Please find related posts summarizing recent agency activity on the Provider Relief Fund on the Healthcare Essentials blog. 

Providers that received relief monies through the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act Provider Relief Fund (“PRF”) in 2020 were previously notified that reporting obligations would begin in the first two months of 2021. The Department of Health & Human Services (“HHS”) released various notices of post-payment reporting requirements between July and November 2020 indicating that a reporting portal would be available, and providers would need to either partially or fully complete reporting between January 15 and February 15, 2021. HHS recently delayed that deadline, and published a new post-payment notice of reporting requirements on January 15, 2021, which supersedes the prior November 2, 2020 guidance.  

HHS released the new January 15, 2021 guidance to reflect the reporting process mandated by Congress in the Coronavirus Response and Relief Supplemental Appropriations (“CCRSA”) Act. Among the updates found in the January 15 guidance is a revised methodology for calculating “lost revenue,” which is described generally at the bottom of this alert. The methodology for calculating “lost revenue” has a storied history, and this most recent guidance comes after significant backlash from policymakers and providers when HHS briefly announced it would significantly limit allowable methods last fall. The January 15 notice also adds an important note for those recipients that received monies from one of the targeted distributions, but later transferred those funds. Generally, such transfer is allowable if the targeted funds recipient is a subsidiary of a parent organization, and that parent transfers the monies to another of its subsidiaries. That targeted distribution transfer must be reported, and providers are warned that “transferred targeted distributions face an increased likelihood of an audit by [the US Health Resources & Services Administration] (“HRSA”).”

HHS has published more than 30 new FAQs, found here, since publishing the new January 15, 2021 reporting guidance. Given the dynamic nature of guidance in this area, it is imperative that providers cross-reference and carefully review all available guidance and information, always downloading the most current versions of all documents. Providers should regularly consult the HHS Reporting Website for updates regarding PRF reporting requirements. 

As February draws to a close, HHS is now allowing PRF recipients to register for the PRF Reporting Portal. There is not yet a due date for the completion of the registration process, however, providers must register before reporting on the use of funds. Only providers that received more than $10,000 in total funds are required to register and eventually submit a report detailing their use of PRF Funds. Providers that have spent or intend to spend more than $750,000 in PRF Funds will be subject to the Single Audit Requirement and should consult their legal counsel or accountant on how to proceed. HHS has published a Reporting Portal Frequent Asked Questions document to assist providers with the registration process. 

While HHS is not yet allowing providers to submit detailed reports, recipients should consult the existing PRF guidance to ensure their compliance with the PRF expenditure requirements. Current HHS guidance identifies three broad categories for which providers may use PRF Funds. These are: 

1. General and Administrative expenses, which include items such as mortgage/rental payments, taxes on PRF Funds, insurance premiums, lease payments, and utility payments; 
2. Healthcare Related expenses, which include medical supplies and equipment, IT related items, and medical facility costs; and 
3. Lost revenues attributable to coronavirus. 

Lost revenues attributable to coronavirus may be calculated using one of the following options: 

1. The difference between 2019 and 2020 actual patient care revenue; 
2. The difference between 2020 budgeted and 2020 actual patient care revenue; or 
3. Any reasonable method of estimating revenue. 

For more detailed and up-to-date information regarding the use of PRF Funds, we recommend that providers consult the HHS Frequently Asked Questions. 

HHS is expected to release additional information in the coming weeks. Providers should begin gathering information and confirming their compliance with PRF expenditure guidelines before submitting any reports to HHS.  Nelson Mullins will be monitoring PRF developments and updates on reporting requirements and guidelines closely. Reach out to a member of the Nelson Mullins Healthcare Team if you have any questions or would like help understanding any aspect of the PRF.