Update: If missed deadline, complete PRF reporting by April 22

Originally published in the April 7, 2022, issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

Due in large part to #MGMAAdvocacy, the Health Resources & Services Administration (HRSA) will allow medical groups who missed the Provider Relief Fund (PRF) reporting deadline to submit a “Request to Report Late Due to Extenuating Circumstances for Reporting Period 1” between April 11 and April 22, 2022, at 11:59 p.m. ET. Physician practices should receive information about how to submit a request directly from HRSA via email. Recipients must attest to an extenuating circumstance, examples of which are listed in the linked guidance above.

If HRSA approves the extenuated circumstances form, you will receive a notification to proceed with completing PRF Period 1 reporting shortly thereafter. Providers will have 10 days from the notification receipt date to submit the late Period 1 report in the PRF Reporting Portal.

Apply Now for Phase 4 and ARP Rural Distributions

The application is now open for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments.

• Apply via the Provider Relief Fund Application and Attestation Portal
• Review the Application Instructions Webpages

The application will close on October 26, 2021 at 11:59 p.m. ET. Applications must undergo a number of validation checks before financial information is submitted so providers are encouraged to begin their application as soon as possible to ensure they are able to meet the deadline.

In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application, and HRSA will use existing Medicaid, Children’s Health Insurance Program (CHIP), and Medicare claims data in calculating portions of these payments.

Click here for a printable flyer

RESCHEDULED to January 27th: Curi Provider Relief Fund Grant Webinar

Getting It Right: Using and Reporting on Provider Relief Fund Grants

January 27, 2021 | 12:00 PM – 1:00 PM EST

As part of Curi’s ongoing effort to help practices weather the COVID-19 crisis, they invite you to join them for this webinar on Provider Relief Fund Grant reporting. The session, led by healthcare attorney Robert Shaw of the firm Smith Anderson, will help you learn what you need to know to accurately report to HHS on how your practice has spent these funds, which can be used to compensate for lost revenue due to the pandemic.

Curi is rescheduling this webinar due to some technical difficulties during their originally scheduled date and time. Follow the online registration link at the button below to join Curi on January 27th.

Click here for online registration

Provider Relief Funds Deadline Extended to September 13th

The Centers for Medicare & Medicaid Services (CMS) announced the deadline for Medicaid/CHIP providers to submit their financial data to apply for federal Provider Relief Funds has been extended to Sept. 13, 2020.

Providers that have not yet submitted their applications are encouraged to apply. Providers who received payments from the Provider Relief Fund previously or had a change in ownership are now eligible to receive payments. More information is available in SPECIAL BULLETIN COVID-19 #126: New Deadline for Medicaid Providers Applying for Federal Relief Funds.

HHS to reopen Provider Relief Fund applications for certain Medicare providers

Originally published in the August 6, 2020 issue of MGMA’s Washington Connection. Reprinted with permission from MGMA.

HHS announced it will allow a second opportunity for Medicare providers to access payments from the CARES Act Provider Relief Fund (PRF). Starting the week of Aug. 10, HHS will permit Medicare providers that missed the opportunity to apply for additional funding from the $20 billion second tranche of the $50 billion Medicare General Distribution. This opportunity will also be opened to Medicare providers that experienced a change in ownership in 2020 and therefore failed to receive a PRF payment based on 2019 CMS claims data. Both groups of providers will have until Aug. 28 to submit their revenue information to be considered for additional funding. Additional information on this second funding opportunity is expected via the PRF webpage next week.

$15B More in Relief Available for Those Participating in Medicaid/CHIP

Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers who participate in state Medicaid and CHIP programs. HHS expects to distribute approximately $15 billion to these eligible clinicians who have not already received a payment from the Provider Relief Fund General Allocation.

Tomorrow, Wednesday, June 10, HHS is launching an enhanced Provider Relief Fund Payment Portal that will allow eligible Medicaid and CHIP providers to report their annual patient revenue, which will be used as a factor in determining their Provider Relief Fund payment. The payment to each provider will be at least 2 percent of reported gross revenue from patient care; the final amount will be determined after the data is submitted, including information about the number of Medicaid patients served.

The initial General Distribution provided payments to approximately 62 percent of all those participating in state Medicaid and CHIP programs. This Medicaid and CHIP Targeted distribution will make the Provider Relief Fund available to the remaining 38 percent. HHS has already provided relief funding to over one million providers, and today’s announcement is expected to reach several hundred thousand more, many of whom are safety net providers operating on thin margins.

This funding offers relief to those experiencing lost revenues or increased expenses due to COVID-19. Examples of providers, serving Medicaid/CHIP beneficiaries, possibly eligible for this funding include pediatricians, obstetrician-gynecologists, dentists, opioid treatment and behavioral health providers, assisted living facilities and other home and community-based services providers.

To be eligible for this funding, health care providers must not have received payments from the $50 billion Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs for health care-related services between January 1, 2018, to May 31, 2020. Close to one million health care providers may be eligible for this funding.

Read the announcement.

Learn more about eligibility and the application process here. 

HHS also announced the distribution of $10 billion in Provider Relief Funds to safety net hospitals. The safety net distribution will occur this week. For updated information and data on the Provider Relief Fund, visit hhs.gov/providerrelief

MGMA to HHS: Disburse remaining Provider Relief Funds

MGMA is urging the Department of Health & Human Services (HHS) to expeditiously provide financial relief to group practices by disbursing the remaining Provider Relief Funds. Congress appropriated $175 billion to HHS to deliver financial relief to healthcare providers in order to cover expenses and lost revenue attributable to COVID-19. HHS is making disbursements through a $50 billion General Distribution, however some providers that submitted applications for additional funding have yet to receive payments, despite applying over a month ago. MGMA is encouraging HHS to quickly deliver funds pursuant to those applications.

After accounting for disbursements to date, HHS still has approximately $95 billion in unallocated Provider Relief Funds. Since eligibility for payments under the $50 billion General Distribution was contingent upon Medicare enrollment, MGMA is urging HHS to support group practices underrepresented in this distribution, such as providers that do not accept Medicare.

HHS extends deadline for acceptance of terms and conditions for Provider Relief Fund payments

HHS announced another extension to the deadline to accept the Terms and Conditions for Provider Relief Fund payments from the $50 billion general distribution. Providers now have 90 days from the date they received a Provider Relief Fund payment to accept the Terms and Conditions or return the funds. For example, providers that received funds on April 10 will have a new deadline for attestation of July 9. Furthermore, providers that do not accept the Terms and Conditions after 90 days of receipt will be deemed to have accepted the funds and associated Terms and Conditions.

MGMA will continue to track and report developments pertaining to the HHS Provider Relief Funds, including the nearly $100 billion in appropriated funding that has yet to be allocated.

MGMA advocates for additional relief for physician practices, ACOs

Last week, Democratic leadership in the U.S. House of Representatives introduced the ‘‘Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act,” which includes several provisions that directly pertain to medical practices. The legislation would make further amendments to the PPP, Medicare’s Advance Payment Program, and the Provider Relief Fund. While this bill is not expected to pass due to lack of bipartisan support, MGMA offered several key recommendations for consideration as Congress works to come to a bipartisan agreement.

Additionally, MGMA and other industry-leading associations have urged the Centers for Medicare & Medicaid Services (CMS) to provide flexibility for practices participating in a Medicare accountable care organization (ACO) and to protect them from potentially harmful losses created by the COVID-19 pandemic. Specifically, MGMA called on CMS to:

• Adopt a policy to give ACOs an option to be protected from losses in exchange for a reduced shared savings rate, no less than 40%;
• Extend the current June 1 Medicare Shared Savings Program (MSSP) deadline to voluntarily terminate to avoid financial losses to no earlier than Oct. 31;
• Reverse its decision to cancel the 2021 MSSP application cycle; and

Pay ACO shared savings payments and advanced alternative payment model bonuses as soon as possible

Regulatory Alert: HHS CARES Act Grant Funding Attestation Portal Now Open

Originally published by MGMA on April 16, 2020
Reprinted with permission from MGMA

The Attestation Portal for the initial $30 billion general distribution from the Department of Health & Human Services (HHS) is now open. Providers that received a payment from HHS as part of the Provider Relief Fund authorized under the CARES Act must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions within 30 days of receiving payment.

To complete the attestation, billing entities must provide their Taxpayer Identification Number. Should you choose to reject the funds, you must also complete the attestation to indicate this. The Portal will guide you through the attestation process to accept or reject the funds.

Group practices with questions about the grant funds can call the Provider Relief hotline at (866) 569-3522. Please note that the terms and conditions are subject to further clarification by HHS, and MGMA will pass along any additional guidance if it is made available.