HHS Publishes Reporting Requirements for Provider Relief Fund Recipients and Changes Lost Revenue Calculation

On September 19, 2020, the Department of Health and Human Services (HHS) published new Post-Payment Reporting Requirements applicable to providers who received payments of more than $10,000 from the Provider Relief Fund*.  Qualifying recipients will be required to report: (1) healthcare expenses attributable to the coronavirus not reimbursed by other sources; (2) general and administrative expenses attributable to the coronavirus; (3) lost revenues attributable to the coronavirus; and (4) additional non-financial data.

Notably, HHS has changed how lost revenues must be calculated.  Formerly, HHS provided that “lost revenues” meant any revenue that a health care provider lost due to the coronavirus, such as the difference between a provider’s budgeted revenue and actual revenue, or comparison to revenues for the same period last year.  The new calculation of “lost revenues” defines it as a year-over-year change in net patient care operating income, which is equal to patient care revenue for the year minus patient care related expenses for the year.  The new guidance also places a cap on how much lost revenue providers can claim.

The HHS reporting portal will open on January 15, 2021. *The Post-Payment Reporting Requirements do not apply to Nursing Home Infection Control grants, Rural Health Clinic Testing grants, or reimbursements from the Health Resources and Services Administration Uninsured Program.

Assisted Living Facilities Eligible for COVID-19 Funding

On September 1, 2020, the Department of Health and Human Services (HHS) announced that assisted living facilities may now apply for Provider Relief Fund payments to help address the economic harm and additional expenses caused by the COVID-19 pandemic. Assisted living facilities that may have previously been ineligible for Phase 2 General Funding of the Provider Relief Fund are invited to apply.  Assisted living facilities may receive 2% of their annual revenue from patient care under this funding.  Eligible facilities can apply at the Provider Relief Fund site here until September 13, 2020.

HHS Announces Additional CARES Act Funds for Nursing Homes

On August 7, 2020, the Department of Health and Human Services (HHS) announced that nursing homes and long-term care facilities will receive an additional $5 billion in payments from the Provider Relief Fund. $2.5 billion will support increased testing, staffing, Personal Protective Equipment (PPE) needs, and establishment of COVID-19 isolation facilities. The remaining $2.5 billion will be linked to nursing home performance, which will consider the prevalence of COVID-19 in the nursing home’s local geography and the facility’s ability within this framework to control COVID-19 spread and related fatalities among its residents.