Senators Call for Changes to Provider Relief Fund Reporting

Senators are raising issues with recent changes to Provider Relief Fund reporting requirements, citing concerns about hospitals having to return the payments during the ongoing public health emergency.

HHS released a guidance document on September 19, 2020, stating that providers who received payments from the Provider Relief Fund will need to report lost revenues attributable to the novel coronavirus, represented as a negative change in year-over-year net operating income from patient care related sources.

However, the definition of lost revenues in the guidance document was significantly different than one given in a June notice from HHS on Provider Relief Reporting requirements. In the June notice, HHS stated that providers could report revenues using “any reasonable method of estimating the revenue during March and April of 2020 compared to the same period had COVID-19 not appeared.”

The newest definition is less forgiving for providers, who will now have to provide more financial data to HHS in order to comply with Provider Relief Fund Terms and Conditions and will lead to uncertainty and financial hardship for hospitals, according to a group of 31 Senators.

“In the midst of the COVID19 pandemic, our health care providers need more certainty, not less,” the group led by Senator Marsha Blackburn (R-TN) wrote in a letter to HHS Secretary Alex Azar. 

In a separate letter led by Senators Amy Klobuchar (D-MN) and Tina Smith (D-MN), 20 Senators also called on HHS to reinstate the original requirement for calculating lost revenues to prevent hospitals from having to return the much-needed funding from the Provider Relief Fund.

“We have heard from hospitals and health systems in our states who are concerned that this change in the definition of lost revenue will force them to return funds to HHS that they have received from the PRF,” the letter stated. “In particular, rural hospitals and those that serve high numbers of low-income, elderly, and severely ill patients—which already operate on thin financial margins— may be especially impacted by this change.”

Hospitals have already expressed dismay with the change in reporting requirements, with the American Hospital Association (AHA) urging HHS to go back to the June reporting requirements days after the department announced the changes in the guidance document.

The hospital group reported that a member hospital, which is a rural safety-net provider, would have to return approximately $16 million out of the $20 million it received in Provider Relief Funds under the new reporting requirements. Another member also said 10 of its rural hospitals would be forced to return $20 million of the $65 million it received from the fund.

“Communities rely on America’s hospitals and health systems to be strong and resilient so they can provide essential public services, particularly during emergencies and public health challenges,” AHA told HHS leaders. “The PRF funds have helped them continue to put the health and safety of patients and personnel first, and in many cases, ensure they are able to keep their doors open. HHS’s Sept. 19 guidance jeopardizes this position and will come at the cost of access to care for patients and communities.”

Providers who accepted payments from the Provider Relief Fund must submit data on lost revenues from the coronavirus within 45 days of the end of the 2020 calendar year, according to HHS’ latest reporting requirements.

Additionally, providers must also report data on demographics, expenses attributable to coronavirus that are not eligible for other reimbursements, general and administrative expenses attributable to the virus, healthcare-related expenses attributed to the virus, and other non-financial information.

HHS has yet to respond to stakeholder feedback on changes to the reporting requirements in the September 19 guidance document.

Providers should immediately start gathering the data and documentation needed to comply with the new definition of lost revenues, lawyers from Butler Snow LLP advised.