Medicare Compliance & Reimbursement

Tip: Watch for changes to HHS dates and deadlines.

It’s critical to stay on top of COVID-19 policy changes — especially those related to your practice finances. In a recent update, the feds offer new guidance and major revisions to Provider Relief Fund (PRF) reporting.

Change #1: When the Department of Health and Human Services (HHS) first announced PRF details in the spring, it indicated that in accordance with the CARES Act, providers receiving $150,000 or more in PRF funds would be required to submit quarterly reports. As recently as June 13 in its PRF Frequently Asked Questions (FAQ), HHS stated that “the Terms and Conditions for all Provider Relief Fund payments require recipients who receive at least $150,000 in the aggregate from any statute primarily making appropriations for the coronavirus response to submit quarterly reports to HHS and the Pandemic Response Accountability Committee. This requirement is from section 15011 of the CARES Act.” The FAQ is still up on the HHS webpage.

Now, in a two-page notice posted July 20, HHS says the notice “is to inform Provider Relief Fund (PRF) recipients that received one or more payments exceeding $10,000 in the aggregate from the PRF of the timing of future reporting requirements.”

“No explanation has been provided for requiring providers receiving less than the originally stated $150,000 to file reports,” notes consulting firm The Health Group in Morgantown, West Virginia, in its electronic newsletter.

The $10,000 benchmark applies to the payment total in the aggregate, notes the National Association for Home Care & Hospice. That implies that providers that returned their automatically distributed PRF payments — whether all or a portion that makes their total under $10,000 — will not have reporting duties.

Change #2: The CARES Act and HHS first announced quarterly reporting requirements, but the new notice makes it clear that providers must submit only one or possibly two reports, depending on timing.

“Last month, HHS clarified that it would not require quarterly reports,” points out the American Hospital Association. Many providers missed the quiet June 13 announcement ahead of the July 10 quarterly reporting date.

But HHS didn’t announce what would take the place of the quarterly reporting structure.

Change #3: Now HHS has revealed the reporting date details. If a provider expends all of its funds by Dec. 31, 2020, it must submit one report that “demonstrate[s] compliance with the [Terms and Conditions], including use of funds for allowable purposes, for each PRF payment,” HHS explains in the new notice. Providers may start submitting reports as early as Oct. 1, but they are due by Feb. 15 — 45 days after the calendar year ends.

In contrast, if a provider takes until next year to spend its PRF funds, it “must submit a second and final report no later than July 31, 2021,” HHS instructs.

That new information indicates a new deadline. “Based on these notices, it appears that providers must expend Provider Relief funds, in full, prior to submitting a final report by July 31, 2021,” advise attorneys Aaron Cohen and Kate Broderick with accounting and advisory firm Citrin Cooperman in online analysis.

Stay tuned: HHS pledges to release “detailed instructions regarding these reports” by Aug. 17, according to the notice.

Prepare For Possible PRF Paybacks

“Finally, they are giving us something,” declares finance expert Dave Macke with VonLehman & Co. in Fort Wright, Kentucky. Providers that have received and kept PRF funds should pay close attention when the further reporting specifics come out.

HHS plans to release “detailed PRF reporting instructions and a data collection template with the necessary data elements” by Aug. 17, it says.

Why it matters: According to the PRF Terms and Conditions, providers must spend their PRF money on COVID-19 expenses or losses. If such expenses and losses, as detailed in the report(s), don’t add up to the amount they received, providers must pay back the difference.

Instead of being the “no strings attached” payments Centers for Medicare & Medicaid Services Administrator Seema Verma first touted, these funds have come with heavy ropes attached, experts quip.

There has been speculation since the PRF mechanism was announced that HHS would give blanket forgiveness for the payouts. But this notice seems to contradict that idea.

“They want accountability,” Macke believes.

Plus, the Internal Revenue Service recently announced that COVID-19 funds that are forgiven, such as PRF monies, should count as taxable income (see Medicare Compliance & Reimbursement, Vol. 46, No. 14). That means the PRF funds’ forgivability affects how much providers will pay in taxes, Macke points out.

Note: The notice is at www.hhs.gov/sites/default/files/provider-post-payment-notice-of-reporting-requirements.pdf. More PRF information is at www.hhs.gov/coronavirus/cares-act-provider-relief-fund/general-information/index.html.