Home Health & Hospice Week

Warning: Missing this crucial deadline could cost you big.

If you’re one of the thousands of providers that missed the Provider Relief Fund reporting deadline for Period 1 last Sept. 30, you have a limited window of time to make it right.

Recap: The Health Resources and Services Administration has distributed about $13.5 billion to more than 86,000 providers so far through the PRF program authorized in the CARES Act in 2020, the Department of Health and Human Services says in an April 13 release (see related item, p. 104). HRSA set out timelines for five Reporting Periods and their related usage and reporting deadlines, with the due date for Reporting Period 1 at Sept. 30, 2021.

According to press reports, about 10,000 providers failed to meet that reporting deadline, resulting in about $100 million that would have to be returned.

“Anecdotally, McGuireWoods is aware of providers whose previous HHS communications were not received or were misplaced,” confirm attorneys from the firm in a client alert.

Reminder: “Providers that received $10,000 or more in aggregated General and Targeted Distribution PRF payments must report on the use of funds in accordance with HRSA PRF reporting requirements,” note attorneys Dawn Helak and Danielle Scheer with law firm McDermott Will & Emery in online analysis. “Providers that fail to satisfy reporting requirements may be excluded from receiving or retaining future PRF payments, including applicable Phase 4 payments,” Helak and Scheer add.

HRSA sent notifications to providers informing them of the clawbacks starting in early March, notes Dave Macke with CPA firm VonLehman & Co. in Ft. Wright, Kentucky. That “caused a stir in the healthcare community,” Macke notes in online analysis.

Attorneys Michael Paddock and Theresa E. Thompson with law firm Sheppard Mullin describe it as more of a “panic.”

That’s when the American Medical Association, the Medical Group Management Association, and 30 other physician-focused trade groups got involved, sending a March 31 letter to HRSA Administrator Carole Johnson. “Small and rural physician practices appear to be particularly impacted by the reporting deadline and the potential recoupment of funds,” the letter said. “These practices, often under-resourced even while they provide critical health care services, cannot afford to have the funds they received recouped. During the late fall when the Delta variant was surging, these physician practices and others were greatly impacted by the COVID-19 surges in many ways that may have prevented or delayed the required reporting.”

Providers “were not contacted about the requirement to report and were thus unaware of the deadline,” the AMA-led letter insisted. And “medical and administrative staff contracted COVID-19 or were acting as a caregiver and, therefore, were out of off the office which caused them to miss the reporting deadline,” it added. Plus, “staffing challenges and turnover resulted in the practice’s point of contact no longer being affiliated with the practice,” the letter stressed.

“We ask that HRSA reopen the Period 1 reporting window for at least 60 days and engage in a targeted campaign to reach those who have yet to comply,” the AMA and other trade groups said in the letter.

Physicians and other affected providers, such as home health and hospice agencies, did not get that reprieve, Helak and Scheer note. But they did get a more modest late reporting option.

“Providers who experienced one or more extenuating circumstances that prevented them from submitting a completed PRF Report in Reporting Periods 1 and/or 2 by the deadline, can now submit a request to report late via the Request to Report Late Due to Extenuating Circumstances Form,” HRSA says on its Provider Relief Fund Reporting Requirements and Auditing webpage. But providers have only until April 22 at 11:59 pm ET to do so.

“Providers who submit a request will be notified by HRSA if their request is approved or denied,” HRSA explains. “Providers whose request is approved will receive a notification to proceed with completing the report. Providers whose request is denied will need to return their funds to become compliant with their PRF reporting requirement,” the agency explains.

Limitation: General chaos won’t be enough to invoke the exception. To qualify for the late reporting option, providers must have experienced one of six specified “extenuating circumstances” (see box above).

“Providers should carefully review their extenuating circumstances and determine which, if any, of the … acceptable extenuating circumstances applies,” the McGuireWoods attorneys advise.

“Submission of a Request to Report Late Due to Extenuating Circumstances does not guarantee the request will be approved or that a provider will be allowed to enter the PRF Reporting Portal to complete and submit a report,” HRSA cautions on its Request to Report Late Due to Extenuating Circumstances webpage.

Sidestep This Documentation Landmine

While providers “must indicate and attest to a clear and concise explanation related to the applicable extenuating circumstance … supporting documentation will not be required,” HRSA says.

Do this: But “providers should ensure for their comfort that such supporting information is available and maintained for any filing made to the government in case there is a future audit or review,” the McGuireWoods attorneys recommend.

And this: “Providers should begin preparing the information required to submit a period 1 report as soon as possible,” the McGuireWoods attorneys urge. “HHS has stated that providers will have only 10 days from notification that their request was approved to submit the report. The reports will require financial and organizational information, as well as information about how the funds were used.”

“This timeframe is much shorter than the 60-day timeframe requested by the American Medical Association,” Helak and Scheer point out. But it appears to be better than nothing.

“Providers who need to take advantage of the Request to Report Late Due to Extenuating Circumstances process should move quickly,” urge attorneys Alexander B. Foster and Hedy Silver Rubinger with law firm Arnall Golden Gregory in online analysis.

Providers should also keep an eye out for future communications. “Any email address provided through the reporting portal (as well as emails given in government reimbursement program enrollment and licensure applications) should be monitored to ensure the provider receives all important communication in the future,” the McGuireWoods attorneys stress. “To that end, providers may want to ensure emails received from @hrsa.gov, @hhs.gov, and @ProviderEmail. uhc.com domains are added to safe receipt lists.”

Note: More PRF reporting details are at www.hrsa.gov/provider-relief/reporting-auditing.