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What is Provider Relief Funding?

On October 1st, the Department of Health and Human Services (HHS) announced $20 billion in new long term care assistance for providers on the coronavirus pandemic’s frontlines through the Phase 3 General Distribution allocation.

Phase one and two already went through earlier in 2020, but as of October 5th, 2020, providers, including long term care, skilled nursing, assisted living, etc., can apply for funding.

Facilities who already received Provider Relief Fund payments can apply for additional funding, as well as previously ineligible providers, such as an expanded group of behavioral health providers. HHS stated the new Phase 3 General Distribution is “designed to balance an equitable payment of 2 percent of annual revenue from patient care for all applicants plus an add-on payment to account for revenue losses and expenses attributable to COVID-19.”

The Provider Relief Fund supports healthcare providers in the battle against the COVID-19 pandemic. With the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act (PPPCHE), the federal government has allocated $175 billion in payments to be distributed through the Provider Relief Fund (PRF).

Are these payments a loan or is this a grant?

These distributions do NOT need to be repaid to the US government, assuming recipients comply with the terms and conditions corresponding to their provided service.

Who Is Eligible?

Any provider of healthcare, services, and support in a medical setting, at home, or in the community that can prove healthcare-related expenses or lost revenue due to COVID-19.

All relief payments are being made to billing tax identification numbers (TINs). There may be instances where a billing TIN includes multiple facilities.

Providers include, but are not limited to:

  • Assisted Living Facilities

  • Nursing Homes

  • Acute care hospitals

  • Behavioral health providers

To be eligible for Provider Relief Funding you must:

  • Be a state-licensed / certified assisted living facility as of March 31, 2020

  • Billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan.1, 2018-Mar.31, 2020.

  • Bill Medicare A for services

How much is HHS allocating to each targeted distribution?

The $20 billion new funding follows $30 billion HHS distributed earlier this year, reaching up to $50 billion in financial support to provide relief to eligible providers throughout the American healthcare system.

HHS is methodically allocating targeted distribution funding to providers in areas especially affected by the COVID-19 spread, rural providers, and providers requesting reimbursement for the treatment of uninsured patients. The amounts vary depending on the state and the provided service.

$22 Billion – COVID-19 High-Impact Distribution

HHS is allocating the greater distribution to hospitals with a high amount of confirmed COVID-19 positive inpatient admissions.

Read the breakdown of the first and second rounds of High-Impact Distribution by state.

$11 Billion – Rural Distribution

HHS distributes $10 billion to rural hospitals, including Rural Acute Care General Hospitals and Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs), and Community Health Centers located in rural areas.

Additionally, $1 billion is destined for specialty Rural hospitals, Urban Hospitals with certain rural Medicare designations, and hospitals in small metropolitan areas.

$9.4 Billion – Skilled Nursing Facilities/Nursing Homes Distribution

More funding is also being allocated to SNFs and Nursing Homes nationwide. The first distribution was $4.9 billion to Skilled Nursing Facilities (SNFs), and the second distribution of almost $2.5 billion was to Skilled Nursing Homes/ Facilities across the nation.

A separate $2 billion incentive payment structure provides more funding to Nursing Homes and Skilled Nursing Facilities based on certain performance measures.

$14.4 Billion – Safety Net Hospitals Distribution

HHS distributes $14.4 billion in PRF to Safety Net Hospitals that disproportionately provide care to the most vulnerable and operate on fragile margins.

Originally, HHS allocated $10 billion and then an additional $3 billion distribution, so certain Acute Care Hospitals meeting the revised profitability threshold would qualify.

Another $1.4 billion is going to nearly 80 free-standing Children’s Hospitals suffering from the pandemic’s financial difficulties.

Get Your Provider Relief Fund Application in on Time!

  • Applicants who submit by Friday, November 6, 2020, at 11:59 p.m. ET will be considered for funding.

  • All applicants must submit their TIN and financial information to the Provider Relief Fund Application and Attestation Portal. Applicants who submit by Friday, November 6, 2020, at 11:59 p.m. ET will be considered for funding.

  • This is the 3rd round, and maybe the last!

Here’s the link again:

How to sign up for the PRF:

Once you get signed up at the link above, just walk through the basic steps below. The system does a good job of taking you through these steps, but be sure to have someone knowledgeable about long-term care, assisted living, or skilled nursing finances involved or in charge of the application!

  1. Get signed up on the website:
  2. Determine eligibility
  3. Validate Tax ID Number (TIN)
  4. Apply for funding
  5. Receive payment
  6. Attest to payment – Provider can reject the payment if its within 90 days
  7. Report on the use of funds: Post-Payment Notice of Reporting Requirements

COVID-19 Uninsured Program Portal

If you need reimbursement for providing COVID-19 testing to uninsured individuals, the HHS has your back! Go over to the Covid Uninsured Claims website and get paid for those tests!

This portal is for providers seeking reimbursement for COVID-19 testing and treatment of uninsured individuals on or after February 4, 2020.

As part of the Families First Coronavirus Response Act, the Paycheck Protection Program and Health Care Enhancement Act, and the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the U.S. Department of Health and Human Services (HHS) will provide claims reimbursement to health care providers generally at Medicare rates for testing uninsured individuals for COVID-19, for treating uninsured individuals with a COVID-19 primary diagnosis, and for COVID-19 vaccine administration to the uninsured.

Here’s That Link Again:

Want to get your data together to apply for the money?

NetSolutions’ General Financials makes it simple to gather service revenue for any time period needed for the Provider Relief purpose or any other.

Give a call if you want some help figuring out your long term care financials!

For more on recent trends in long term care, read our blog and subscribe to the LTC Heroes podcast.