HRSA is prepared to send out $9B of Phase 4 PRF payments to providers this week. 75% of Phase 4 applications are processed and ready to be paid this week with over 69,000 providers receiving a payment. HRSA will send all communication through email as payments are processed and will also send communication if no payment will be issued after review of submitted applications.
This still leaves $7B of Phase 4 PRF funds to pay out and HRSA says they will continue to make payments into 2022 as applications are processed. Read the entire press release here.
Finally, we encourage you to read the terms and conditions for the Phase 4 payment and the ARP payment as new notifications to HRSA surrounding merger and acquisition activity have been added.
Phase 4 Payment Insights
Phase 4 payments are determined based on applications you submitted back in late October. You’ll need to refer to your own application to understand how your payment calculation.
Step 1: Calculate Base Payment
Approximately 75% of your payment relates to a base payment. The change in quarterly revenues and expenses from your application are multiplied by a payment percentage based on the size of your organization in the table below:
Step 2: Deductions of Prior PRF Payments from Base Payments
HRSA will deduct and prior PRF payments not previously deducted in Phase 3 payments and applications.
Step 3: Calculating Bonus Payments
Approximately 25% of your payment relates to a bonus payment based on Medicare, Medicaid and CHIP claims data from January 1, 2019 through September 30, 2020. Medicaid and CHIP claims are repriced at Medicare rates and that information is used to calculate bonus payments for providers and consolidated at the TIN level.
There are additional nuances to the payment calculation if you were a new provider in 2019 or 2020 or if you were a pharmacy or DME supplier. Additionally, adjustments will be made if application data falls outside expected ranges. So while we’ve simplified the calculation above, that should only be used a guideline to validate your payment.
You can read through the entire detailed calculation and search for updates here.
If you have questions about the additional Phase 4 Payments, Period 2 Reporting, or Provider Relief Funds in general, please contact your local Blue & Co. advisor or one of our PRF experts below.
Michael Alessandrini, Director
Peter Szostak, Senior Manager