Ever since the release of reporting guidance regarding the Provider Relief Fund (PRF) program in September 2020, the Department of Health and Human Services (HHS) has stated that a reporting portal would be available starting January 15, 2021. On Friday, January 15, 2021, HHS opened a portal; however, this was only a registration page, which will ultimately be needed in order to report within the actual online portal.
Learn more about new guidance on the Provider Relief Fund.
The portal itself and the deadline are currently “delayed” and “HRSA will announce the timeline for submission of these reports when it is available.” A frequently asked question (FAQ) document, as well as detailed instructions have been released for this registration process. Almost all individuals or organizations that received greater than $10,000 in the aggregate will need to register. If only the Rural Health Clinic (RHC) Testing distribution was received, there is separate reporting, so there is no need to register. Information needed to complete the registration process includes:
Post-Payment Notice of Reporting Requirements
In addition to the registration page, HHS released a new Post-Payment Notice of Reporting Requirements document and it has some SIGNIFICANT changes. A copy of the reporting document, dated January 15, 2021, can be accessed on the HHS.gov website. Below are some of the significant changes:
The calculation of lost revenues was expanded to allow for three options.
First, the calculation can be actual 2020 calendar year net patient care revenue compared to actual 2019 calendar year net patient care revenue. If this option is selected, the 2019 revenue is required to be reported to HHS by payor and by quarter.
Second, the calculation can be actual 2020 calendar year net patient care revenue compared to budgeted 2020 calendar year net patient care revenue; however, the budget must have been approved prior to March 27, 2020. A copy of the budget must be submitted, along with an attestation from management regarding the budget.
Third, an alternate methodology may be used as long as it is a “reasonable method of estimating revenue.” If this methodology is utilized, the reporting entity must submit a description of the methodology, an explanation of why the methodology is reasonable, an explanation establishing how lost revenue was a loss attributable to COVID-19 versus a loss caused by something else, and a calculation of the lost revenue utilizing this methodology. The use of this methodology is explicitly noted as having an increased likelihood of an audit by HRSA. Should HRSA not deem a methodology reasonable, the reporting entity will have 30 days from notification to either resubmit a calculation using the actual 2019 calendar year or budgeted 2020 calendar year net patient care revenue information.
The “Reporting Entity” is now further defined and segregated by type of PRF distribution received. Recipients of the Nursing Home Infection Control distribution should still register for the portal, but the reporting requirements discussed herein are not applicable. As previously noted, if only the RHC Testing distribution was received, separate reporting is required outside of this reporting portal. General distribution payments may be reported by the original recipient, the final recipient or a parent entity, regardless of which entity attested to accepting the payments. Targeted distributions, however, are required to be reported by the original recipient that attested to accepting the payments.
Healthcare Related Expenses
There were limited changes to the expense section of the reporting requirements document, but two worth noting. First, “attributable to coronavirus” was specifically added to the description of expenses that can be claimed. Second, the concept of “maintaining healthcare delivery capacity, which includes operating and maintaining facilities, etc.” was removed from the document.
A new section was created to the expected report to HHS wherein reporting entities will need to provide the interest income earned on PRF funds. Two pieces of information previously expected to be reported in the lost revenue section have been updated.
First, the annual expense information requirement has been removed.
Secondly, the “Other Assistance Received” category (which includes programs such as PPP, FEMA, other CARES Act assistance) was moved into the “Additional Data” section.
Finally, if targeted distributions have been transferred to related entities, as allowable under the Coronavirus Response and Relief Supplemental Appropriations (CRRSA) Act, these amounts must be indicated. Amounts of targeted distributions transferred are noted to face an increased likelihood of an audit by HRSA.
These changes reflect many of the provisions included in the CRRSA Act (stimulus bill passed in December 2020). The Frequently Asked Questions document has not yet been updated, however, so conflicting guidance continues to exist. Stay tuned for more updates, including the eventual release of the actual reporting portal.
How to Move Forward with Provider Relief and the Portal
In the meantime, it is recommended that you review your organizational structure and distribution receipt information with the guidance in order to determine which entities should register for the Portal and then the registration process should be completed. In addition, continue to track expenditures incurred that are attributable to coronavirus and accumulate the other information that will be requested by HHS. Finally, the lost revenue calculation approach that is expected to be used by your organization should be determined in order to accumulate necessary information or commentary.
The program continues to issue guidance and make changes. Make sure you’re in compliance.