Provider Relief Fund Reporting Guidance

RELATED: End of COVID-19 Emergency: Legal Implications for Healthcare Providers (May 1, 2023)

Healthcare providers will have 90 days, beginning July 1, 2021, to report on funds they received in the first half of 2020 from the Public Health and Social Services Emergency Fund (Provider Relief Fund).

This announcement, along with confirmation that funds received in the first half of 2020 must be used by June 30, 2021, finally gives healthcare providers some certainty around the Provider Relief Fund program’s next steps. Providers have been waiting on guidance regarding mandatory reports from the U.S. Department of Health and Human Services (HHS) since it announced on Jan. 15, 2021, that it was delaying reporting deadlines but didn’t state when such reports would be required, as discussed in a prior McGuireWoods alert. This most recent HHS announcement clarified that reporting begins next month.

HHS also issued a new reporting requirement document, multiple deadlines (discussed further below) for when recipients must use received funds and when applicable reports are due to HHS, and additional guidance through frequently asked questions (FAQs) for Provider Relief Fund recipients.

The Provider Relief Fund was created through congressional appropriations now totaling $178 billion to reimburse providers’ eligible expenses and lost revenues attributable to COVID-19 (as covered in previous McGuireWoods legal alerts, including those discussing the three bills with such funding on, respectively, March 27, 2020, April 23, 2020, and Jan. 4, 2021). HHS developed the Provider Relief Fund through multiple rounds of payments, including general distributions to most healthcare providers and targeted distributions to certain provider categories. HHS also published FAQs and other program announcements, such as the latest reporting guidance discussed above.

From this guidance, HHS will now require any provider that received at least $10,000 from the Provider Relief Fund between April 10 and June 30, 2020 (Period 1), to use all such funding by June 30, 2021. Providers also must report healthcare-related and general and administrative expenses and lost revenue attributable to COVID-19 between July 1 and Sept. 30, 2021, with more detailed expense reporting required for each provider receiving $500,000 or more.

This alert summarizes six key Provider Relief Fund updates healthcare providers should understand from HHS’ latest announcement.

1. The first deadline to use received funds remains June 30, 2021; three later deadlines are created for funding received after July 1, 2020.
   
   Healthcare providers have been asking HHS for flexibility on timing to use the Provider Relief Fund payments as the pandemic has continued to impact different geographic regions and different specialties in different waves. HHS ultimately gave providers more flexibility in its latest announcements — allowing “all funds [to] be available for at least 12 months and a maximum of 18 months” — while keeping the previously announced expenditure deadline of June 30, 2021, only for funds received during the first half of 2020 (as opposed to that deadline applying to all payments, without reference to receipt date).
   
   HHS announced three additional deadlines to use Provider Relief Fund payments. These deadlines are based on the date the provider received the payment and give providers additional time to utilize this federal support. In each case, the funding may be used only for eligible expenses, with reporting to ensure this was the case. The chart below shows the deadlines to use or expend funds for each receipt period, with a deadline announced for funds received the second half of this year, likely to include a future phase mandated by Congress, as discussed in a Jan. 4, 2021, McGuireWoods alert.

2. Four reporting deadlines also are created, with Period 1 reporting due Sept. 30, 2021.
   
   Consistent with four separate deadlines for flexible usage based on receipt date, HHS also created four reporting periods with separate applicable deadlines for reporting on spending such funds. Each reporting period lasts 90 days and begins the day immediately after the use-of-funds deadline described in the preceding paragraph. This 90-day reporting period is an expansion of HHS’ previously anticipated 30-day reporting period. This longer reporting period should allow providers time to review the reporting requirements during each period and receive technical assistance from HHS and others before submitting required reports.

3. Providers must submit a report for each period they received $10,000 or more from the Provider Relief Fund, even if a provider spent all funds before an earlier report.
   
   HHS guidance states that “recipients are required to report in each Payment Received Period in which they received one or more payments exceeding, in the aggregate, $10,000.” To underline this guidance, a recipient will submit a report if it received $10,000 or more during the applicable period, not if it received such amounts in aggregate across all periods. This means that even if a provider received more than $10,000 in the aggregate from multiple distributions, the provider may not need to submit any actual report to HHS if the provider never received more than $10,000 in any single applicable period.
   
   Of course, for many more providers who received $10,000 or more in multiple periods, HHS will require multiple reports. Even if the provider has used all of its funds by the first deadline, further reporting will be required during future reporting periods, if a provider received funds over multiple periods. This is different from prior HHS guidance where additional reporting was based on whether funding was fully expended in 2020 or Provider Relief Fund payments were still being utilized in 2021.

4. Reporting requirements now apply to skilled nursing facility and nursing home infection control distribution recipients.
   
   HHS’ updated guidance requires reporting from the nursing home infection control distribution payment recipients. This program allows recipients to use payments for (a) costs associated with administering COVID-19 testing; (b) reporting such test results to local, state or federal governments; (c) hiring staff to provide patient care or administrative support; (d) providing additional services to residents; or (e) other expenses incurred to improve infection control.
   
   The guidance requires reporting 12 separate subcategories of expenses for those recipients that received more than $500,000 in aggregate Provider Relief Fund payments during a payment period. The subcategories of expenses are similar to those previously required for all other applicable distributions but include specific requests related to the terms of this particular infection control distribution. This is a change from earlier HHS guidance where this distribution was expressly not included in reporting requirements.
   
   HHS separately noted that the reporting requirements still do not apply to either the Rural Health Clinic COVID-19 Testing Program or claims reimbursements from the HRSA COVID-19 Uninsured Program and the HRSA COVID-19 Coverage Assistance Fund. Further reporting guidance may be provided to these separate distributions in the future.

5. New information is required, including answers to survey questions on the Provider Relief Fund’s impact.
   
   The revised reporting instructions request additional information from healthcare providers. This new information includes: (a) general provider information, such as a provider’s business name and address as it appears on the entity’s IRS Form W-9, contact information for the responsible individual for the report and selection of the recipient’s provider type and subtype from a provided category list; (b) the TINs of any subsidiaries the reporting entity is including in its report; and (c) supplementary information about any acquisitions or divestures involving subsidiaries of the recipient reporting on Provider Relief Fund payments, with instructions to self-report changes of ownership to the reporting entity itself through the Provider Relief Fund hotline.
   
   Additionally, reporting entities will answer survey questions regarding the impact of the Provider Relief Fund payments. HHS did not provide the exact survey questions but suggested seven categories for these questions. These categories cover overall operations, prevention of bankruptcy, rehiring staff from furlough, caring for COVID-19 patients and a narrative statement on business or patient impact. It appears HHS wants this information to give examples of how the Provider Relief Fund supported the healthcare industry. More information will likely come on the survey questions when the July 1 reporting period opens, so providers will be able to prepare responses before logging into the Provider Relief Fund Reporting Portal.

6. HHS will provide additional guidance throughout the four reporting periods.
   
   In issuing its new reporting guidance, HHS released four new FAQs and modified 14 previously issued FAQs. HHS also committed to webinars with “opportunities for question and answer sessions.” Its guidance also suggests that a detailed Provider Relief Fund Reporting Portal user guide will be released to give “greater clarity about the reporting process” in addition to the current registration user guide already posted to the Reporting Portal. Such evolving guidance is consistent with the Provider Relief Fund’s evolution over the last 14 months.

Until HHS provides additional guidance, healthcare providers that have not yet registered to report should do so on the Reporting Portal and should also review the Provider Relief Fund’s applicable terms and conditions to ensure their compliance with the program. In addition, healthcare providers can review McGuireWoods’ previous guidance on reporting to HHS (which may largely still apply except for the updates and changes discussed above):

• Jan. 19, 2021, alert, “HHS Delays Provider Relief Fund Reporting — Five Updates for Healthcare Providers”
• Nov. 3, 2020, alert, “Health Department Updates Provider Relief Fund Reporting Guidance”
• Oct. 2, 2020, alert, “Provider Relief Fund: New $20 Billion Available Starting Oct. 5 and Reporting Guidance Issued”

McGuireWoods anticipates providing additional guidance throughout the four reporting periods and stands ready to assist Provider Relief Fund recipients with any questions about this updated information. McGuireWoods will also continue to monitor developments regarding reporting and auditing for those who received Provider Relief Fund payments.

McGuireWoods has published additional thought leadership analyzing how companies across industries can address crucial business and legal issues related to COVID-19.