Providers: $25.5 billion in Provider Relief Fund & American Rescue Plan rural funding is now available. Submit your application by October 26, 2021.

About ARPA Rural

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making available $8.5 billion in American Rescue Plan (ARPA) funding to safety net providers who offer critical access to care for many of the most vulnerable patients in rural communities. ARPA Rural Payments will reimburse providers who have incurred health care related expenses and lost revenues that are attributable to COVID–19. These payments will be administered via the Provider Relief Fund (PRF) program.

ARPA Rural is intended to help address the disproportionate impact that COVID-19 has had on rural communities and rural health care providers. Data from the Centers for Disease Control and Prevention (CDC) shows that rural communities have experienced the highest rate of deaths due to COVID-19 per 100,000 residents. Many rural health care providers who faced challenges even before the pandemic have been hard hit by the financial pressures imposed by COVID-19. HRSA’s Federal Office of Rural Health Policy (FORHP) notes that nearly 100 rural hospitals have closed over the past decade, and rural providers now face increased need to invest in COVID-related resources while weathering lost revenues attributable to the pandemic.

Providers will be able to begin applying for funds [in a matter of weeks/later this month] when the application period opens. The program will make payments to providers based on Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) health care-related services provided to rural patients. It will also prioritize equity across these beneficiary groups by pricing most services at the highest available rate regardless of the insurance program originally billed for the service.

HRSA plans to host technical assistance webcast sessions on [PLACEHOLDER FOR WEBCAST DATES/TIMES] to support providers in submitting their ARPA Rural application(s).

Eligibility

To apply for ARPA Rural Payments, the applicant’s billing Tax Identification Number(s) (TIN) must be:

  1. A rural health clinic as defined in section 1861(aa)(2) of the Social Security Act; or
  2. A provider treated as located in a rural area pursuant to section 1886(d)(8)(E), such as critical access hospitals; or
  3. A provider or supplier that:
  • Has directly billed for health care-related services between January 1, 2019 and the end of Q3 2020:
    • Medicare fee-for-service (Parts A and/or B);
    • Medicare Advantage (Part C);
    • Their state/territory Medicaid program (fee-for service or managed care); or
    • Their state/territory CHIP; and
  • Operates in or serve patients living in the HHS Federal Office of Rural Health Policy’s (FORHP) definition of a rural area, which includes:
    • All non-Metro counties;
    • All Census Tracts within a Metropolitan county that have a Rural-Urban Commuting Area (RUCA) code of 4-10. The RUCA codes allow the identification of rural Census Tracts in Metropolitan counties; and
    • 132 large area census tracts with RUCA codes 2 or 3. These tracts are at least 400 square miles in area with a population density of no more than 35 people per square mile.

Payment Calculation

HRSA will use data on eligible applicants’ claims for health care-related services from Medicare, Medicaid, and CHIP to determine payment amounts for eligible billing TINs. HRSA will price most services at Medicare rates, with limited exceptions for some services provided predominantly in Medicaid and CHIP. HRSA will then scale payments based on the total funds available and applications received with each eligible provider that served at least one rural beneficiary from January 1, 2019 to September 30, 2020 receiving a payment. Finally, payments calculated at the billing TIN will be aggregated to the applicant’s filing TIN.

Date Last Reviewed:  August 2021