The Biden Administration is infusing the Provider Relief Fund (PRF) with an additional $17.7 billion. The program is designed to help defray some of the financial burden of the pandemic. The boost to PRF is part of a $25.5 billion package that also includes billions of dollars for the American Rescue Plan and the Children’s Health Insurance Program.

The U.S. Department of Health and Human Services (HHS) and the Health Resources and Services Administration (HRSA) manage the PRF. The program was created via the CARES Act, enacted last year, which earmarked $175 billion to assist health care providers across the continuum. The amount of funds earmarked for each health care sector is based on a percentage of the Medicare reimbursement that a provider receives.

“This funding critically helps health care providers who have endured demanding workloads and significant financial strains amidst the pandemic,” said HHS Secretary Xavier Becerra. “The funding will be distributed with an eye towards equity, to ensure providers who serve our most vulnerable communities will receive the support they need.”

The financial and operational impact of the pandemic has been monumental for hospices. Providers have been in dire need of additional supplies, with acquiring personal protective equipment (PPE) as a top priority. The tremendous global demand for those products has driven up prices. Hospices have also had difficulty accessing patients, investing in new telehealth capabilities and covering paid leave for staff who have been exposed to the virus.

HHS issued guidance on the fund on June 19, 2020 that defined “lost revenue” as any revenue that a health care provider lost due to coronavirus. The agency later clarified that hospices can include revenue lost due to diminished fundraising and philanthropic donations in their relief requests.

The new round of payments, designated PRF Phase 4, will be based on providers’ lost revenues and expenditures between July 1, 2020, and March 31, 2021. HHS indicated that PRF Phase 4 will reimburse smaller providers at a higher rate compared to larger organizations. Phase 4 will also include bonuses for providers that care for Medicaid, CHIP, or Medicare patients who tend to have lower incomes and more complex medical needs. The bonuses will be based on Medicare reimbursement rates.

Stakeholders in the home-based care community have raised concerns that some providers are being left out of the program.

“Home health and hospice will have an opportunity to tap these new funds,” William A. Dombi, president of the National Association for Home Health & Hospice, said. “Our concern is that non-Medicare, non-Medicaid home care is still not included. We have been pushing for their inclusion for months, but have seen no movement on such.”

Those providers tend to be home care companies offering private-pay aide services, or that receive payment from the U.S. Department of Veterans Affairs or regional agencies on aging, according to Dombi.

The application portal will open Sept. 29. HHS will require recipients to inform the agency of any mergers or acquisitions of other providers during the period in which they can use the funds. Regulators may audit some of these buyers to ensure that the PRF funds were applied to pandemic-related costs.

HHS has also implemented a 60-day grace period to providers to comply with PRF Reporting requirements if they do not meet the current Sept. 30 deadline for the program’s first reporting period. The department will not initiate collection activities or enforcement actions during the grace period.

National Hospice & Palliative Care Organization President & CEO Edo Banach told Hospice News that the funds represent a “financial lifeline” for providers contending with rising labor costs, COVID-19 testing requirements, expensive PPE and new vaccine requirements, which NHPCO supported.

“The administration’s announcement is welcome news for hospice and palliative care organizations who have continued to face extraordinary financial burdens from COVID-19,” Banach said. “We will continue engaging with the administration to ensure our member’s voices are heard and relief is delivered.”