Provider Relief Fund Phase 4

On September 29, 2021, the U.S. Department of Health and Human Services (HHS) will open applications for a new round of Provider Relief Fund payments totaling $25.5 billion in distributions, including $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural patients and $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 COVID-19 pandemic.

This round of payments will be based on providers’ lost revenues and changes in operating expenses associated with the COVID-19 pandemic between July 1, 2020 and March 31, 2021.

PRF Phase 4 will also include new elements specifically focused on equity, including reimbursing smaller providers for their lost revenues and COVID-19 expenses at a higher rate compared to larger providers, and bonus payments based on the amount of services providers furnish to Medicaid/CHIP and Medicare patient.

• 75% of the Phase 4 allocation will calculated based on revenue losses and COVID-related expenses.
  • Large providers will receive a minimum payment amount that is based on a percentage of their lost revenues and COVID-related expenses.
  • Medium and small providers will receive a base payment plus a supplement, with small providers receiving the highest supplement, as smaller providers tend to operate on thin margins and often serve vulnerable or isolated communities.
  • HHS will determine the exact amount of the base payments and supplements after analyzing data from all the applications received, but no applicant will receive a Phase 4 payment that exceeds 100% of their losses and expenses.
• 25% of the Phase 4 allocation will be put towards bonus payments that are based on the amount and type of services provided to Medicaid, CHIP, and Medicare patients.
  • HHS will price Medicaid and CHIP claims data at Medicare rates, with some limited exceptions for some services provided predominantly in Medicaid and CHIP.

Providers who serve Medicaid, CHIP, and Medicare patients who live in rural communities are eligible for the ARP Rural payments.

• HHS will make payments to providers based on the amount and type of Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) services provided to rural patients.
  • HHS will price Medicaid and CHIP claims data at Medicare rates, with some limited exceptions for some services provided predominantly in Medicaid and CHIP.
  • Providers who serve any patients living in Federal Office of Rural Health Policy-defined rural areas with Medicaid, CHIP, or Medicare coverage, and who otherwise meet the eligibility criteria, will receive a minimum payment.

The application and additional eligibility details will be posted on HRSA’s Future Payments  page