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Additional Details for Provider Relief Fund (PRF) Phase 4 and Rural Distribution

Posted Sep 16, 20212 min Read

Payment & Reimbursement

Yesterday, the Health Resources and Services Administration (HRSA) released additional details on the $25 billion September 10th announcement composed of the $17 billion Phase 4 distribution and the $8.5 billion rural distribution.  The announcement yesterday also provided information on Phase 3 distribution reconsiderations and a PRF grace period for reporting.

Phase 4 Funding

HRSA has confirmed that virtually all skilled nursing facilities and assisted living communities are eligible for Phase 4. There will be two allocations based on the calculation methodologies below.   The portal opens on September 29, 2021, and HRSA will release application guidance the week of September 20, 2021.

  • 75% calculated based on revenue losses and COVID-related expenses
  • 25% put towards bonus payments that are based on the amount and type of service provided to Medicaid, CHIP and Medicare patients.

Rural Distribution

Providers may determine whether or not they are considered rural by inputting their address into the HRSA Rural Provider Validator.

Phase 3 Reconsideration

To promote transparency in the PRF program, the U.S. Health and Human Services (HHS) has released detailed information about the methodology used to calculate Phase 3 payments. Providers who believe their payment was not correct may email HRSA now at to indicate they will be requesting reconsideration and to be included in a reconsideration email distribution list.

Grace Period for Reporting

PRF recipients are required to submit information to document whether a provider’s lost revenue and expenses match the awards received.  The reports are technically still due September 30, 2021, but HRSA is providing a penalty-free grace period until November 30, 2021.

For additional detail, click here to access a summary from AHCA/NCAL on this update.

About the Author

Elizabeth Eichhorn, Director of Reimbursement Policy and Payor Affairs