Additional Funds, Delay in Reporting Requirements, and Audits

The Provider Relief Fund (PRF) was established when Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support American families, workers, and healthcare providers in the battle against COVID-19. The fund allows eligible providers to receive payments for healthcare-related expenses or lost revenue due to Covid-19. In the last few weeks, there have been updates related to the funds.

New Fund Distributions

Health and Human Services (HHS) announced last week that providers would be able to apply for an additional $17 billion for PRF Phase 4 beginning September 29, 2021, to cover revenue losses and changes in operating expenses between the period of July 1, 2020, and March 31, 2021. This Phase will reimburse smaller providers at a higher rate as they operate on thinner margins and more rural communities. Eligibility for these additional funds is available here.

Reporting Grace Period

The deadline to submit reports for Reporting Period 1 has not changed and is September 30, 2021; however, HHS recently announced a 60-day grace period for those unable to meet this initial deadline due to natural disasters, impacts of Delta variant, etc. The grace period begins on October 1, 2021, and will end on November 30, 2021. HSS will not initiate any recoupment or enforcement actions until after November 30, 2021. Unused funds should be returned as soon as possible after submitting the PRF report. All unused funds must be returned no later than 30 days after the end of the grace period (December 30, 2021).

New Hospital Audits 

The Health Resources and Services Administration (“HRSA”), the agency of HHS that administers the Provider Relief Fund, has announced it will soon begin auditing provider compliance with and the integrity of the PRF program. Consistent with the requirements of the CARES Act of 2020, providers are held to detailed reporting requirements. The agency plans to conduct supplemental auditing of providers to ensure appropriate uses of funds. Auditing may also extend to checks on compliance with other requirements in the Terms and Conditions, such as the ban on balance billing COVID-19 patients.

To ensure compliance with these requirements and to ensure the integrity and efficacy of the Program, HHS has taken steps to contract four well-known auditing firms (Creative Solutions Counseling, Grant Thorton, PriceWaterhouseCoopers, and Kearney & Company) to begin audits, financial reviews, assessments, and analytical reviews of providers who received at least $750,000 under the PRF program. KPMG has also been contracted to separately assess overall program integrity. HHS has noted these audit activities are not expected to commence until after September 30, 2021. However, given the 60-day grace period, it is more likely that the audits will not fully ramp until after November 30, 2021.