2020 were utilized in accordance with their specified terms and conditions. HHS, however, recognizes the impact that recent natural disasters and the surge of COVID cases has had on some providers, so they are instituting a 60-day “grace period.”

While providers who do not submit a report by September 30, 2021 will technically be deemed out of compliance, HRSA will not initiate collection activities or similar enforcement actions until after November 30, 2021.