COVID-19 Funding

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The U.S. Department of Health and Human Services (HHS) has provided much-needed funding to many long term care facilities through the CARES Act Provider Relief Fund (PRF) and Quality Incentive Program (QIP). These funds support American families, workers, and the heroic health care providers in the battle against the COVID-19 outbreak.

AHCA/NCAL is helping our skilled nursing and assisted living​ member providers address PRF and QIP issues through work with Capitol Hill and the Administration. In partnership with our state affiliates, AHCA/NCAL is collecting outstanding funding concerns our members are facing. Contact with any questions.

UPDATE: HHS released​ updated reporting requirements for recipients of PRF payments. With this announcement, HHS expands the amount of time providers will have to report information, aims to reduce burdens on smaller providers, and extends key deadlines for expending PRF payments for recipients who received payments after June 30, 2020. Read More​

 Provider Relief Fund

The Provider Relief Fund​ (PRF) supports health care providers in the battle against the COVID-19 pandemic. This funding is provided through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act.​

 PRF Resources

Update: Provider Relief Fund FAQs
HHS recently updated the ​Provider Relief Fund (PRF) FAQs to clarify Ownership Structures and Financial Relationships between “parent” and “subsidiary” entities that received PRF funding (General and Targeted).

Provider Relief Fund Questions
There are several resources to assist with PRF questions. Contact the CARES Act Fund Hotline at (866) 569-3522 (for TTY dial 711). You can also review the HHS Frequently Asked Questions, which includes information about using the PRF for vaccine administration​.​

WebEx: Provider Relief Fund Reporting Requirements
This WebEx recording includes registration details, registration FAQs, recommended terms and conditions compliance controls, and a PRF reporting update overview.

U.S. Government Accountability Office (GAO) Report
The January 28th GAO report – Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal Attention (GAO-21-265) – made several recommendations (focused around areas like COVID-19 testing, vaccines and therapeutics, and the medical supply chain) to federal agencies to improve the ongoing response and recovery efforts in the areas of public health and the economy. It is important to note that there is a summary of the PRF allocations and disbursements as of 12/31/20 on page 54.

This document offers detail on u​se of funds for health care related expenses and transfer of funds to higher need buildings. 

 Quality Incentive Payments

AHCA/NCAL is advocating on behalf of our members to provide the necessary resources regarding the Quality Incentive Payments (QIP), as well as promoting a fairer incentive program. This step-by-step chart is available to help providers correct any previously made errors when filling out NHSN data. 

Entering this data is valuable in determining how cases are spreading throughout facilities.

With the distribution of December QIP payments on Friday, February 12, it appears that this will be the last payment that HHS will make for this program. Although HHS previously stated there would be an aggregate payment, the running total through December is $2 billion – which is the total allocated for the program.

The county population and county case rate are factored in the methodology, as well as the resident occupancy level and resident case rate. The vast majority of facilities with at least 1 infection will not receive payment. The number of facilities paid per month decreased from around 10,000 in September to 6,000 in December due to the increasing number of cases in the later months of the program. Additionally, since all of the factors varied in each month, the payment you may have received can also vary widely.



PRF Reporting Period 3 Due September 30 Reporting Period 3 Due September 309/22/2022 4:00:00 AM<p>​</p><div>Providers who received Provider Relief Fund (PRF) payments exceeding $10,000, in the aggregate, between January 1, 2021- June 30, 2021, are required to report in Reporting Period 3 (RP3). There will be no extension. <strong>You must submit a report on use of funds by September 30, 2022, at 11:59 p.m. ET.</strong></div><div><br></div><div>On September 8, 2022, providers received a notification, based on their status in the reporting process, reminding them of their reporting requirement. The RP3 reminder email for <strong>providers registered but who have not yet reported</strong> may be viewed <a href="/Reimbursement/Documents/PRF/RP3%20-%20Reporting%20Reminder%20Email%20-%20Registered,%20Not%20Started.pdf" data-feathr-click-track="true" target="_blank">here</a>. The RP3 reminder email for <strong>providers registered and in progress</strong> may be viewed <a href="/Reimbursement/Documents/PRF/RP3%20Reporting%20Reminder%20Email%20-%20Registered,%20In%20Progress.pdf" data-feathr-click-track="true" target="_blank">here</a>. <br></div><div><br></div><div><strong>Request to Report Late Due to Extenuating Circumstances</strong></div><div><br></div><div>Providers who experienced one or more extenuating circumstances that prevented them from submitting a completed PRF Report in Reporting Periods 1 and/or 2 (RP1 and RP2) by the deadline had the opportunity to submit a Request to Report Late Due to Extenuating Circumstance. The opportunities to submit late reports for RP1 and RP2 have passed. While it’s anticipated that the Extenuating Circumstances option will be offered for RP3, providers are highly encouraged to complete the report by the September 30 deadline. It is a request process that will open and approved providers will be required to submit reports in a two-week window of time.</div><div><br></div><div>For more details about the Extenuating Circumstances process and what is considered in this category, please review the <a href="" data-feathr-click-track="true" target="_blank">Request to Report Late Due to Extenuating Circumstances webpage</a>. </div><div><br></div><div><strong>Upcoming reporting periods:</strong></div><div><br></div><div><ul><li>​Reporting Period 4 opens on January 1, 2023</li><li>Reporting Period 5 opens on July 1, 2023</li></ul></div><div><br></div><div><strong>Need Help with Reporting?<br><br></strong></div><div>HRSA has detailed answers to common questions related to reporting requirements and auditing. Read the <a href="" data-feathr-click-track="true" target="_blank">PRB Reporting and Auditing FAQ</a>.</div><div><br></div><div>For all other questions related to reporting, call the Provider Support Line at 866-569-3522; for TTY, dial 711. Hours of operation are 9 a.m. - 11 p.m. ET, Monday through Friday. Hours are subject to change.</div><div><br></div><div><strong>Providers Must Enroll in Optum Pay to Claim their Payments</strong></div><div><span style="font-size:11pt;">Deadline to Enroll: October 21, 2022, at </span><span style="font-size:11pt;">6</span><span style="font-size:11pt;"> p.m. E</span><span style="font-size:11pt;">T</span><br></div><div><br></div><div>There are PRF Phase 4 or American Rescue Plan (ARP) Rural payments available, but providers have not taken the required actions to receive their funds. HRSA has attempted to contact these providers through the point of contact listed on the application. </div><div><br></div><div><strong>A FINAL REMINDER was sent: to receive these funds, providers must fully complete an </strong><a href="" data-feathr-click-track="true" target="_blank"><strong>Optum Pay account</strong></a><strong> </strong><strong>by October 21, 2022 at 6 p.m. ET. Fully enrolling in Optum Pay may take up to 10 business days. Enrollment MUST be completed before the deadline.</strong><br></div><div><br></div><div>HRSA’s program integrity safeguards require providers receiving payments over $100,000 to register for an Optum Pay account to retrieve their payment. An explanation of the requirement was included in the application guidance.</div><div><br></div><div>Depending on when providers have successfully enrolled in Optum Pay, it may take an additional two weeks for funds to be available in their accounts.</div><div><br></div><div>For more information on PRF Phase 4 and ARP Rural payments, visit <a href="" data-feathr-click-track="true" target="_blank"></a>.</div><div><br></div><div><strong>Instructions for Setting Up an Optum Pay Account</strong></div><div><br></div><div>Visit <a href="" data-feathr-click-track="true" target="_blank"></a> to begin the online enrollment process. Providers must use the TIN associated with their Phase 4 PRF application to enroll. This process will not involve credentialing or contracting with UnitedHealth Group. The information providers submit will only be used to administer PRF and ARP Rural payments. Required information:<br><br></div><div><ul><li>​Organization demographic information (name, phone number and email address)</li><li>Contact information for one or two individuals from the organization to support administration and oversight of the account, including editing bank account deposit information for any future payments</li><li>The organization's banking information (routing number, account number, and account type)</li><li>Clear, legible, and unaltered voided check and/or a bank letter signed and dated from a bank officer</li><li>Clear and legible IRS Form W-9 signed and dated within 1 year</li></ul></div><div><br></div><div>To date, HRSA has released approximately $15.4 billion to more than 90,000 providers. Almost all (99 percent) applications have been processed. If a facility is anticipating a payment and it hasn’t been received, check the status of its Optum Pay account. </div><div><br></div><div><strong>For additional support with the Optum Pay set-up, please call the Provider Support Line at 866-569-3522 or the Optum Support line at 877-620-6194.</strong><br></div>Providers who received Provider Relief Fund payments exceeding $10,000, in the aggregate, between Jan. 1- Jun. 30, 2021, are required to report in Reporting Period 3.
Provider Relief Fund Reminders Relief Fund Reminders8/2/2022 4:00:00 AM<p>​<br></p><div><strong>Phase 4 and ARP Rural Distributions - Payment Status </strong></div><div><br></div><div>Approximately $14.5 billion of Phase 4 Payments has been distributed to more than 89,000 providers and 98 percent of applications have been processed. To date, more than $8 billion has been distributed through ARP Rural Payments and 99% of applications have been processed.   </div><div><br></div><div>For the applications pending review, HRSA continues to make payments on a rolling basis every few weeks. Please continue to check the Provider Support Line at 866-569-3522; for TTY, dial 711 for status updates.   </div><div><br></div><div>Providers should be aware that payment notifications are sent from the email address <a href="" data-feathr-click-track="true" target="_blank"></a>. Providers are advised to add this address to their “Safe Sender” list and check their “Spam” and “Junk Mail” folders regularly to ensure that they do not miss payment notifications or related correspondence. </div><div><br></div><div>Providers are also encouraged to check the status of their Optum Account by calling the Optum Pay Support line at 877-620-6194 to make sure the account is “active” and ready to receive payment. </div><div><br></div><div><strong>Provider Relief Fund Reporting Period 3 Reminder  </strong></div><div><br></div><div>Reporting Period 3 (RP3) is open as of July 1, 2022. The deadline to use funds for payment RP3 was June 30, 2022. </div><div><br></div><div>Providers who received Provider Relief Fund (PRF) payments exceeding $10,000 in the aggregate between January 1, 2021, and June 30, 2021, are required to report in RP3. <strong>The deadline for providers to submit a report is September 30, 2022, at 11:59 PM ET.  </strong></div><div><br></div><div>Reports must be submitted via the <a href="" data-feathr-click-track="true" target="_blank">PRF reporting portal</a>. <strong>Providers who do not submit a completed report by the deadline will be subject to further enforcement actions. </strong></div><div><br></div><div><strong>Reporting Help </strong></div><div><br></div><div>Providers may visit the <a href="" data-feathr-click-track="true" target="_blank">PRF Reporting Requirements and Auditing Webpage</a> and view the below technical assistance webcasts for assistance with their reports: </div><div><br></div><div><ul><li>​New Reporters: <a href="" data-feathr-click-track="true" target="_blank">Webinar Recording (July 12, 2022)</a><br></li><li>Returning Reporters: <a href="" data-feathr-click-track="true" target="_blank">Webinar Recordin​g (July 13, 202</a>2)<br></li><li><a href="" data-feathr-click-track="true" target="_blank">Nursing Home Infection Control Reporting Webcast (February 17, 2022)​</a>  </li></ul></div><div><br></div><div><strong>Upcoming reporting periods: </strong></div><div><br></div><div><ul><li>Reporting Period 4 opens on January 1, 2023 </li><li><span style="font-size:11pt;">Reporting Period 5 opens on July 1, 2023 </span></li></ul></div><div><br><strong></strong><strong>Request to Report Late Due to Extenuating Circumstances </strong></div><div><br></div><div>Providers who experienced one or more extenuating circumstances that prevented them from submitting a completed PRF Report in Reporting Periods 1 and/or 2 (RP1 and RP2) by the deadline had the opportunity to submit a Request to Report Late Due to Extenuating Circumstance. <strong>The opportunities to submit late reports for RP1 and RP2 have passed. </strong></div><div><br></div><div>Providers who did not submit an RP1 report by the deadline and returned funds prior to HRSA announcing the Request to Report Late Due to Extenuating Circumstances process have a one-time opportunity to have their RP1 PRF payment(s) reissued. <strong>The projected window for report submissions is August 22 to September 9, 2022. </strong></div><div><br></div><div>Review the Request to Report Late Due to Extenuating Circumstances <a href="" data-feathr-click-track="true" target="_blank">webpage</a> for more details on this new process. </div><div><br></div><div><strong>Need Reporting Help? </strong></div><div><br></div><div>Answers to common questions related to reporting requirements and auditing. Read the <a href="" data-feathr-click-track="true" target="_blank">Reporting and Auditing FAQ</a>. </div><div><br></div><div>For all other questions related to reporting, call the Provider Support Line at 866-569-3522; for TTY, dial 711. The hours of operation are 8:00 AM to 10 PM CT, Monday through Friday. Hours are subject to change. ​<br></div>Approximately $14.5 billion of Phase 4 Payments has been distributed to more than 89,000 providers and 98 percent of applications have been processed.
HRSA Offers New PRF Reporting Flexibilities Offers New PRF Reporting Flexibilities4/8/2022 4:00:00 AM<p></p><div>HRSA has announced information on the opportunity to request the submission of a late Provider Relief Fund report based on extenuating circumstances for payments received between April 10 to June 30, 2020. Below is detailed information that is also located on the <a href="" data-feathr-click-track="true" target="_blank">HRSA PRF website</a>. </div><div> </div><div><strong>If a provider who missed Reporting Period 1 has not previously registered for the PRF Reporting Portal, the provider should proceed with registering now by visiting </strong><a href="" data-feathr-click-track="true" target="_blank"><strong></strong></a><strong> and click on “Register” located below “First Time User? Click on “Register” to create an account” on the left side of the page.</strong> They may call the Provider Support Line at 866-569-3522 for help with registering.</div><div><br></div><div>Starting April 11, 2022, providers that missed Reporting Period 1 due to extenuating circumstances will be able to submit their request for a late report through April 22, 2022. Then, the opportunity to complete the report will approximately start on May 9. The providers approved for late reporting will receive notification of the limited timeframe to complete the report at the email shared when they submitted their request for a late report. <strong>It will be a two-week opportunity to complete and submit the report, and there will be no option for extension to the communicated deadline.</strong> </div><div><br></div><div>Providers should not return the PRF funds per the March 2022 letter from HRSA. HRSA will contact providers in the future on the return of funds if they do not submit a request for a late report or complete the required report. Until the required report is submitted, the provider remains out of compliance with the reporting requirement for Reporting Period 1, which will impact the provider's eligibility to receive additional PRF payments.<br></div>HRSA announced the opportunity to request the submission of a late PRF report based on extenuating circumstances for payments received between April 10 to June 30, 2020.
Provider Relief Fund Updates: Phase 4 Awards Continue and Reporting Period 1 Challenges Relief Fund Updates: Phase 4 Awards Continue and Reporting Period 1 Challenges3/23/2022 4:00:00 AM<div><span style="font-size:14.6667px;">​The Health Resources and Services Administration (HRSA) announced it is making more than $413 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 3,600 providers across the country this week. Providers would have received an email notification on March 21 if their application was among those processed in this latest batch. HRSA is working to review all remaining applications as quickly as possible and anticipates another round of Phase 4 to be released in late April or early May. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">For more information: </span></div><div><ul><li>​The U.S. Department of Health and Human Services (HHS) updated the <a href="" data-feathr-click-track="true" target="_blank">state-by-state table</a> detailing all Phase 4 payments made to date.  </li><li>As individual providers agree to the terms and conditions of Phase 4 payments, it will be reflected on the <a href="" data-feathr-click-track="true" target="_blank">public dataset</a>.  <br></li></ul></div><div><span style="font-size:11pt;">If you have neither received your Phase 4 award nor a No Pay Letter, your Phase 4 payment likely is still in manual review. </span><br></div><div><span style="font-size:14.6667px;"><br></span></div><div style="text-align:center;"><span style="font-size:14.6667px;"><strong>Reporting Period 1 Challenges</strong> </span></div><div><br></div><div>Providers began receiving failure to report notifications beginning March 14. AHCA/NCAL identified three reasons for receiving such a notification: <br> </div><div><ol><li><span style="font-size:11pt;">​SNF Targeted Allocation Filed at Parent Level: All Targeted Allocations must be reported on at the subsidiary level, not parent. </span></li><li>Omitted sections </li><li>Data entry errors </li></ol></div><div>The transmittals providers are now receiving are simply notifications that HRSA believes it has found a problem with Reporting Period 1 (RP1) submissions. The 30-day repayment notification language in these transmittals is confusing. No funds should be returned to HRSA unless a provider receives a Demand Letter. Before Demand Letters, providers will be offered the opportunity to correct reporting errors or for HRSA to determine whether the notification was sent in error. Below is a summary of points verbally shared by HRSA and suggested member action steps. <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What is considered non-compliance?  </strong></span></div><div>Non-compliance is defined as a failure to report funds in any reporting period. Reporting errors are not considered non-compliance. Providers who feel they received the “Failure to Report” email in error (i.e., they did complete their RP1 report), should call the Provider Support for assistance. <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><em>*ACTION ITEM</em>: Provider should check their submitted RP1 reports to ensure they included all General and Targeted Distributions received from April 10, 2020, through June 30, 2020. Stated differently, the provider should self-identify. Keep on file a copy of the submitted letter/report that shows they have completed RP1 by TIN and Funds (General and Targeted). If providers have the needed documentation, they should pursue error correction and only use the documentation if a Demand Letter is sent later. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What happens if the letter was driven by data entry errors</strong><strong>?</strong> </span></div><div>If a provider believes they had typos in their report, call the Provider Support to alert them of a necessary edit. There is significant flexibility to edit. <strong>Use the term “EDIT” - not “MISSED DEADLINE” for RP1 to get in the correct response queue.</strong> If the ‘unused funds’ listed on the report is related to an error in completing the report, there may be the opportunity to revise the report.   <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What if I reported all awards, including SNF Targeted and Infection Control at the parent level?</strong>  </span></div><div>The parent organization may not report on a targeted distribution received by a subsidiary. HRSA has received inquiries related to a Failure to Report from entities that did not report on a Targeted distribution, which is required to be reported by the entity that received it. HRSA’s Customer Service team is finding examples of subsidiaries who failed to report on the Targeted money, though the Parent did report on their general dollars. When contacting the Support Line, providers also should ask about making these reporting corrections. <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>What does it mean to be non-compliant?</strong>  </span></div><div>If the provider did not submit their RP1 report, they are required to return the funds received from April 10, 2020, through June 30, 2020. <strong>Only the funds not in the PR1 must be returned</strong><strong>.</strong> Payments for future distributions will not be awarded until non-compliance for RP1 is corrected. Providers who have not reported will receive a Demand Letter at a future stage with specific action steps if the federal government plans to take recovery steps or other actions outlined in the Terms and Conditions Reporting requirements.   <br></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><em>*ACTION ITEM</em>: Providers who received RP1 failure to report letters to determine whether the HRSA notice was generated due to an error or whether funds were not reported upon. If funds were not reported, providers should review the Terms and Conditions reporting section to assess steps and proactively monitor for HRSA Demand Letters which will contain repayment instructions. ​</span></div>HRSA announced it is making more than $413 million in PRF Phase 4 General Distribution payments to more than 3,600 providers across the country this week.