Provider Relief Fund Reporting Guidance: May 18 Deadline to Request Late Reporting for Provider Relief Fund Period 2

• May 18 Deadline to Request Late Reporting for Provider Relief Fund Period 2 (May 16, 2022)
• Provider Relief Fund Late Reporting Requests for Extenuating Circumstances Accepted April 11-22 (April 7, 2022)
• Looming Deadlines to Report Provider Relief Fund Period 2 Payments and COVID-19 Vaccine Claims (March 28, 2022)
• HHS to Reopen Provider Relief Fund Period 1 Reporting Dec. 13-20 (December 10, 2021)
• HHS Grants Reporting Grace Period Until Nov. 30 for Provider Relief Fund (September 28, 2021)
• Provider Relief Fund Reporting Portal Opens — Nine Things to Know to Report by Sept. 30 (July 6, 2021)
• Provider Relief Fund Reporting Begins July 1 — Six Updates on New Guidance (June 21, 2021)

May 18 Deadline to Request Late Reporting for Provider Relief Fund Period 2

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The U.S. Department of Health and Human Services (HHS) announced a deadline extension for providers that received $10,000 or more in the second half of 2020 from the Provider Relief Fund. Such providers that missed the previous reporting deadlines now have until May 18, 2022, at 11:59 p.m. (ET) to submit a request to report late if they experienced a specific extenuating circumstance.

They can submit the request through the Request to Report Late Due to Extenuating Circumstances Form. Providers approved by HHS to report late can then submit their required reports via the Provider Relief Fund reporting portal.

Like the Period 1 extenuating circumstances late reporting requests (discussed in an April 7, 2022, McGuireWoods alert), this opportunity “does not guarantee the request will be approved or that a provider will be allowed to … submit a report.” This opportunity utilizes the same rules and processes that applied during Period 1, including requiring the provider to submit a clear and concise explanation of why it meets one of six categories that may qualify as an extenuating circumstance for late reporting. If denied, the provider will be required to return to HHS all funds not reported before the earlier deadline, for failing to comply with the Provider Relief Fund’s terms and conditions.

Separately, for providers that submitted Period 1 extenuating circumstances late reporting requests, HHS stated that “[s]tarting the week of May 9, 2022, providers who submitted a request will receive an email notification from [email protected] if their request is approved.” Upon approval, providers then have 10 days to submit their reports. Providers are strongly encouraged to add this email address to any spam filter safe sender lists to ensure they receive all necessary information in response to their late reporting requests.
 
As reported in a previous McGuireWoods alert, the Period 2 reporting period closed March 31, 2022, for any healthcare provider that received at least $10,000 from the Provider Relief Fund during July 1 to Dec. 31, 2020.

Provider Relief Fund Late Reporting Requests for Extenuating Circumstances Accepted April 11-22

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The U.S. Department of Health and Human Services (HHS) announced that providers that received $10,000 or more in the first half of 2020 from the Provider Relief Fund but missed the reporting deadlines will have an opportunity to request to report late if they experienced a specific extenuating circumstance.

Such request must be submitted by April 22, 2022, at 11:59 p.m. (ET) through a form that will become available April 11. Providers approved by HHS to report late can then submit their required reports via the Provider Relief Fund reporting portal.

HHS has cautioned, however, that this opportunity “does not guarantee the request will be approved or that a provider will be allowed to … submit a report.” If denied, a provider will be required to return to HHS all funds that were not reported before the earlier deadline for failing to comply with the Provider Relief Fund’s terms and conditions.

To request an opportunity to complete a late report, the provider must select one of six reasons explaining why it was unable to submit a completed report in reporting period 1 before the passed deadline. The provider must also provide a concise explanation related to the applicable extenuating circumstance and attest to the truthfulness and accuracy of such circumstance. The six categories (each with a definition on the late reporting request website) are:

• severe illness or death;
• impacted by natural disaster;
• lack of receipt of reporting communications;
• failure to click “submit”;
• internal miscommunication or error; or
• incomplete Targeted Distribution payments.

This opportunity comes after required reports for period 1 were initially due Sept. 30, 2021, extended with a grace period for reporting until Nov. 30, 2021, and then a subsequent reopening for a week in December, as discussed in previous McGuireWoods alerts (Sept. 28 and Dec. 10, 2021). After the close of period 1, HHS began notifying nonreporting providers that they were noncompliant and would need to return received funds.

This late reporting request period appears to be a response to industry outcry from such notices and potential industry harm stemming from the perceived inflexibility and inadequate compliance opportunities for providers. Further, HHS likely was aware that, for some providers, returning funds would be unfair and seriously challenging, particularly in light of the ongoing COVID-19 surges. Anecdotally, McGuireWoods is aware of providers whose previous HHS communications were not received or were misplaced. HHS has indicated that there will be similar late reporting request periods for future reporting periods, including the recently closed period 2 (for funds received during the second half of 2020), discussed in a March 28, 2022, McGuireWoods alert.

Providers that need to request an opportunity for late reporting due to extenuating circumstances should promptly take the following actions:

1. If the provider has not previously registered on the Provider Relief Fund reporting portal, such provider should immediately complete the reporting portal registration. Registration will be required to submit the late report request and this process takes time for HHS to review and link the account with the received funds. More information on registering, including a registration manual, is available at Step 1 of the reporting requirements webpage.
2. Providers should carefully review their extenuating circumstances and determine which, if any, of the above-listed acceptable extenuating circumstances applies. As noted above, the provider will need to submit a clear and concise explanation related to the extenuating circumstance. While supporting documentation will not be required, providers should ensure for their comfort that such supporting information is available and maintained for any filing made to the government in case there is a future audit or review.
3. Providers should begin preparing the information required to submit a period 1 report as soon as possible. HHS has stated that providers will have only 10 days from notification that their request was approved to submit the report. The reports will require financial and organizational information, as well as information about how the funds were used. More information on the required reports is available in prior McGuireWoods alerts (see, e.g., July 6 and June 21, 2021) and on the HHS reporting requirements webpage.
4. Providers should also ensure they carefully monitor and review future Provider Relief Fund communication. Any email address provided through the reporting portal (as well as emails given in government reimbursement program enrollment and licensure applications) should be monitored to ensure the provider receives all important communication in the future. To that end, providers may want to ensure emails received from @hrsa.gov, @hhs.gov, and @ProviderEmail.uhc.com domains are added to safe receipt lists.

McGuireWoods will continue to monitor further HHS reporting periods, including the dates for reopening opportunities for period 2 reporting, particularly since the penalty for nonreporting is returning the Provider Relief Fund payments within 30 days of the end of the reporting period, and as period 3 reporting opens on July 1, 2022. McGuireWoods has published additional thought leadership analyzing how companies across industries can address crucial business and legal issues related to COVID-19. 

Looming Deadlines to Report Provider Relief Fund Period 2 Payments and COVID-19 Vaccine Claims

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The U.S. Department of Health and Human Services (HHS) reporting portal remains open only through March 31, 2022, at 11:59 p.m. (ET) for Provider Relief Fund Period 2 reporting. On April 5, 2022, at 11:59 p.m. (ET), due to insufficient funds, HHS will close claim submission under two programs reimbursing providers for COVID-19 vaccinations — one for the uninsured and the other for the underinsured. Providers who fail to report before these deadlines may have to refund payments to the government or may lose out on government financial support.

As discussed in prior McGuireWoods alerts (July 6 and June 21, 2021), any healthcare provider that received at least $10,000 from the Provider Relief Fund during period 2 (July 1 to Dec. 31, 2020) must report on its use of those funds by March 31, 2022. Provider Relief Fund payments were to be used only for healthcare-related expenses or lost revenue attributable to COVID-19, as supported by this mandatory report to HHS, by Dec. 31, 2021. This report follows a period 1 report initially due Sept. 30, 2021, extended with a grace period for reporting until Nov. 30, 2021, and then a subsequent reopening for a week in December, as discussed in previous McGuireWoods alerts (Sept. 28 and Dec. 10, 2021). To date, HHS has not suggested there would be any extension forthcoming for period 2 reporting.

For those providers that reported on period 1 payments, the period 2 report should look familiar. HHS has released very few updates on its frequently asked questions (FAQ) reporting page regarding the period 2 report, instead focusing on its June 11, 2021, guidance and published Therefore, providers will likely want to largely track the same choices made during period 1 reports.

That said, HHS did release answers to several FAQs clarifying that it would allow providers to utilize a different methodology for reporting lost revenue in a subsequent reporting period than they used in a previous reporting period (i.e., using a different methodology for lost revenue calculations in this period 2 report than they used in the period 1 report). A provider that utilizes this flexibility, however, should understand that this revision could impact its earlier report as “the system will recalculate total lost revenues for the entire period of availability, which may impact the previously reported unreimbursed lost revenues.” HHS noted that because of an “overlapping period of availability … they may be required to return more funds than they received during the applicable ‘Payment Received Period.’”

On the other hand, HHS has not removed the January 2022 Lost Revenues Guide: Reporting Period 2 that states the opposite as a best practice — “The same approach used for lost revenues calculation should be used in any subsequent Reporting Periods.” Additional guidance regarding the overlapping periods of availability and avoiding duplicative reports can be found in the HHS resources for reporting period 2.

Also, regarding the period 1 reopened reporting period, HHS answered a question many providers asked — why the reporting portal requires the provider to detail certain patient metrics and other nonfinancial information. HHS stated that providers must report such information so it can “gather information on the number of patients treated by Provider Relief Fund recipients.” HHS also suggested that providers should “count the distinct encounters or visits in the category that is the most fitting category available,” likely so HHS can easily aggregate such information in reporting to Congress and other stakeholders on the Provider Relief Fund’s impact during the COVID-19 pandemic (even if such aggregated data has certain inaccuracies from the categories not fitting all provider or facility patient encounters).

Last, in addition to the Provider Relief Fund reporting deadlines, HHS will stop accepting “vaccination claims due to a lack of sufficient funds” on April 5, 2022, at 11:59 p.m. (ET), for the two vaccine programs referenced above. HHS plans to make payment for claims submitted before that time “subject to availability of funds.” Ending the vaccine payment programs for the uninsured and underinsured comes on the heel of HHS closing claim submissions for COVID-19 testing and treatment for the uninsured on March 22, 2022. The uninsured testing and treatment program, discussed in April 29, 2020, McGuireWoods alert, provided funding for qualifying healthcare providers conducting COVID-19 testing for uninsured patients or providing treatment to uninsured patients with a positive COVID-19 diagnosis on or after Feb. 4, 2020.

HHS ended these COVID-19-related programs after Congress enacted its FY 2022 omnibus appropriations package without $15 billion in additional COVID-19 funding, as discussed in a March 14, 2022, McGuireWoods Consulting update. HHS may reopen the program if Congress later funds it, but providers participating in the vaccination program should submit claims before the April 5 deadline to avoid losing out on reimbursement.

McGuireWoods will continue to monitor further HHS reporting periods, including any reopening opportunities for period 2 reporting, particularly since the penalty for nonreporting is returning the Provider Relief Fund payments within 30 days of the end of the reporting period. McGuireWoods has published additional thought leadership analyzing how companies across industries can address crucial business and legal issues related to COVID-19. 

HHS to Reopen Provider Relief Fund Period 1 Reporting Dec. 13-20

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The U.S. Department of Health and Human Services (HHS) reporting portal includes a new statement appearing to give providers an additional week in mid-December to submit reports and correct errors for Provider Relief Fund reporting. At this time, solely published on the HHS reporting portal, there is a note that the portal will “open for the completion or submission of reports for Reporting Period 1 from December 13, 2021 to December 20, 2021 at 11:59 pm ET.” This additional week could provide critical relief for providers who did not submit required reports by earlier deadlines, although other HHS guidance continues to reflect potential penalties for those who failed to report.

As discussed in prior McGuireWoods alerts (July 6, 2021 and June 21, 2021), any healthcare provider that received at least $10,000 from the Provider Relief Fund during period 1 (April 10 to June 30, 2020) needed to report on its use of those funds by Sept. 30, 2021. Provider Relief Fund payments could be used only for healthcare-related expenses or lost revenue attributable to COVID-19, supported by this mandatory report. Subsequently, HHS announced a grace period for reporting until Nov. 30, 2021, discussed in a Sept. 28, 2021, McGuireWoods alert. Certain providers may have missed the grace period’s expiration as anecdotally there were some technology issues at the end of this period.

While the reporting portal includes the information quoted above, other HHS sites continue to reflect that failing to report by Nov. 30, 2021, means the provider is “out of compliance” with the Provider Relief Fund. HHS requires such providers to return their unused and noncompliant Provider Relief Fund payments by Dec. 30, 2021. Similarly, at this time, the Health Resources Services Administration website reflects that the reporting period has closed:

Assuming the reporting portal’s announcement is accurate, and HHS is allowing this unexpected week to report, providers who need to submit a report or correct errors should prepare to utilize the reporting portal when it opens Dec. 13, 2021. Anyone needing to correct an error should contact the Provider Support Line (866-569-3522), because that is the stated first step to accessing the reporting portal for those who previously submitted a report for error correction. Providers that need to utilize this special reporting period can learn more about reporting elements on the McGuireWoods Provider Relief Fund Reporting Guidance page. Additional instructions on the portal registration process and reporting resources are available on the Health Resources & Services Administration website.

McGuireWoods will continue to monitor further HHS instruction, particularly since the penalty for nonreporting is returning the Provider Relief Fund payments by Dec. 30. With this additional week, it is possible HHS will give providers additional time to make repayments. In addition, providers should be aware that HHS will open the reporting portal for Period 2 (receiving payments July 1 to Dec. 31, 2020) on Jan. 1, 2022.

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

HHS Grants Reporting Grace Period Until Nov. 30 for Provider Relief Fund

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The U.S. Department of Health and Human Services (HHS) recently announced a 60-day grace period to allow providers to comply with the Provider Relief Fund reporting requirements, should they fail to meet the Sept. 30, 2021, deadline. Providers will have until Nov. 30, 2021, to submit their reports, although HHS strongly encouraged submitting reports by Sept. 30.

As discussed in the July 6, 2021, McGuireWoods alert, any healthcare provider that received at least $10,000 from the Provider Relief Fund during the first payment period (April 10 to June 30, 2020) must report on its use of those funds through the HHS reporting portal by Sept. 30, 2021. Additional instructions on the portal registration process and reporting resources are available on the Health Resources & Services Administration website. Provider Relief Fund payments could be used for healthcare-related expenses or lost revenue attributable to COVID-19.

HHS has clarified that this Sept. 30, 2021, reporting deadline remains in place; however, HHS is granting providers a 60-day grace period — beginning Oct. 1, 2021, and ending Nov. 30, 2021 — in which HHS will not initiate recoupment or other enforcement actions against out-of-compliance providers. Despite this enforcement grace period, HHS strongly encouraged providers to complete their submissions through the HHS reporting portal by the Sept. 30, 2021, deadline to report on compliance with the Provider Relief Fund’s terms and conditions.

Providers should also be aware that HHS has not changed deadlines with respect to the period of availability for use of the Provider Relief Funds (already passed for the first payment period), but with the grace period, HHS will give additional time for returning unused funds, as discussed in greater detail below.

1. Providers that received one or more payments exceeding $10,000, in the aggregate, during a payment received period outlined below in the table provided by HHS, must use the funds during the period of availability also outlined below. HHS has cautioned that there is no extension on the use of funds beyond the period of availability.

2. In addition, providers must return unused funds as soon as possible after submitting their reports. All unused funds must be returned no later than 30 days after the end of the grace period (Dec. 30, 2021).

HHS also announced that applications will open Sept. 29, 2021, for Phase 4 and American Rescue Plan (ARP) rural applicants from the $25.5 billion in additional relief funds. HHS will distribute $8.5 billion in ARP resources for providers who serve rural Medicare, Medicaid or Children’s Health Insurance Program patients and $17 billion in Phase 4 of the Provider Relief Fund covering a broad range of providers with changes in operating revenues and expenses. The portal for applications for payments under both acts opens Sept. 29, 2021. Expect further updates to the Provider Relief Fund Application and Attestation Portal and Future Payments guidance to address questions on the Phase 4 and ARP rural applications in advance of the Sept. 29, 2021, opening date.

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.

Provider Relief Fund Reporting Portal Opens — Nine Things to Know to Report by Sept. 30

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Any healthcare provider that received at least $10,000 from the Provider Relief Fund (described further below) during the first half of 2020 must report on its use of those funds by Sept. 30, 2021. To facilitate these reports, the U.S. Department of Health and Human Services (HHS) opened its reporting portal on July 1, 2021.

To aid providers in preparing their reports, HHS also issued data entry worksheets, updated and added new portal user guides, issued nine pages of reporting portal frequently asked questions (FAQs) and updated reporting-specific Provider Relief Fund FAQs. Using these new instructions and guidance, in conjunction with past updates, healthcare providers must report on Provider Relief Fund payments received between April 10 and June 30, 2020 (Period 1), before the Sept. 30 deadline.

This alert summarizes nine key updates healthcare providers need to know to complete the mandatory Provider Relief Fund reports to HHS.

1. No extensions will be provided for reporting or spending deadlines. HHS has made it clear that healthcare providers that must report on Period 1 payments must do so prior to 11:59 p.m. (ET) on Sept. 30, 2021, and that HHS will not grant extensions to this deadline. Subsequent reporting deadlines discussed in item No. 1 of the June 21, 2021, McGuireWoods alert and included in the summary chart below, will similarly be maintained without flexibility. Furthermore, while the deadline to spend Period 1 payments has now passed, those providers that received Provider Relief Fund payments on or after July 1, 2020, will similarly need to spend those funds on eligible expenses or lost revenue before such deadline to use funds, and likewise will not be granted spending extensions. Therefore, healthcare providers that received Provider Relief Fund payments after the initial automatic funding made on April 10, 2020, should review the following summary chart and monitor these deadlines to ensure compliance.

2. Healthcare providers must register for the reporting portal before submitting reports. Although the reporting portal did not open until July 1, HHS has allowed healthcare providers to register an account on the site since January 2021. If a Provider Relief Fund recipient has not yet registered for an account, the recipient must do so before reporting by clicking “Register” on prfreporting.hrsa.gov. This registration process links the recipient entity and its tax identification number, as well as any subsidiary entities to be included in the report and the amounts received from the Provider Relief Fund program. Some recipients have needed to work with HHS to register their accounts and link subsidiaries, so anyone who has not yet registered is encouraged to do so as soon as possible. HHS has updated its Registration User Guide (originally issued in January 2021) to guide users through the process.

3. While there is plenty of time to submit a Period 1 report, providers should not wait to start the report. The reporting portal will allow providers to save information they are submitting and return to the portal prior to the final submission (unlike the registration process, which required submission to be completed during a single site visit). Providers should take advantage of this save feature and advance at least through Step 4 of the reporting process, where the recipient reviews and can download a summary table highlighting the payments made to the recipient during the reporting period. Each healthcare provider must confirm this record’s accuracy before continuing with the reporting process.

If the information is incorrect, call the Provider Support Line (866.569.3522 for TTY dial 711). Do not annotate any corrections in the box provided in the reporting portal, as this box will not be submitted to or reviewed by HHS. Any discrepancies in this information likely will take time to be investigated, and given the 90-day reporting deadline, providers should advance to at least this point so they can address discrepancies as soon as possible. HHS has issued a Reporting User Guide to assist providers through this step and the entire reporting process.

4. Reporting portal login information. Each login to the reporting portal will require the user to enter a separate six-digit code generated by the system and sent to the user’s email address. This additional step is intended to protect the user’s account through two-factor authentication. HHS instructs users to add the email address [email protected] to their email safe list to increase the likelihood they will receive these emails.

5. In calculating expenses and lost revenue, healthcare providers need to carefully review applicable HHS guidance. The Provider Relief Fund payments may be used for eligible expenses or lost revenue attributable to COVID-19 that are not reimbursed from another source. Providers will need to report other assistance received, such as Paycheck Protection Program loans and commercial payor reimbursement, and may report only those expenses that remain unreimbursed after such support.

While requiring this information, HHS’ back-end calculator will not automatically calculate it against the provider’s overall expenses. Instead, HHS appears to be requiring providers to report all expenses, and then separately report expenses and lost revenues after considering reimbursement from other sources. This guidance will apply to each provider in a different manner. For example, critical access hospitals paid based upon cost of care, will need to allocate their expenses paid by such sources and offset the Medicare reimbursement determining if other expenses were left unreimbursed from commercial payors.

Significant guidance already exists in the FAQs about these items, with more guidance likely to be added as HHS receives additional questions with the reporting portal’s opening. Additionally, providers can review the Nov. 3, 2020, McGuireWoods alert starting with item No. 2. As providers review this guidance and prepare to report, they may also want to utilize the data entry worksheets to review numbers and calculations with their teams prior to reporting.

6. If the provider’s eligible expenses equal the amount received from the Provider Relief Fund, the provider does not need to detail lost revenue. HHS previously indicated that healthcare providers would be required to detail both expenses and lost revenue in their reports. HHS appears to have walked back that indication, instead requiring a provider to report actual patient care revenue for 2019, 2020 and 2021 only if the amounts received in Period 1 were used entirely for eligible expenses under the Provider Relief Fund. (Expenses will be reported before lost revenue.) As a reminder, eligible expenses are those used to prevent, prepare for and respond to COVID-19, including services rendered to COVID-19 patients and certain other healthcare-related and administrative expenses, including taxes paid on amounts received from the Provider Relief Fund, that were not reimbursed by any other source. HHS noted that the provider must keep adequate documentation to support its expenses and lost revenue calculations and the provider has the burden of proof that the spending was appropriate under the Provider Relief Fund’s terms and conditions.

7. Lost revenue calculations will be on a quarter-by-quarter basis. HHS also appears to have walked back previous statements that lost revenue would be calculated on an annualized basis, which could have led some providers that lost significant revenue in the first two quarters of 2020 to lose eligibility for the program because they offset those losses later in 2020. HHS’ instructions on reporting lost revenue indicate that the calculations will be done on a standalone quarter-by-quarter basis, with any quarters with increased revenue effectively represented by a zero dollar amount (or not counted in the lost revenue calculation). This approach should increase the number of healthcare providers eligible to utilize the lost revenue metric to support receipt of Provider Relief Fund payments. HHS also gave instructions in its Reporting User Guide for the three lost revenue options discuss in the Jan. 19, 2021, McGuireWoods alert: (a) year-over-year actual lost revenue, (b) lost revenue to an approved budget and (c) other reasonable methodologies for determining lost revenue (with the third option receiving the most scrutiny that could lead to an HHS conclusion that it was not a reasonable methodology).

8. “Surplus” expenses and lost revenue can carry over to future reporting periods; “shortfalls” cannot. For those healthcare providers that report eligible expenses attributable to COVID-19 that exceed the amount of Provider Relief Funds received in Period 1, or whose lost revenue exceeds such amounts, HHS made it clear that the “surplus” may carry over to future reporting periods. This clarification means that if in Period 1, the amounts received from the Provider Relief Fund were less than eligible usages, the balance can be used in reporting during Periods 2, 3 or 4 if the provider received payments in those periods, too. (As a reminder, HHS will require separate reports for each period where the provider received more than $10,000.) On the other hand, if the amounts received during Period 1 exceeded eligible expenses or lost revenue spent before June 30, 2021, there will be a “shortfall.” The provider cannot carry that shortfall forward — the Period 1 spending deadline has now passed. Even if the provider incurs further expenses or lost revenue on or after July 1, 2021, those amounts cannot be used for funds received during Period 1, and can be used to report on future reporting periods only if the provider received subsequent payments in subsequent periods.

9. Any shortfall must be returned to the government by Oct. 30, 2021. Instead of rolling over shortfalls calculated through the reporting portal to future reporting periods, money must be returned to the government. HHS indicated that money received during Period 1 that the healthcare provider cannot support through spending on eligible expenses or lost revenue, must be returned within 30 days of the end of the Sept. 30 reporting period, or Oct. 30, 2021. Similar 30-day repayment requirements will exist for subsequent reporting periods after each reporting deadline. HHS’ Reporting User Guide suggests within Step 16 on page 67 that there will be instructions in the reporting portal to return such excess funds. HHS may provide additional guidance on returning funds through future amendments to its FAQs document.

Provider Relief Fund Reporting Begins July 1 — Six Updates on New Guidance

June 21, 2021

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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”