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Phase 4 Application Portal Open

Tiffany Karlin

September 29, 2021

On Wednesday, September 29th, the HRSA Reporting Portal opened to apply for Phase 4 Provider Relief Funding.  This Phase 4 Funding consists of $17 billion for healthcare providers who exhibit continued loss in revenue and expenses due to COVID-19 and $8.5 billion to the American Rescue Plan resources who serve rural patients.  Click here to learn more from our previous client alert.

Providers have until Tuesday, October 26, 2021 at 11:59PM EST to apply for additional funds.

Similar to the application process for Phase 3, Phase 4 funding requires quarter by quarter reporting of patient care revenues, and expenses and associated supporting documentation. The quarter breakdowns can be found below.

2019 Q1 (Jan 1 – Mar 31)

2019 Q3 (July 1 – Sept 30)

2019 Q4 (Oct 1 – Dec 31)

2020 Q3 (July 1 – Sept 30)

2020 Q4 (Oct 1 – Dec 31)

2021 Q1 (Jan 1 – Mar 31)

Supporting documentation needed:

  • A comprehensive list of all billing TINs under the filing TIN that provide patient care and are owned by the filing TIN that is applying.
  • Internally-generated financial statements that substantiate operating revenues and expenses from patient care in 2019 Q1, Q3, and Q4; 2020 Q3 and Q4; and 2021 Q1.
  • Federal income tax return, audited financial statements, or internally-generated financial statements submitted in their entirety

Example of reporting information required: Click here to download.

Example of Annual Revenues Patient Care worksheet: Click here to download.

Example of Annual Revenues Adjustment worksheet: Click here to download.

Application Instructions: Click here for application instructions.

Terms and Conditions: Acceptance of Terms and Conditions

Similar to other “general fund” distributions, the terms and conditions state that the recipient certifies that the payment will only be used to prevent, prepare for, and respond to coronavirus, and that the payment shall reimburse the recipient only for health care related expenses or lost revenues that are attributable to coronavirus. Additionally, the recipient certifies that it will not use the payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.

FAQs: Click here.

Definitions of Patient Care Revenue and Expenses: Operating Revenues from Patient Care

“Operating revenues from patient care” means revenues that represent amounts received for the delivery of health care services directly to patients. Operating revenues from patient care include:

  • Revenues for patient services delivered;
  • Prescription sales revenues derived through the 340B program; and
  • Interest and depreciation on building and equipment used in the provision of patient care.

The following are not considered patient care revenues and must be excluded from the reported patient care revenues figures:

  • Insurance settlements;
  • Retail, or real estate revenues (exception for nursing and assisted living facilities’ real estate revenues where resident fees are allowable);
  • Prescription sales revenues (exception when derived through the 340B program);
  • Grants or tuition;
  • Contractual adjustments from all third-party payors;
  • Charity care adjustments;
  • Bad debt;
  • Any gains and/or losses on investments;
  • Prior PRF payments received; and
  • Other pandemic assistance received, including Rural Health Clinic COVID-19 Testing funds.

Operating Expenses from Patient Care

“Operating expenses from patient care” means the operating expenses incurred as part of the delivery of care, including:

  • Salaries and benefits;
  • Contracted and/or employed physicians;
  • Medical supplies; and
  • Interest and depreciations on building and equipment used in the provision of patient care.

The following are not considered patient care expenses and must be excluded from the reported patient expenses figures:

  • Any non-operating expense such as costs incurred on any rental property not used for direct patient care (e.g., nursing and assisted living facilities’ real estate costs where resident costs are allowable),
  • Contributions made; and
  • Gains and/or losses on investments.

Reporting Subsidiaries:

Applications must be consolidated across eligible subsidiaries and submitted by the parent entity. Applications must be made at the filing TIN level, whenever possible. Applications must include all subsidiaries that provide patient care.

Payment Methodology: Click here for payment methodology.

PRF Phase 4 consists of two components:

  1. Base Payments: Approximately 75% of the funding will be allocated to providers based on their reported changes in revenues and expenses for the period from July 1, 2020 to March 31, 2021. Smaller and medium-sized providers (based on annual net patient care revenues) will receive relatively higher percentages of their changes in revenues and expenses from this period.
  2. Bonus Payments: Approximately 25% of the funding will be used to make bonus payments to providers based on the provider’s level of participation in Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare.

Where to apply: Click here to apply.

Application Process:

As always, our team is here to assist with the application, and guidance as well as the Provider Relief Reporting Requirements.  Please contact us for assistance!

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