HHS has made a few noteworthy changes to Provider Relief Fund (PRF) reporting guidelines in accordance with the Coronavirus Response and Relief Supplemental Appropriations Act of 2021. It’s possible that the new administration will amend some of this guidance, but here is a summary of key updates in the interim:
Application of Payments
Former guidance states that PRF recipients may apply payments toward lost revenue, up to the amount of the difference between their 2019 and 2020 actual patient care revenue. However, the new guidance states:
Recipients may choose to apply PRF payments toward lost revenue using one of the following options, up to the amount:
- of the difference between 2019 and 2020 actual patient care revenue;
- of the difference between 2020 budgeted and 2020 actual patient care revenue. If recipients elect to use 2020 budgeted patient care revenue to calculate lost revenue, they must use a budget that was established and approved prior to March 27, 2020.
- In order to verify the 2020 budget used for this methodology, providers must also submit an attestation from the reporting entity’s CEO, CFO, or similar responsible individual, attesting under 18 USC § 1001 [penalty for submitting false statements to a government agency] that the exact budget being submitted was established and approved prior to March 27, 2020.)
- calculated by any reasonable method of estimating revenue. Alternate reasonable methodology for calculating lost revenues attributable to coronavirus, the recipient must submit a description of the methodology, an explanation of why the methodology is reasonable, and establish how the identified lost revenues were in fact a loss attributable to coronavirus, as opposed to a loss caused by any other source. All recipients seeking to use an alternate methodology face an increased likelihood of an audit by HRSA.
Former guidance states that providers with PRF funds not fully expended by the end of calendar year 2020 will have an additional six months to use the remaining funds. However, in accordance with the changes described the above, the guidance documents differ slightly in how to calculate lost revenue for 2021. The new guidance states:
Providers have an additional six months in which to use remaining amounts toward expenses attributable to coronavirus…and/or lost revenues in an amount not to exceed the difference between:
- 2019 Quarter 1 to Quarter 2 and 2021 Quarter 1 to Quarter 2 actual revenue, or
- 2020 Quarter 1 to Quarter 2 budgeted revenue and 2021 Quarter 1 to Quarter 2 actual revenue.
Updated guidance indicates that a subsidiary’s parent organization may transfer the subsidiary’s Targeted Distribution to another subsidiary of the parent organization. However, transferred Targeted Distributions will face an increased likelihood of audit by HRSA. Notably, this seems to contradict an answer that remains in HHS’ FAQs, but it is likely that will be revised and this new guidance will take precedence.