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HHS expands relief fund eligibility, updates reporting requirements

The relief resources are meant to assist providers regardless of whether they accept Medicare or Medicaid payments.

Jeff Lagasse, Associate Editor

According to the U.S. Department of Health and Human Services, the latest Provider Relief Fund application period has been expanded to include provider applicants such as residential treatment facilities, chiropractors, and eye and vision providers that have not yet received Provider Relief Fund distributions. 

On October 1, HHS announced it would be making up to $20 billion in new Phase 3 General Distribution funding available for providers on the front lines of the COVID-19 pandemic. 

The relief resources are meant to assist providers regardless of whether they accept Medicare or Medicaid payments. HHS also said it will be updating its most recent PRF reporting instructions to broaden use of provider relief funds.

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Under the Phase 3 General Distribution, which began accepting applicants on October 5, HHS invited providers that had already received PRF payments to apply for additional funding that considers changes in patient care operating revenue and expenses caused by the coronavirus. 

HHS also expanded the list of eligible applicants to providers who had not previously received PRF payments, including behavioral health providers known to the Substance Abuse and Mental Health Services Administration and certain providers who began practicing in 2020.

Still, pandemic-related needs across the entirety of the provider community remain high. HHS said it is maintaining an open line of communication with providers and provider organizations, members of Congress, and state and local officials.

HHS is also expanding the pool of eligible Phase 3 applicants to include more providers. Many providers who accept Medicare and Medicaid within these new categories of practices have already received a PRF payment, but others have not. HHS said it's working to ensure more providers are eligible.

Eligible practices where providers may now apply for Phase 3 funding, whether or not they accept Medicaid or Medicare, include: behavioral health providers; allopathic and osteopathic physicians; dental providers; assisted living facilities; chiropractors; nursing service and related providers; hospices; respiratory, developmental, rehabilitative and restorative service providers; emergency medical services; hospital units; residential treatment facilities; laboratories; ambulatory healthcare facilities; eye and vision service providers; physician assistants and advanced practice nurses; nursing and custodial care facilities; and podiatric medicine and surgery service providers.


In September, HHS published final reporting guidance to set expectations for PRF payment recipients. The agency also updated its Frequently Asked Questions to clarify that for purposes of relief payments for lost revenues attributable to COVID-19, recipients must submit information showing a negative change in year-over-year net patient-care operating income.

In response to some of the concerns raised by providers and Congress, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenues attributable to the coronavirus. After reimbursing healthcare-related expenses attributable to coronavirus that were unreimbursed by other sources, providers may use remaining PRF funds to cover any lost revenue, measured as a negative change in year-over-year actual revenue from patient-care-related sources.

Twitter: @JELagasse
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