Home Health & Hospice Week

Reporting portal opens July 1.

In a new notice, the Department of Health and Human Services grants Provider Relief Fund recipients’ wishes — but also adds to their reporting burden.

Old way: Under the CARES Act, providers receiving PRF funds must submit reports that substantiate qualifying COVID-19 costs and losses to retain their payments. Previously, there were two reporting periods and reports for health care providers receiving PRF monies. The first period included April through December 2020 and the report for it was due Feb. 15, 2021. The second period ran from Jan. 1 to June 30, 2021 and the report was due July 31.

New way: In a June 11 notice, the HHS Health Resources and Services Administration announced four reporting periods and related due dates (see chart, p. 174). That translates to an extension for the use of some PRF funds. “The period of availability of funds is based on the date the payment is received (rather than requiring all payments be used by June 30, 2021, regardless of when they were received),” HRSA says in a release about the notice.

The reporting applies to any period where a provider received at least $10,000 in PRF funds during that period, HRSA explains in the notice. The first PRF report will be due Sept. 30, consulting firm BKD notes in online analysis.

“We are pleased that [HHS] is providing a limited extension on providers’ use of funds, and we are pleased to see some clarification on reporting,” NAHC President Bill Dombi says in a release. “We do hope HHS will consider further extensions on the use of funds due to the immense pressures on providers brought on by the public health emergency.”

In addition to the date changes, HHS issued six new PRF Frequently Asked Questions and modified 12 more, point out attorneys David Snow, Lori Wink, Joseph Krause, Elizabeth Elias and Benjamin Fee with law firm Hall Render in online analysis.

For example: “If an entity received payments totaling over $10,000, but returned some, do they still have to report?” asks one question modified on June 11. “A Reporting Entity must report only when they have retained over $10,000 in aggregated Provider Relief Fund payments received during a single calendar year,” HHS responds. The same presumably goes for each of the new periods.

HHS had pushed off the previous February 2021 reporting deadline, but had issued few other details. The new announcement comes after “after months of quiet introspection” at HHS, say attorneys Dawn Perez-Slavinski and Danielle Sloane with law firm Bass Berry & Sims.

In May, representatives for hospitals and other groups asked HHS Secretary Xavier Becerra for relief on the PRF timeline (see HCW by AAPC, Vol. XXX, No. 18).

“This extension of the June 30, 2021 deadline for using or ‘spending’ PRF dollars for any payments received after June 30, 2020 represents a partial win for the industry which had been asking for an extension tied to the continuation of the official Public Health Emergency,” the Hall Render attorneys judge.

But it’s not a total win, because the extension only applies to funds received July 1, 2020 or later. “Unfortu­nately, recipients that received a bulk of their PRF payments during the first Payment Received Period are still subject to the June 30, 2021 deadline for using funds,” the Hall Render attorneys explain. “This disproportionately impacts smaller organizations … that were already challenged to demonstrate sufficient lost revenue and expenses necessary to retain the money they received,” they lament.

One way around this problem may be if providers are allowed to carry expenses and losses “forward” or “back” to different time periods. HHS does not make clear in its release, notice, or FAQs whether they can, the Hall Render attorneys note.

“If HHS requires recipients to demonstrate lost revenue and expenses during the Period of Availability in which the recipient received a distribution without carrying-forward losses and expenses from the prior Period of Availability, recipients would be facing the prospect of refunding millions of PRF dollars despite still having substantial amounts of lost revenues unreimbursed,” the Hall Render attorneys stress. “The multi-million dollar question is whether recipients will be permitted to carry losses forward or carry back in some cases.”

Why it’s so important: Many providers “incurred sub­stantial financial losses during April, May and June of 2020,” the Hall Render attorneys explain. These providers “therefore, had substantial lost revenues during the first Period of Availability.” Then some providers saw revenue stabilize during the second half or fourth quarter of 2020, “even if they did not return to full pre-COVID levels,” they note. These providers “would not have much, if any, lost revenue during the second Period of Availability (July 1, 2020 through December 31, 2021). Though, these same systems would have received considerable distributions during the second Payment Received Period.”

Bottom line: “If expenses and losses cannot be carried forward, the new multi-time period approach could have a devastating impact on the ability of recipients to retain PRF payments,” the Hall Render attorneys warn.

Another downside: Home health and hospice agencies may now need to submit up to four reports, depending on when they received funds, compared to the previous one or two. “Recipients who received one or more payments exceeding $10,000 in total during a ‘Payment Received Period’ are required to report in each applicable ‘Reporting Time Period,’” Perez-Slavinski and Sloane highlight.

“The new approach … requires most recipients to submit multiple reports rather than a single comprehensive report since most recipients received PRF distributions during multiple Payment Received Periods, making an already complicated reporting process even more challenging,” the Hall Render attorneys criticize. “Requiring multiple reports based on when funds were received will only add to the accounting and record-keeping burden for recipients related to PRF compliance,” they charge.

A newly added FAQ reveals another unfavorable development. “How does a Reporting Entity determine whether an expense is eligible for reimbursement through the Provider Relief Fund?” the FAQ says.