The U.S. Department of Health and Human Services (HHS) recently announced that it would soon be implementing new reporting requirements for hospitals, physicians, and other healthcare providers who received General and Targeted distributions from the Provider Relief Fund (PRF), established through the CARES Act that became law with President Trump’s signature on March 27, 2020. $100 billion (of the more than $2 trillion authorized in the bill) is set aside for “health care related expenses or lost revenues that are attributable” to the COVID-19 pandemic. An additional $75 billion (made available through the Paycheck Protection Program and Health Care Enhancement Act) was distributed less than a month later.
As we reported previously, in June of this year HHS temporarily suspended CARES Act provider reporting requirements: https://www.butlersnow.com/2020/06/provider-relief-fund-reports-temporarily-suspended/. However, the agency made it clear at that time that a new reporting requirement would be announced on or before October 1.
A Preview of the Forthcoming Reporting Requirement
On August 14, 2020, HHS published a notice announcing that it would soon be releasing details of a new PRF reporting requirement: https://www.hhs.gov/sites/default/files/provider-post-payment-notice-of-reporting-requirements.pdf. Until further details are released, here is what we know about the new regulations:
- Recipients receiving one or more payments exceeding $10,000 in the aggregate from the PRF will be required to report. This requirement includes recipients who receive funds from any combination of programs and distributions made from the PRF.
- The reporting requirement will apply to both Phase 1 and Phase 2 of the General Distribution. Phase 1 of the General Distribution was a $30 billion direct-to-bank account distribution to Medicare fee-for-service providers. Phase 2 consisted of a distribution of $20 billion to certain eligible applicants, including participants in state Medicaid/CHIP programs, Medicaid managed care plans, dentists, and certain Medicare providers (including those who missed Phase 1 payments equal to 2% of their total patient revenue or had a change of ownership in 2019 or 2020).
- Recipients of the Targeted Distribution are also included. HHS is set to distribute approximately $55.9 billion to providers in areas particularly impacted by the COVID-19 pandemic. Recipients include hospitals in high-impact areas, rural health care providers, skilled nursing facilities, tribal health care facilities, and safety net hospitals.
- The system is set to go live on October 1, 2020. Until it does so, we can only speculate as to what information will be required in these reports. However, it is worth noting that the Terms and Conditions agreement (that bind recipients through attestation or retention of funds) puts providers on notice that they could be called on to report all amounts received, a “detailed list” of all projects for which funds were used, estimated number of jobs created or retained, and disclosure of subcontractors and grantees, if any. Providers should be prepared to provide this information, at a minimum.
- Preliminary reporting deadlines have also been announced. The HHS announcement includes the following (tentative) deadlines for reporting:
- All recipients must report within 45 days of the end of calendar year 2020 on their expenditures through the period ending December 31, 2020.
- Recipients who have expended funds in full prior to December 31, 2020 may submit a single final report at any time during the window that begins October 1, 2020, but no later than February 15, 2021.
- Recipients with funds unexpended after December 31, 2020, must submit a second and final report no later than July 31, 2021.
Detailed PRF reporting instructions should be available through a special HHS.Gov website, soon to be made available. Providers should continue to check the CARES Act Provider Relief Fund website for further details: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/index.html. Butler Snow will update this posting with an analysis of the new reporting requirements as soon as possible after details are released.