Since its January 15, 2021, announcement that the CARES Act Provider Relief Fund (PRF) reporting deadlines would be extended indefinitely, the Department of Health and Human Services (HHS) has not provided an updated reporting timeline. It appears the reporting portal will not be opened any time soon.
Nor has HHS provided substantive guidance to recipients regarding the appropriate use of funds. HHS has made some minor modifications to its 60-page FAQs, but several key questions remain unanswered.
Several state and national associations recently have penned letters to HHS championing modifications to and clarifications of the guidance published to date. The Top 10 issues identified in these communications include:
- Extend the June 30, 2021, deadline for recipients to expend PRF dollars.
- Reverse the directive to include Medicaid Disproportionate Share Hospital and supplemental payments as patient care revenue or to treat these payments as an offset to coronavirus-related expenses.
- Clarify that reimbursement for services furnished to COVID-19 patients should be treated as an offset for coronavirus-related expenses, but not as patient revenue in lost revenue calculations.
- Revise the comparison to the budget lost revenue calculation to accommodate recipients with non-calendar fiscal years.
- Provide specific examples of what HHS considers “reasonable methods” for calculating lost revenue.
- Provide specific examples regarding the calculation of marginal costs.
- Permit a parent organization to report on both general and targeted distributions received by its subsidiaries (as opposed to having subsidiaries separately report on targeted distributions).
- Allow any reduction of tax receipts, grants, or fundraising that can be documented as attributable to coronavirus to be treated as lost revenue.
- For Round 3 applicants, explain the basis for refusing a request for payment or awarding less than the requested amount.
- Eliminate the burdensome requirement to report revenue and specified personnel, patient, and facility metrics by calendar quarter.
We would add one more to the list: How and when will HHS distribute the remaining billions already appropriated by Congress to help healthcare providers?
With billions of dollars at stake and providers clamoring for direction, it is surprising HHS has not moved more quickly to fill the void. With no formal regulations in place–only vague agency guidance–HHS may be challenged in proving a provider that acted in good faith to use funds appropriately should be penalized.
A provider’s demonstration of good faith–transparent decision-making, avoidance of any double-counting, thorough documentation of specific facts and circumstances, meticulous record-keeping–will be critical in defending any future challenges. With our multi-disciplinary PRF task force, PYA can assist your organization in securing your defense of appropriate use of PRF dollars.
To learn how PYA can assist your organization with PRF compliance and reporting, contact a PYA executive below at (800) 270-9629.