In The News

Provider Relief Fund: Phase 4 Payments

Beginning September 29, 2021, providers can now apply for Phase 4 payments from the Provider Relief Fund, with application submission through the Provider Relief Application and Attestation Portal. Providers must submit their completed application by the final deadline of October 26 at 11:59 p.m.

The application will require the following documentation:

  • Applicant TIN and TINs for any subsidiaries included in the applicant TINs IRS tax filing.
  • 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.

Most providers who have completed their PRF reporting for initial funding, should have this information gathered already.

Following is an announcement from HRSA regarding the portal.  Please note that the announcement contains information regarding another webinar on the funding (Oct. 5).

Dear Partner –

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced a new application cycle for $25.5 billion in COVID-19 provider funding. Applicants will be able to apply for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments during the application process. PRF Phase 4 is open to a broad range of providers with changes in operating revenues and expenses. ARP Rural is open to providers who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP).

See a detailed list of eligible provider types here.

The application is open now and will close on October 26, 2021 at 11:59 p.m. ET. Providers who have previously created an account in the Provider Relief Fund Application and Attestation Portal and have not logged in for more than 90 days will need to first reset their password before starting a new application. In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application.

HHS recently hosted a briefing session to provide information about these upcoming funding opportunities – view the video here. HRSA will also host webinar sessions featuring guidance on how to navigate the application portal. Register now using the links below.

  • Two additional webinars the weeks of October 11th and 18th (dates, times, and registration forthcoming)
Real time technical assistance is available by calling the Provider Support Line at (866) 569-3522, for TTY dial 711. Hours of operation are 8 a.m. to 10 p.m. CT, Monday through Friday.

Marvin Figueroa, Director 
Office of Intergovernmental and External Affairs
U.S. Department of Health and Human Services
Washington, D.C.

Nominate a Home Care Aide for a CellTrak Scholarship!

This will be the second year a scholarship program will be offered through NAHC for home care aides specifically. Aides awarded with scholarships will be announced in during Home Care & Hospice Month November 2021. If you are interested in nominating an outstanding aide for the scholarship, please do so by October 8, 2021.

Click Here to Nominate an Outstanding Aide! 


CMS Launches New Tool to Compare Nursing Home Vaccination Rates

The Centers for Medicare & Medicaid Services (CMS) is making it easier to check COVID-19 vaccination rates for nursing home staff and residents with a new feature on Today’s announcement makes vaccination data available in a user-friendly format to help people make informed decisions when choosing a nursing home for themselves or a loved one. CMS and the Centers for Disease Control and Prevention (CDC) are also continuing to use this data to monitor vaccine uptake among residents and staff and to identify facilities that may need additional resources or assistance to respond to the pandemic.

“CMS wants to empower nursing home residents, their families and caregivers with the information they need when choosing care providers for their loved ones. As we continue to work with our partners to monitor the spread of COVID-19 and keep nursing home residents safe, we want to give people a new tool to visualize this data to help them make informed decisions,” said CMS Administrator Chiquita Brooks-LaSure. “CMS knows that nursing home staff want to protect their residents and is calling on them to get vaccinated now. The COVID-19 vaccine is safe, effective and accessible to all at no out-of-pocket cost.”


Medicare and Medicaid-certified nursing homes have been required to report weekly COVID-19 vaccination data for both residents and staff since May, and CMS has been posting the information on the CMS COVID-19 Nursing Home Data website. The addition of this new consumer-friendly data feature is another valuable tool for patients, residents, and families to understand the quality of nursing homes when making health care decisions.


Critical Time Window for Rehabilitation After a Stroke

National Institutes of Health

Every 40 seconds, an American has a stroke. About 750,000 new strokes occur in the United States each year.

Restoring brain function after a stroke remains a challenge. Functional recovery from brain damage requires networks of nerves to adapt and reorganize. This “neuroplasticity” naturally occurs during early development. But studies in rodents suggest that there is a brief period of similarly high neuroplasticity after a stroke. Intensive motor training provided to rodents during this window can lead to nearly full recovery. But no evidence for a similar recovery window in humans has previously been found.

To find out if such a window exists in people, a team led by Dr. Alexander Dromerick of Georgetown University Medical Center and MedStar National Rehabilitation Hospital conducted a randomized phase II clinical trial. NIH’s National Institute of Neurological Disorders and Stroke (NINDS), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and National Institute on Deafness and Other Communication Disorders (NIDCD) supported the study. Results appeared in the Proceedings of the National Academy of Sciences on September 20, 2021.

The researchers recruited 72 patients from a rehabilitation hospital in Washington, DC. They randomly assigned participants to one of four groups. All participants received standard stroke rehabilitation therapy. Those in three of the four groups received an extra 20 hours of intensive motor skills therapy. In the first group, the extra therapy began within 30 days of stroke onset. In the second group, extra therapy began 2-3 months after stroke onset. In the third, it began 6-7 months after stroke onset. Participants in the fourth (control) group received no extra therapy.

The researchers assessed arm and hand function at various points before and after treatment, up to 12 months after stroke onset. People in the 2–3 month therapy group showed the greatest improvement one year after their strokes. Participants in the 30-day group showed smaller but still significant improvement. By contrast, participants in the 6-7 month group showed no significant improvement over controls.

“Our results suggest that more intensive motor rehabilitation should be provided to stroke patients at 60 to 90 days after stroke onset,” co-author Dr. Elissa Newport says.

“Previous clinical trials have found few or very small improvements in motor function post-stroke, so our research could be an important breakthrough in finding ways we can make substantial improvements in arm and hand recovery,” Dromerick says.

The results strongly suggest that there is a critical time window for rehabilitation following a stroke. For this study, that window was 2-3 months after stroke onset. Larger clinical trials are needed to better pin down the timing and duration of this critical window. A larger trial could also determine what dose of therapy would achieve the best results during this window.

—by Brian Doctrow, Ph.D.

References: Critical Period After Stroke Study (CPASS): A phase II clinical trial testing an optimal time for motor recovery after stroke in humans. Dromerick AW, Geed S, Barth J, Brady K, Giannetti ML, Mitchell A, Edwardson MA, Tan MT, Zhou Y, Newport EL, Edwards DF. Proc Natl Acad Sci U S A. 2021 Sep 28;118(39):e2026676118. doi: 10.1073/pnas.2026676118. PMID: 34544853.


What Can Providers Give to Patients?

Elizabeth A. Hogue recently sent the series of articles below about what providers can give to patients. Please do not hesitate to contact her at (877) 871-4062 or [email protected] with comments, questions, or requests for additional information.

Copyright, 2021. Elizabeth E. Hogue, Esq. All rights reserved.  No portion of this material may be reproduced in any form without the advance written permission of the author.

Part 1 – Applicable federal statutes and exceptions

Part 2 – Exception for items and services of nominal value

Part 3 – Circumstances under which free items and services may be given to patients who have a demonstrated financial need

Part 4 – Recent OIG guidance regarding incentives to promote COVID-19 vaccination

Part 5 – Exception for preventive items or services

Part 6 – Exception for free items or services that promote access to care

Part 7 – Case example from OIG Advisory Opinion No. 09-11

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