The federal government this week is distributing $2 billion in Phase 4 Provider Relief Funds (PRF) to more than 7,600 health care providers nationwide. To date, the U.S. Department of Health and Human Services (HHS) has not indicated what portion of those dollars will go to hospice providers. 

HHS manages the PRF through a sub-agency, the Health Resources and Services Administration (HRSA). Congress enacted the program in 2020 via the CARES Act, which earmarked $175 billion in PRF 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. The agency’s last PRF outlay occurred in Dec. 2021, totalling $9 billion.

“Provider Relief Fund payments have served as a lifeline for our nation’s heroic health care providers throughout the pandemic, helping them to continue to recruit and retain staff and deliver care to their communities,” said HHS Secretary Xavier Becerra in a statement.

To date, the current fourth phase of the program has distributed a total of $11 billion to more than 74,000 providers in all 50 states, five territories and the District of Columbia. HHS indicated that thus far the agency has processed nearly 82% of all Phase 4 applications.

HRSA last December also paid out close to $7.5 billion to about 43,000 rural health care organizations through a separate program, the American Rescue Plan.

Phase 4 PRF payments have been weighted to reimburse smaller providers at high rates and include additional payments to providers that care for Medicaid, Children’s Health Insurance Program (CHIP) and Medicare beneficiaries. The payment amounts for this phase are based on providers’ pandemic-related revenue losses that occurred between July 1, 2020, and March 31, 2021.

Nearly two years into the pandemic, hospices continue to face surging costs for personal protective equipment (PPE) supplies and COVID-19 testing kits, paid leave for staff and investments in telehealth. They have also seen declines in institutional referrals and hospice length of stay, further eroding their margins.

Providers are now also faced with the cost of implementing the U.S. Centers for Medicare and Medicaid Services COVID-19 vaccine mandate for health care workers, which some in the hospice space have said should come with additional provider aid. This includes the National Hospice & Palliative Care Organization (NHPCO), which supported the mandate.

“Any vaccine requirement would have to come along with additional support,” NHPCO President and CEO Edo Banach told Hospice News last September. “It does cost money, and it could cost even more to make sure that we can stem the loss of individuals who work for our members.”

HHS defines “lost revenue” as any amount that a health care provider lost due to the COVID-19 public health emergency. The agency later clarified that hospices can include revenue lost due to diminished fundraising and philanthropic donations in their relief requests.

Philanthropic and fundraising dollars often finance programs such as palliative care services, complementary therapies, hospice houses as well as programs for the homeless, among other initiatives.

“The COVID-19 pandemic is an unprecedented challenge for health care providers and the communities they serve,” HRSA Administrator Carole Johnson said in a statement. “The Provider Relief Fund remains an important tool in helping to sustain the critical health care services communities need and support the health care workforce that is delivering on the frontlines every day.”