Update: Application Portal for New Phase 4 of the HHS Provider Relief Fund is Open - Eligibility Criteria Also Outlined

Published in Government Relations on September 30, 2021

As of September 29, the application portal for Phase 4 of the HHS Provider Relief Fund (PRF) is open, and HHS has released further details regarding which providers are eligible to apply for additional funding in this latest round. The application portal is scheduled to remain open until Oct. 26. There are technically two separate programs or sources of funding available right now, but the single application serves for both programs. In addition to Phase 4 of the PRF, there is also separate funding available through the ARP Rural Distribution, which is made available through the American rescue plan. As we previously reported, there is a lot of emphasis being placed on providers who serve rural areas for the ARP Rural Distribution program. In total, there are $25.5 billion dollars being made available through these two programs: $17B in general distribution dollars through the PRF, and $8.5B for the ARP Rural Distribution.

The application portal can be found here: https://cares.linkhealth.com/#/, and there are several additional details, fact sheets, worksheets, and additional information regarding this available funding here: https://www.hrsa.gov/provider-relief/future-payments. HHS is hosting four separate webinars regarding this latest round of funding, the first of which is today, Sept. 30 at 3:00 p.m. ET. There will also be webinars Oct 5, 13, and 21. If you would like to register to attend any of those, you can also do that on the main page linked above.

As you know, DME providers have been included in previous rounds of the HHS PRF. DMEs were eligible for Phase 1 and Phase 2, but were excluded from Phase 3. DME providers are indeed eligible again in Phase 4. The full eligibility requirements for both of these programs can also be found at the link above, but is also copied below. As you can see in the sections I’ve bolded, providers need to have billed either Medicare or Medicaid in 2019 or 2020 in order to be eligible.

Phase 4 General Distribution:

To be eligible to apply, the applicant must meet ALL of the following requirements:

Must fall into ONE of the following categories:
1. Must have either directly billed, or owns (on the application date) an included subsidiary that has directly billed, their state/territory Medicaid program (fee-for service or managed care) or Children’s Health Insurance Program (CHIP) for health care-related services during the period of January 1, 2019 to December 31, 2020; or
2. Must be a dental service provider who has either directly billed, or owns (on the application date) an included subsidiary that has directly billed, health insurance companies or patients for oral health care-related services during the period of January 1, 2019 to December 31, 2020;
3. Must have either directly billed, or owns (on the application date) an included subsidiary that has directly billed, Medicare fee-for-service (Parts A and/or B) or Medicare Advantage (Part C) for health care-related services during the period of January 1, 2019 to December 31, 2020;
4. Must be a state-licensed/certified assisted living facility on or before December 31, 2020;
5. Must be a behavioral health provider who has either directly billed, or owns (on the application date) an included subsidiary that has directly billed, health insurance companies or patients for health care-related services during the period of January 1, 2019 to December 31, 2020;
6. Must have received a prior Targeted Distribution payment.
Must have either (i) filed a federal income tax return for fiscal years 2018, 2019, or 2020, or (ii) be an entity exempt from the requirement to file a federal income tax return and have no beneficial owner that is required to file a federal income tax return (e.g. a state-owned hospital or health care clinic); and
Must have provided patient care after January 31, 2020; and
Must not have permanently ceased providing patient care directly, or indirectly through included subsidiaries; and
If the applicant is an individual that was providing patient care, have gross receipts or sales from providing patient care reported on Form 1040, Schedule C, Line 1, excluding income reported on a W-2 as a (statutory) employee.

ARP Rural Distribution:

In accordance with the statutory requirements, to be eligible to apply for ARP Rural Payments, the applicant or at least one subsidiary TINs must be:

A rural health clinic as defined in section 1861(aa)(2) of the Social Security Act; or
A provider treated as located in a rural area pursuant to section 1886(d)(8)(E), such as critical access hospitals; or
A provider or supplier that:
1. Has directly billed for health care-related services between January 1, 2019 and September 30, 2020:
  1. Medicare fee-for-service (Parts A and/or B);
  2. Medicare Advantage (Part C)
  3. Their state/territory Medicaid program (fee-for service or managed care); or
  4. Their state/territory Children’s Health Insurance Program (CHIP); and
2. Operates in or serves patients living in the HHS Federal Office of Rural Health Policy’s (FORHP) definition of a rural area:
  1. All non-Metro counties;
  2. All Census Tracts within a Metropolitan county that have a Rural-Urban Commuting Area (RUCA) code of 4-10. The RUCA codes allow the identification of rural Census Tracts in Metropolitan counties;
  3. 132 large area census tracts with RUCA codes 2 or 3. These tracts are at least 400 square miles in area with a population density of no more than 35 people per square mile; and
  4. 295 outlying Metropolitan counties with no Urbanized Area population.

Source: https://www.hrsa.gov/provider-relief/future-payments

If you have any questions, you can reach out to Craig Douglas at 877-218-2825, or call the HHS Provider Help Line at 866-569-3522. VGM will continue to monitor this program and provide updates if any new changes or updates are announced.

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