Top 5 Questions: HHS Provider Relief Fund
We have received many, many questions related to the initial $100 billion in funding for health care providers and suppliers under the CARES Act and the subsequent replenishing of that fund with another $75 billion under the Paycheck Protection Program & Health Care Enhancement Act. That’s $175 billion appropriated since March 27, 2020, with $100 billion of that money already designated and flowing to health care providers and suppliers.
With that amount of money being distributed very quickly, there are a lot of questions. Here’s our list of the top 5 we have been hearing.
Provider Relief Fund Allocations
Before we answer some of the most pressing questions, let’s take a quick look at the distribution allotments of the first $100 billion. As of April 28, HHS has not indicated its approach to the next $75 billion.
General Distribution Allocation
Now, let’s answer a few of the questions we’ve been fielding specific to the $50 billion in general distributions.
Q: Why didn’t I/we receive any funds from the first $50 billion?
There could be a variety of answers to this question, but here are a few we’ve seen. Providers or suppliers would need to have Medicare Fee-For-Service (FFS) A or B reimbursements in 2019 to receive any funds. If you did not receive any of the first $30 billion funds (because you had no Medicare FFS in 2019) then you would not receive any from the next $20 billion either.
If you did receive funds under the first $30 billion but haven’t seen any additional from the next $20 billion then it may be because the Department of Health & Human Services (HHS) does not have the necessary revenue data for you. You will need to input several pieces of data at the General Distribution portal. All providers/suppliers receiving any of these funds will need to input their data. Read HHS’s FAQs for details.
Another reason is that you do not use electronic payments. This may have delayed receiving your payment. Also, since HHS is using the Tax Identification Number, the funds may have gone to an organization’s central billing office and not to you directly. If that is the case, you should check there.
Q: What can I use these funds for?
The answer is that HHS has not released detailed guidance on exactly what you can use these funds for, so we would be speculating if we provided a definitive answer. In the absence of detailed guidance, you should always look to the statute, read the terms and conditions, Frequently Asked Questions and other official publications from the regulatory agencies. To be safe, you would consult with your legal counsel as well.
That said, the CARES Act statute does indicate that the funds are for “eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus” as well as “for building or construction of temporary structures, leasing of properties, medical supplies and equipment including personal protective equipment and testing supplies, increased workforce and trainings, emergency operation centers, retrofitting facilities, and surge capacity.” This statutory language gives a bit of a list of uses.
HHS pulls some of the statutory language into the “terms and conditions” as well. For example, one requirement you must attest to is: “The Recipient certifies that the Payment will only be used to prevent, prepare for, and respond to coronavirus, and shall reimburse the Recipient only for health care related expenses or lost revenues that are attributable to coronavirus.”
Generally, you can see the statute and what has been officially released from HHS directly tie the use of funds to the pandemic. There are other requirements and considerations you must pay very close attention to as well. We await more guidance from HHS on all of this, and consulting legal counsel may be a wise step in the absence of further details.
Q: How should I track these funds?
For certain, you will need detailed and justifiable documentation. To help separate out the tracking of these funds from other revenues, best practice will be to create a separate bank account and use that only for receipts and payments related to COVID-19 or to create separate COVID-19 departments in your general ledger. There are other approaches as well, but these are a few examples.
Also, if you refer to the terms and conditions, there are additional examples of what HHS will require you to include in the quarterly reporting as well as documentation requirements (i.e.: for federal awards).
The bottom line: we know from HHS’s statements and related requirements that they will be watching the use of these funds closely through various reporting requirements and (we assume) future audit activity. Document, document, document and be able to justify why you used the funds in the ways that you did. You also may want to consider creating a calendar and/or ongoing narrative to document key dates — for example, the date of a state’s stay-at-home order or an outbreak in your area — which then can be helpful to support your organization’s state of mind and use of funds.
We all await further guidance from HHS on this particular subject.
Q: What are the terms and conditions related to these funds?
We strongly encourage everyone to read the terms and conditions closely. These are not insignificant. Those can be found here and vary depending on the type of fund(s) allocation you received. You may want to involve your legal counsel in assessing these terms and conditions as well.
Q: How do I return the money?
Should you decide not to accept the terms and conditions and choose to return the funds, you can do so via the attestation portal. Once there, you will be provided instructions on what to do.
In Closing
As with everything COVID-19 related, the situation and details are changing every day. Make sure you’re consulting with the appropriate people in your organization along with your finance and tax professionals and legal counsel for additional insights.
If you have questions, please feel free to reach out. We are here to help.
Jennifer Boese is the Director of Health Care Policy at CLA. She is a highly successful public policy, legislative, advocacy and political affairs leader, including working in both the state and federal government as well as the private sector. She brings over 20 years of government relations and public policy knowledge with her to CLA. Well over half of her career has been spent dedicated to health care policy and the health care industry, affording her a deep understanding of the health care market and environment, health care organizations and health care stakeholders. Her role at CLA is to provide thought leadership, policy analysis and strategic insights to health care providers across the continuum related to the industry's ongoing transformation towards value. A key focus of that work is on market innovations and emerging payment models. Her goal is to help CLA clients navigate and thrive in an increasingly dynamic health care environment.
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