The fight for provider relief continues as hospitals, nursing homes, practitioners, dentists and assisted living facilities, among others, vie for a piece of the phase 4 $25.5 billion distribution that HHS says will advance equity by rewarding medium and smaller providers with a special add-on relief payment.
HHS clarified in a webinar with providers that those receiving more than $10,000 in relief will be required to report any mergers with or acquisitions of another provider for audit purposes. The department also said that providers do not have to be in a rural area to qualify for part of the $8.5 billion in relief created under the American Rescue Plan in March, and that those receiving the rural relief cannot redistribute it to other providers in the same health care system.
The application period for the long-awaited fourth general distribution of provider relief opened Sept. 29, and providers will have through Oct. 26 to apply for $17 billion in general COVID-19 relief and $8.5 billion if they serve patients in rural areas.
Argentum held a webinar the same day the application period opened, encouraging its members, assisted living facilities, to apply early and submit as thorough of an application as possible.
“What we’re encouraging folks to do is — and [HHS] did specifically invite this — to really detail and explain your losses. Really set yourselves apart from other, different entities who, again, were not frontline caregivers,” Argentum Senior Vice President Maggie Elehwany said Sept. 29, suggesting members use the application’s addendum to make their case for relief.
Unlike previous relief payments that reimbursed providers up to 2% of patient revenue and 88% of revenue loss, phase 4 payments will be scaled to the provider’s size, which is based on their annual patient care revenue.
But HHS has yet to release the definitions for large, medium and small providers, Tom Barker from Foley Hoag LLP told Argentum members.
Most of the relief payment will be based off changes to providers’ operating revenues and expenses from July 1, 2020, to March 31, 2021. The agency in charge of distributing the $178 billion provider relief fund, the Health Resources and Services Administration, will give medium and smaller providers bonus payments calculated from their number of Medicare, Medicaid and CHIP beneficiaries; small providers will receive the highest supplement.
“HRSA will determine the exact percentage for the payments and supplements after analyzing data from all the applications received to ensure we remain within our budget and funds are distributed equitably,” reads HRSA’s slides from its webinars on Sept. 30 and Oct. 5.
Phase 4 relief has similar terms and conditions as previous distributions, like reporting requirements, but HRSA will now require providers receiving more than $10,000 in relief to tell the department of any mergers with or acquisitions of another provider.
“That’s the step we’re taking to help ensure that these funds are used for patient care,” HRSA staff said during the webinars. “Providers who do report a merger or acquisition may be more likely to be audited to confirm their funds were used for Coronavirus-related costs, consistent with an overall risk-based audit strategy.”
House Appropriations Committee Chair Rosa DeLauro (D-CT) and Rep. Katie Porter (D-CA) penned a letter to HHS and the Federal Trade Commission in May letter asking the departments to identify whether any CARES Act funds were used to engage in consolidation and/or fund potentially anticompetitive behavior.
HRSA also clarified that providers do not have to be in a rural area to qualify for part of the $8.5 billion in provider relief created under the American Rescue Plan in March. They just need to serve patients who live in rural areas — a fact HRSA will determine on its own.
The ARP rural relief has new restrictions that forbid providers from redistributing this relief to other providers in the same health care system. The American Hospital Association raised concerns with this restriction almost a year ago, arguing that it does not account for the fact that hospital systems function as an integrated coordinated whole in managing care and resources.
“I’m particularly pleased that the administration heeded my calls to set aside $8.5 billion for rural providers, including those in New Hampshire,” Sen. Jeanne Shaheen (D-NH) said in a statement Sept. 29. “These federal dollars can’t come soon enough to our hospitals, nursing homes and assisted living centers — this is a matter of life and death for patients across the country. I encourage providers to apply as soon as they can.”
Providers Prep For Tough Competition Over Next Relief Distribution
Inside Health Policy
October 6, 2021 7:13 pm
The fight for provider relief continues as hospitals, nursing homes, practitioners, dentists and assisted living facilities, among others, vie for a piece of the phase 4 $25.5 billion distribution that HHS says will advance equity by rewarding medium and smaller providers with a special add-on relief payment.
HHS clarified in a webinar with providers that those receiving more than $10,000 in relief will be required to report any mergers with or acquisitions of another provider for audit purposes. The department also said that providers do not have to be in a rural area to qualify for part of the $8.5 billion in relief created under the American Rescue Plan in March, and that those receiving the rural relief cannot redistribute it to other providers in the same health care system.
The application period for the long-awaited fourth general distribution of provider relief opened Sept. 29, and providers will have through Oct. 26 to apply for $17 billion in general COVID-19 relief and $8.5 billion if they serve patients in rural areas.
Argentum held a webinar the same day the application period opened, encouraging its members, assisted living facilities, to apply early and submit as thorough of an application as possible.
“What we’re encouraging folks to do is — and [HHS] did specifically invite this — to really detail and explain your losses. Really set yourselves apart from other, different entities who, again, were not frontline caregivers,” Argentum Senior Vice President Maggie Elehwany said Sept. 29, suggesting members use the application’s addendum to make their case for relief.
Unlike previous relief payments that reimbursed providers up to 2% of patient revenue and 88% of revenue loss, phase 4 payments will be scaled to the provider’s size, which is based on their annual patient care revenue.
But HHS has yet to release the definitions for large, medium and small providers, Tom Barker from Foley Hoag LLP told Argentum members.
Most of the relief payment will be based off changes to providers’ operating revenues and expenses from July 1, 2020, to March 31, 2021. The agency in charge of distributing the $178 billion provider relief fund, the Health Resources and Services Administration, will give medium and smaller providers bonus payments calculated from their number of Medicare, Medicaid and CHIP beneficiaries; small providers will receive the highest supplement.
“HRSA will determine the exact percentage for the payments and supplements after analyzing data from all the applications received to ensure we remain within our budget and funds are distributed equitably,” reads HRSA’s slides from its webinars on Sept. 30 and Oct. 5.
Phase 4 relief has similar terms and conditions as previous distributions, like reporting requirements, but HRSA will now require providers receiving more than $10,000 in relief to tell the department of any mergers with or acquisitions of another provider.
“That’s the step we’re taking to help ensure that these funds are used for patient care,” HRSA staff said during the webinars. “Providers who do report a merger or acquisition may be more likely to be audited to confirm their funds were used for Coronavirus-related costs, consistent with an overall risk-based audit strategy.”
House Appropriations Committee Chair Rosa DeLauro (D-CT) and Rep. Katie Porter (D-CA) penned a letter to HHS and the Federal Trade Commission in May letter asking the departments to identify whether any CARES Act funds were used to engage in consolidation and/or fund potentially anticompetitive behavior.
HRSA also clarified that providers do not have to be in a rural area to qualify for part of the $8.5 billion in provider relief created under the American Rescue Plan in March. They just need to serve patients who live in rural areas — a fact HRSA will determine on its own.
The ARP rural relief has new restrictions that forbid providers from redistributing this relief to other providers in the same health care system. The American Hospital Association raised concerns with this restriction almost a year ago, arguing that it does not account for the fact that hospital systems function as an integrated coordinated whole in managing care and resources.
“I’m particularly pleased that the administration heeded my calls to set aside $8.5 billion for rural providers, including those in New Hampshire,” Sen. Jeanne Shaheen (D-NH) said in a statement Sept. 29. “These federal dollars can’t come soon enough to our hospitals, nursing homes and assisted living centers — this is a matter of life and death for patients across the country. I encourage providers to apply as soon as they can.”