Wachler & Associates Health Law BlogCMS Releases Reporting Requirements for Provider Relief Fund
On September 19, 2020, the Department of Health and Human Services (HHS) released the much-anticipated reporting requirements for providers who received payments under the Provider Relief Fund (PRF). The PRF is a $175 billion fund created Congress through the CARES Act and administered by HHS to provide financial relief to healthcare providers during the COVID-19 pandemic. HHS previously amended the reporting requirements to require that any provider who received more than $10,000 from the PRF must file a report by February 15, 2021 and indicated that further details on reporting would be released at a later date. The new reporting system opens to payment recipients on October 1, 2020.
HHS breaks down the new reporting requirements into four date groups of data elements. First, providers must report Demographic Information, such as the Reporting Entity (whether the entity is reporting for a PRF payment it received or is reporting for a payment its subsidiary received), TIN, NPI, fiscal year-end date, and federal tax classification.
Second providers must report “expenses attributable to coronavirus not reimbursed by other sources.” Expenses attributable to coronavirus may be incurred in treating confirmed or suspected cases of coronavirus, preparing for possible or actual coronavirus cases, maintaining healthcare delivery capacity, etc. Providers who received between $10,000 and $499,999 in aggravated PRF payments need only report their net expenses that are attributable to coronavirus and not reimbursed by another source. These expenses need only be reported in two aggregate categories: (1) General and Administrative expenses and (2) other healthcare related expenses. However, providers who received $500,000 or more in aggregate PRF funds must report in significant detail on sub-categories of these expenses.
Third, providers must report “lost revenue attributable to coronavirus,” which is calculated as the negative change from 2019 to 2020 in year-over-year net operating income from patient care related sources. Providers must report information on their revenue from patient care related sources and expenses from both 2019 and 2020, as well as any other assistance received in 2020, such as Paycheck Protection Program (PPP) loans, FEMA relief, and paid business insurance claims.
Fourth, providers must report “additional non-financial data.” This data element includes the provider’s personnel, patient, and facility metrics, as well as any changes in ownership and the provider’s Single Audit status. This information will be collected per quarter.
The new reporting requirements also clarify several outstanding issues. It clarified that a parent company may report on and direct the use of a PRF payment received by a subsidiary only where the subsidiary received a General Distribution payment. Where a subsidiary received a Targeted Distribution payment under the PRF, the subsidiary must report on its own use of the payment. Further, any PRF funds that are not expended by the end of 2020 must be expended by June 30, 2021. Lost revenue calculations for payments expended between January 1, 2021 and June 30, 2021 will be compared to the same period in 2019, rather than 2020, and reports on payments expended in 2021 will be due July 31, 2021.
For over 35 years, Wachler & Associates has represented healthcare providers and suppliers nationwide in a variety of health law matters. If you or your healthcare entity has any questions pertaining to Provider Relief Fund reporting, audits, or healthcare compliance, please contact an experienced healthcare attorney at 248-544-0888 or wapc@wachler.com.