Unfair and Arbitrary Provider Relief Fund Rules Leave Long-Term Care Pharmacies and Their Senior Patients Behind

DATE: October 6, 2021

New Provider Relief Fund Distributions Overlook the Unique Patient Care Services of Long-Term Care Pharmacies

Washington, DC – The Senior Care Pharmacy Coalition (SCPC), representing the nation’s Long-term care (LTC) pharmacies, today decried the latest announcement from the Health Services and Resources Administration (HRSA) about the Provider Relief Fund. In April 2021, HRSA, a branch of the U.S. Department of Health and Human Services (HHS), confirmed that LTC pharmacies unquestionably qualify for relief under the Provider Relief Fund, established by Congress through the 2020 CARES Act to funds provider losses due to the COVID pandemic. Regardless, LTC pharmacies have continued to provide high-quality patient care services and uninterrupted access to essential medications for residents in LTC facilities throughout the pandemic.

LTC pharmacies applied for Provider Relief Fund assistance last year with wildly different results among applicants, but very little overall success. Meanwhile, LTC facilities that serve the same residents and have been equally hard hit by the pandemic, have received meaningful much deserved assistance —more than $12 billion in 2020—and they are appropriately about to receive more. HRSA has refused to acknowledge that it is leaving LTC pharmacies behind despite operating costs increasing by 10% and revenues dropping 10-15% due to the pandemic, an economic impact that continues today.

On September 29, 2021, HRSA announced a new Phase 4 General Distribution and the American Rescue Plan Rural Distribution application process. Given HRSA’s confirmation that LTC pharmacies are eligible for funding, SCPC is deeply disappointed that LTC pharmacies once again are being subject to an arbitrary and unfair application of rules which ignore the crucial role LTC pharmacies play in providing patient care to hundreds of thousands of patients daily.

“It is unconscionable that the Administration will not assure fair and equitable assistance for these essential health care providers in support of one of the nation’s most vulnerable patient populations,” said the Senior Care Pharmacy Coalition (SCPC) President and CEO Alan Rosenbloom. “It’s a slap in the face to be told we qualify for funds only to have this latest Provider Relief Fund application—yet again—ignore our unique and essential services.”

The latest Provider Relief Fund announcement included a new methodology that arbitrarily limits by 90% the HRSA calculation of pharmacy revenue attributable to patient care, which unfairly reduces CARES Act funding to LTC pharmacies. SCPC has repeatedly explained to HRSA the costs of providing patient care mandated by the Medicare and Medicaid programs, the total revenues LTC pharmacies earn for providing that patient care, and the substantial losses they have suffered due to COVID-19. In addition, the new rules will not consider most of the services LTC pharmacies provide for Medicare beneficiaries. 

HRSA’s decision is particularly disappointing in light of the Biden Administration’s reliance on LTC pharmacies to get COVID-19 vaccine boosters to facility residents, as they did for initial vaccine rollout, even though federal reimbursement only covered an estimated 60% of actual LTC pharmacy costs. The Administration is also relying on LTC pharmacies to dispense monoclonal antibodies in rural areas, which is extremely expensive and costly for the pharmacies to do.

“SCPC had high hopes that the Biden Administration would finally assure LTC pharmacies the relief they deserve,” added Rosenbloom. “We are astonished and dismayed by the remaining gap between the Administration’s commitment to equitable outcomes and actual policy implementation for LTC pharmacies.  We call upon HRSA to correct this injustice before the application period closes on October 26.”

Each day, long-term care pharmacies consult with patients and their families, train and support facility nursing staff, provide 24/7/365 assistance to patients, administer lifesaving COVID-19 vaccines and monoclonal antibody treatments, and more. For more than 18 months LTC pharmacies have shown up every single day, across the nation, to serve people with often multiple chronic and complex medical conditions. While health systems have faltered under the immense stress, long-term care pharmacy staff have continued to provide high-quality, essential health care services, and they deserve a fair shake when it comes to the Provider Relief Fund.

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About Senior Care Pharmacy Coalition

The Senior Care Pharmacy Coalition (SCPC) is the only national organization exclusively representing the interests of LTC pharmacies, representing 75% of the sector overall. Its members operate in all 50 states and serve 850,000 patients daily in skilled nursing and assisted living facilities across the country. Visit seniorcarepharmacies.org to learn more.