HHS Announces New COVID Relief Funding and Extension of First PRF Reporting Deadline
The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced $25.5 billion in new funding for health care providers affected by the COVID-19 pandemic. This funding includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.
The application will open on September 29, 2021. Providers will apply for both programs in a single application and HRSA will use existing Medicaid/CHIP and Medicare claims data in calculating portions of these payments.
Phase 4 General Distribution – $17 billion will be distributed based on providers’ lost revenues and changes in operating expenses from July 1, 2020 to March 31, 2021.
To promote equity and to support providers with the most need, HRSA will:
- Reimburse a higher percentage of lost revenues and expenses for smaller providers as compared to larger providers.
- Provide “bonus” payments based on the amount of services provided to Medicaid, CHIP, and Medicare patients, priced at the generally higher Medicare rates.
- American Rescue Plan (ARP) Rural — $8.5 billion based on the amount of services providers furnish to Medicaid/CHIP and Medicare beneficiaries living in Federal Office of Rural Health Policy (FORHP)-defined rural areas.
- Providers can review eligibility information posted on the PRF Future Payments web page Additional detail will be added prior to September 29.Providers can review eligibility information posted on the PRF Future Payments web page Additional detail will be added prior to September 29.
- HHS also released detailed information about the methodology utilized to calculate Phase 3 payments. Providers who believe their Phase 3 payment was not calculated correctly according to this methodology will now have an opportunity to request a reconsideration.
Grace Period for Reporting Period 1
In light of the challenges providers across the country are facing due to recent natural disasters and the Delta variant, HHS is also announcing a final 60-day grace period to help providers come into compliance with the September 30, 2021 deadline for the first PRF Reporting Time Period. While the deadlines to use funds and the Reporting Time Period will not change, HHS will not initiate collection activities or similar enforcement actions for noncompliant providers during this grace period. Several helpful resources can be found at on the PRF Reporting web page.
Medicare 10% Reduction in Reimbursement for Anesthesia has been reduced to 3%, effective 01/01/2021
The approximate 10 percent reduction in the anesthesia conversion factor (CF) scheduled to take effect on Jan 1, 2021 has been modified. A statement published by the American Society of Anesthesiologists (ASA) provided the following take on the CAA:
The scheduled cut to the anesthesia conversion factor will be reduced to a 3% cut rather than the previously proposed 10% cut. An improvement, but still entirely inadequate for a specialty already hampered with a flawed payment rate, whose members are caring for COVID-19 patients on the frontlines of the pandemic.
According to an update released by the Centers for Medicare and Medicaid Services (CMS), the new national anesthesia CF will officially be 21.5600 for 2021 instead of the originally set anesthesia CF of 20.0547. This translates to a 2.9 percent reduction from the 2020 anesthesia CF, which is far better than the 9.7 percent reduction that was authorized in the 2021 Medicare Physician Fee Schedule (PFS) Final Rule. Your exact anesthesia CF will vary depending on your geographic location. You can search for the CF in your area by going to the following CMS link: Anesthesiologists Center | CMS.
