Questions remain about the timing and formula of distributions of the remaining money in the fund.
June 23 update: The American Hospital Association (AHA) sent a letter to Xavier Becerra, secretary of the U.S. Department of Health and Human Services (HHS), requesting an extension of Provider Relief Fund deadlines for additional recipients.
Specifically, the AHA hopes recipients of PRF distributions that occurred by June 30, 2020, also can get more time to use their payments and report to HHS. Without an extension, organizations must use their funds by June 30, 2021, and return whatever they don't use to HHS.
Organizations that received payments starting July 1, 2020, were granted additional time to spend and report on their PRF money (see below). But the original spending deadline remains in place for payments made last year during the first phase of the general distribution and the start of the second phase, along with various targeted distributions.
"We urge you to revise your guidance to enable all recipients to retain access to these funds through the later of the end of the COVID-19 public health emergency or June 30, 2022," the AHA wrote.
The letter adds that "the new guidance disadvantages certain providers without providing a clear policy rationale. Specifically, some providers will need to spend their funds well before others simply because they received a PRF payment earlier in the distribution process."
Original: The U.S. Department of Health and Human Services on June 11 announced much-sought flexibility for Provider Relief Fund recipients, including extensions of the deadlines for spending and reporting on funds.
The original spending deadline was June 30, 2021, after which recipients would have needed to return their distributions. The new deadlines apply to allocations received after June 30, 2020. Reporting on use of funds is required only for time periods during which a provider's total distribution exceeded $10,000.
The time periods and corresponding deadlines are:
- For distributions received between April 10 and June 30, 2020, the deadline to use funds remains June 30, 2021, and the reporting period will be July 1-Sept. 30, 2021.
- For distributions received between July 1 and Dec. 31, 2020, the new deadline to use funds is Dec. 31, 2021, and the reporting period will be Jan. 1-March 31, 2022.
- For distributions received between Jan. 1 and June 30, 2021, the new deadline to use funds is June 30, 2022, and the reporting period will be July 1-Sept. 30, 2022.
- For distributions received between July 1 and Dec. 31, 2021, the new deadline to use funds is Dec. 31, 2022, and the reporting period will be Jan. 1-March 31, 2023.
Before the latest updates, reporting was required if a provider received more than $10,000 from the PRF in all time periods combined rather than in a single designated period. Another key change is an increase in the reporting window for each time period from 30 days to 90 days.
The PRF reporting portal had been open for registration since Jan. 15, but providers hadn’t been able to submit their reports while HHS considered changes to the timeline and requirements. The portal is scheduled to be fully operational starting July 1. Updated reporting procedures are spelled out in this document.
More than $30 billion remains in the fund
Provider advocates also have been pushing for the timely and targeted release of the remaining money, which was confirmed to total more than $24 billion in early March, with no distributions announced since. The COVID-19 relief legislation that was passed in mid-March allocated an additional $8.5 billion specifically for rural healthcare providers. That money likewise has yet to be distributed.
In several appearances before Congress over the last month, HHS Secretary Xavier Becerra pledged to be thoughtful in distributing the remaining funds. Prior distributions that were based on Medicare claims left out some safety-net hospitals, for example. The timing and formula regarding subsequent distributions remain uncertain.
The accommodations granted Friday nonetheless came as welcome news. In a statement attributed to President and CEO Rick Pollack, the American Hospital Associated thanked HHS “for listening to our concerns and extending the deadline for hospitals, health systems and other healthcare providers to use this critical relief funding.”
Providers had been pushing for updates to PRF rules and regulations. For example, HFMA was a signatory on a letter to Marvin Figueroa, director of the HHS Office of Intergovernmental and External Affairs, asking that the deadline for spending funds be extended by 18 months to Dec. 31, 2022. The associations also sought expeditious release of the remaining funds.
“These updated requirements reflect our focus on giving providers equitable amounts of time for use of these funds, maintaining effective safeguards for taxpayer dollars and incorporating feedback from providers requesting more flexibility and clarity about PRF reporting,” Diana Espinosa, acting administrator of the Health Resources and Services Administration, which administers the PRF, said in a June 11 news release.