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Analysis

HHS Revises Provider Relief Funds Reporting Requirements

By John Commins  
   October 22, 2020

HHS also is expanding provider eligibility for $20 billion in emergency funding under its Phase 3 distribution of PRF money.

Acknowledging negative feedback from stakeholders, the Department of Health and Human Services announced Thursday that it is revising reporting requirements for $175 billion in pandemic emergency aid under the Provider Relief Fund.

"In response to concerns raised, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenues attributable to coronavirus," HHS said.

"After reimbursing healthcare related expenses attributable to coronavirus that were unreimbursed by other sources, providers may use remaining PRF funds to cover any lost revenue, measured as a negative change in year-over-year actual revenue from patient care related sources," HHS said.

HHS revised the rules on September 19 to address concerns that some providers were profiting from the PRF funding while other providers were struggling financially.

Essentially, the revised rules prohibited providers from being more profitable in 2020 than they were in pre-pandemic 2019, so that funding could be given to less-profitable providers.

That revision drew the ire of providers, who urged HHS to allow providers to use PRF payments for all lost revenues.

In a letter this week to HHS Secretary Alex Azar, American Medical Group Association CEO Jerry Pesno said comparing operating income in 2020 and 2019 "would inadvertently deny PRF aid to clinicians and group practices that would otherwise qualify because of an accounting requirement."

"Under the (Sept. 19) proposed formula, when additional providers join a medical group, it may appear that revenue grew for the group," he said. "However, the increase in volume is a result of the new clinicians joining and not due to growth in volume of services delivered."

"COVID-19 continues to decrease patient volume, and in fact, the average revenue per clinician is well below last year's," he said.

The revision also extends by six months – until mid-June 2021 – the allotted time for providers to spend all of their remaining PRF funds for COVID-19 related expenses that are not reimbursed by other sources, or to apply the funds for lost revenues up to an amount not above the difference between 2020 and 2019 actual revenue.

Phase 3 Distribution

HHS on Thursday also announced that it was expanding provider eligibility for $20 billion in emergency funding under its Phase 3 general distribution of PRF money. 

"Today, we are expanding the pool of eligible providers to include a broader array of practices, such as residential treatment facilities, chiropractors, and vision care providers that may not have already received payments," Azar said.

Under Phase 3, providers that had already received PRF money may apply for additional funding that considers changes in patient care operating revenue and expenses caused by the coronavirus, HHS said.

“In response to concerns raised, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenues attributable to coronavirus.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

HHS had revised the rules on September 19 to address concerns that some providers were profiting from the PRF funding while other providers were struggling financially.

Essentially, the revised rules prohibited providers from being more profitable in 2020 than they were in pre-pandemic 2019, so that funding could be given to less-profitable providers.

That revision drew the ire of providers, who urged HHS to allow providers to use PRF payments for all lost revenues.


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