COVID-19 Stimulus Passes with Support for Rural Hospices, but No Additional PRF

The American Rescue Plan of 2021 has cleared its last congressional hurdle before going to President Biden for signature. The $1.9 trillion stimulus package contains $8.5 billion in aid targeted at rural providers, including hospices. However, the bill did not increase the Provider Relief Fund (PRF) or extend the moratorium on payment sequestration. 

The U.S House of Representatives approved the bill, which has already cleared the Senate. The president is expected to sign before March 14 when unemployment benefits associated with previous COVID relief are set to expire.

“We applaud lawmakers for working together to find solutions for Americans who continue to be hit hard by the COVID-19 pandemic,” said Jon Broyles, executive director of the Coalition to Transform Advanced Care (C-TAC). “As vaccines roll out and variants spread, the landscape of this emergency is constantly evolving.”


Similar to the PRF, the rural health funds will go to help replace revenues lost due to COVID-19 for eligible providers. These include organizations that furnish home health, hospice, or long-term services and support in the home in rural areas. Hospices seeking to access these funds must submit a statement justifying the need for the payment, including documentation of associated expenses and lost revenues.

The legislation also contains $12 billion in funds to support Medicaid home-and-community based services, and $140 million to support health care providers mental and emotional well being during the pandemic. An additional $10 billion is allocated to boost production of medical supplies and equipment through the Defense Production Act, as well as funding for for vaccine programs. 

“The dedicated funding for Medicaid home and community based services will ensure home care recipients can continue to receive care in the safest possible environment, their home,” a National Association for Home Health & Hospice spokesperson said in an email to Hospice News. “Likewise, the increased provider relief funding for rural providers will prove to be a lifeline for patients and providers alike to continue care delivery in rural areas.”


The CARES Act, enacted on March 27, earmarked $175 billion to health care providers across the continuum through the PRF. The new stimulus did not include additional dollars for the program aside from the rural provisions.

The new stimulus bill also did not extend the suspension of payment sequestration which is set to expire March 31. Sequestration began in 2014 under the auspices of the Budget Control Act. CMS began reducing payments to hospice providers by 2% across the board as a cost control measure.

“We’re glad to see Congress swiftly enacting the American Rescue Plan, which includes several important provisions that will help with COVID mitigation, and vaccination among older adults and their care providers including hospice providers,” Ruth Katz, senior vice president of policy at LeadingAge, told Hospice News. “While it does deliver Provider Relief Funds to rural providers including hospice providers, it fails to deliver relief to non-rural aging services providers throughout the continuum.”

A provision that may benefit providers is the extension and expansion of tax credits created in the Families First Coronavirus Response Act of 2020. This provides payroll tax credits for employers who voluntarily provide paid leave through the end of September 2021.

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