Provider Relief Funds: New FAQs Shine a Light on Appeals and Reporting Deadlines

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With both providers and the Department of Health & Human Services (HHS) focused on the Provider Relief Fund (PRF) reporting requirements since the beginning of 2021, relatively few Frequently Asked Questions (FAQs) issued by HHS have addressed topics unrelated to reporting. However, HHS has recently issued a number of FAQs that focus on two important areas other than reporting:

  • Appeals Process – Many providers have received PRFs inconsistent with reported financial information or funding formulas outlined by HHS. To date, HHS has had no formal process to appeal or dispute funding decisions. However, based on a new FAQ, HHS will implement a “structured reconsiderations process” in the coming weeks.
  • Returning Funds – Certain providers are struggling to expend all PRFs by the HHS deadline or have otherwise needed to return PRFs (for example, where a change of ownership occurred and the entity that received PRFs no longer has valid expenses or losses). New FAQs clarify that such providers must return any unused PRFs to the government within thirty calendar days after the end of the applicable period of reporting. Additionally, HHS has developed the Return Unused PRF Funds Portal and issued specific instructions on how to return PRFs.

PRF recipients should continue to monitor the HHS PRF web page for additional guidance and instructions. Based on recent FAQs, HHS has indicated more information on matters related to PRFs will be issued in the near future. Additionally, for the text of the FAQs described above, see below.

How Do I Appeal or Dispute a Decision Made?

HHS recognizes that providers may have questions regarding the accuracy of their PRF payments. HHS is developing a structured reconsiderations process to review and reconsider payment accuracy based on submitted supporting documentation. Details regarding this process will be provided in the coming weeks.

What Should Providers Do If They Have Remaining Provider Relief Fund Money That They Cannot Expend on Permissible Expenses or Losses by the Relevant Deadline?

Providers that have remaining Provider Relief Fund money that they cannot expend on permissible expenses or losses by the relevant deadline will return this money to HHS. Deadlines to use funds correspond to the date they received payment, as outlined in the Post-Payment Notice of Reporting Requirements. The Provider Relief Fund Terms and Conditions and legal requirements authorize HHS to audit Provider Relief Fund recipients now or in the future to ensure that program requirements are met. HHS is authorized to recoup any Provider Relief Fund amounts that were made in error or exceed lost revenue or expenses due to COVID-19 or in cases of non-compliance with the Terms and Conditions.

If a Provider Cannot Expend Its Provider Relief Fund Payment by the Applicable Deadline to Use Funds, What Is the Deadline to Return the Unused Funds to the Government?

The provider must return any unused funds to the government within 30 calendar days after the end of the applicable Period of Reporting.

How Can a Provider Return Unused Provider Relief Fund Payments That It Has Partially Spent?

Providers with remaining Provider Relief Fund payments that they cannot expend on allowable expenses or lost revenues attributable to Coronavirus by the relevant deadline to use funds are required to return this money to the federal government. To return any unused funds, use the Return Unused PRF Funds Portal. Instructions for returning any unused funds are available by visiting here. The Provider Relief Fund Terms and Conditions and applicable laws authorize HHS to audit Provider Relief Fund recipients now or in the future to ensure that program requirements are/were met. HHS is authorized to recoup any Provider Relief Fund payment amounts that were made in error, exceed lost revenue or expenses due to Coronavirus, or in cases of non-compliance with the Terms and Conditions.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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