HHS Updates Provider Relief Fund FAQs; Reporting Portal for Phase 4 Funding Slated to be Available Friday, January 15, 2021
Once again, HHS has updated the Provider Relief Fund Frequently Asked Questions (FAQs). HHS has not yet made an announcement related to Phase 4 funding; however, the HHS website still notes that the Reporting Portal is slated to be available as of Friday, January 15. The new or modified questions are below:
Can a provider that purchased a TIN in 2019 or 2020 accept a Provider Relief Fund payment from a previous owner and complete the attestation for the Terms and Conditions? (Modified 1/12/2021)
No. The new TIN owner cannot accept the payment from another entity nor attest to the Terms and Conditions on behalf of the previous owner in order to retain the Provider Relief Fund payment, including payment under the Nursing Home Infection Control Quality Incentive Program. However, the new TIN owner may still receive funds in other distributions.
Can my organization get an extension to the submission due date for 2020 audit year reports for Single Audits conducted under 45 CFR Part 75? (Added 1/12/2021)
Yes. The Addendum to the 2020 Compliance Supplement, which is available here, permits recipients, which include non-federal entities and commercial organizations, that received COVID-19 funding with original due dates from October 1, 2020, through June 30, 2021, (which is applicable for fiscal year ends January 31, 2020 – September 30, 2020) an extension for up to three (3) months beyond the normal due date in the completion and submission of the Single Audit reporting package. No further action by awarding agencies is required to enact this extension. This extension does not require individual recipients and subrecipients to seek approval for the extension by the cognizant or oversight agency for audit; however, recipients and subrecipients should maintain documentation of the reason for the delayed filing.
Can my organization get an extension to the submission due date for 2019 audit year reports for Single Audits conducted under 45 CFR Part 75? (Modified 1/12/2021)
Yes. The Office of Management and Budget (OMB) in OMB M-20-26, Extension of Administrative Relief for Recipients and Applicants of Federal Financial Assistance Directly Impacted by the Novel Coronavirus (COVID-19) due to Loss of Operations, dated June 18, 2020, provided recipients, which include non-federal entities and commercial organizations, extensions beyond the normal due date to submit 2019 audit year reports. Please see the OMB website for more details. Recipients with questions about this extension should email HRSA’s Division of Financial Integrity at [email protected].
Will HHS provide guidance to certified public accountants and those organizations that providers will rely on to perform audits? (Modified 1/12/2021)
Non-Federal Entities subject to Single Audit requirements can find guidance in the 2020 Compliance supplement addendum, which is available here. The applicable Catalog of Federal Domestic Assistance (CFDA) are as follows: CFDA 93.498 for the Provider Relief Fund (General and Targeted Distributions) and CFDA 93.461 COVID-19 Testing for the Uninsured.
For providers who received the General or Targeted Distributions (CFDA 93.498) with fiscal years ending on or after December 31, 2020 the auditor will need to test compliance of the Provider Relief Fund report. Providers who received $10,000 or more in aggregate Provider Relief Fund payments will need to submit a report on how they used the PRF payment, and for more information on how to accurately fill out these reports, please refer here and here.
What will be the methodology/formula used to calculate provider payment in Phase 3 General Distributions? (Modified 1/12/2021)
Providers will be paid up to 88% of their reported losses (both lost revenue and health care-related expenses attributable to coronavirus incurred during the first half of 2020). Some applicants will not receive an additional payment, either because they experienced no change in revenues or net expenses attributable to COVID-19, or because they have already received funds that equal or exceed reimbursement of 88% of reported losses. Providers that have not yet received and kept a payment that is approximately 2% of annual revenue from patient care as part of a prior General Distribution will receive at least that amount as part of their Phase 3 payment.
Certain applicants may not receive these full amounts because HHS determined the revenues and operating expenses from patient care reported on their applications included figures that were not exclusively from patient care (as defined in the instructions), reported figures were not reflected in submitted financial documentation, or reported figures were extreme outliers in comparison to other applicants of the same provider type; instead, HHS capped the amount paid to these provider types based on industry estimates of revenue and operating expenses from patient care.
What is the payment amount that an applicant should expect to receive from Phase 3 of the General Distribution? (Modified 1/12/2021)
If an applicant has not yet received and kept a payment that is approximately 2% of annual revenue from patient care as part of either Phase 1 or 2 of the General Distribution, then they will receive at least that amount in Phase 3 payment. In addition to this amount, providers will be paid up to 88% of their reported losses (both lost revenue and health care-related expenses attributable to coronavirus incurred during the first half of 2020). Some applicants may not receive this proportion of the losses reported on their applications, because HHS determined the reported revenues and operating expenses from patient care were not exclusively from patient care (as defined in the instructions) or because reported figures were not reflected in submitted financial documentation. Additionally, some applicants will not receive an additional payment either because they experienced no change in revenues or net expenses attributable to COVID- 19, or because they have already received funds that equal or exceed reimbursement of 88% of reported losses.
When will Phase 3 payments be made? (Modified 1/12/2021)
HHS began issuing Phase 3 – General Distribution payments in mid-December 2020, and will continue making payments through the first months of 2021 to those providers that experienced a change in revenues or net expenses attributable to COVID-19 and that have not already received funds that equal or exceed reimbursement of 88% of reported losses, as well as to those that have not yet received and kept a payment that is approximately 2% of annual revenue from patient care as part of either Phase 1 or 2 of the General Distribution. HHS is continuing to review and validate applications received and will disperse payments in batches as applications are adjudicated.
SBA Reopens PPP
Today, Friday, January 15, 2021, the U.S. Small Business Administration, in consultation with the U.S. Treasury Department, reopened the Paycheck Protection Program (PPP) loan portal to PPP-eligible lenders with $1 billion or less in assets for First and Second Draw applications. The portal will fully open on Tuesday, January 19, 2021 to all participating PPP lenders to submit First and Second Draw loan applications to SBA. Earlier in the week, SBA granted dedicated PPP access to Community Financial Institutions (CFIs).
As a reminder, on January 6, the U.S. Small Business Administration (SBA) issued the Interim Final Rule on Second Draw Loans, which outlines the guidelines for the new PPP loans that were included in the Consolidated Appropriations Act, 2021 (Omnibus/COVID-19 relief package) signed into law on December 27. Once open, SBA will accept loan applications through March 31, 2021.
The PPP second draw loans are available to borrowers who can demonstrate a 25% reduction in gross receipts during any quarter in 2020 as compared to the same quarter in 2019 and reduces the maximum number of employees a PPP borrower can have from 500 to 300. To qualify, a borrower must have used the full amount of its initial PPP loan for authorized purposes or will use the full amount prior to the disbursement date of the second draw PPP loan.
CMS Finalizes “CMS Interoperability and Prior Authorization Rule;” ASCRS Joined the Alliance of Specialty Medicine in Comments on the Proposed Rule
On January 15, CMS released the “CMS Interoperability and Prior Authorization Final Rule,” which is focused on improving data exchange, while reducing provider and patient burden. The changes include allowing certain payers, providers, and patients to have electronic access to pending active and prior authorization decisions in addition to requiring plans meet reduced decision timelines.
ASCRS joined the Alliance of Specialty Medicine in comments to CMS on the proposed rule released on December 10, 2020, “Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients’ Electronic Access to Health Information."
The rule, which builds upon requirements finalized through the CMS Interoperability and Patient Access final rule, largely applies to state Medicaid and CHIP FFS programs, Medicaid and CHIP managed care plans, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs). Although Medicare FFS is not directly impacted by this rule, CMS hopes to implement these same proposed provisions, if finalized, so that Medicare FFS beneficiaries would also benefit. The prior authorization proposals would impact “items and services,” but would not include prescription drug or covered outpatient drugs at this time, although CMS seeks feedback on including drugs in the future.
Additional information is available here.
President-Elect Joe Biden Releases $1.9 Trillion COVID-19 Relief Plan Proposal
On January 14, President-Elect Joe Biden released a $1.9 trillion COVID-19 relief plan proposal to fund health initiatives, including a national vaccination program, state and local governments, schools, workers, and childcare among others.
HHS Finalizes Regulatory Review Rule
The U.S. Department of Health and Human Services (HHS) has finalized its Securing Updated and Necessary Statutory Evaluations Timely (SUNSET) rule, which requires an assessment of HHS regulations every 10 years to determine whether they are subject to review under the Regulatory Flexibility Act (RFA), which requires regular review of significant regulations. If a given regulation is subject to the RFA, the Department must review the regulation every ten years to determine whether the regulation is still needed and whether it is having the appropriate impacts. Regulations will expire if the Department does not assess and, if required, review them in a timely manner.
PHE Declaration Extended – Reminder
As a reminder, the U.S. Department of Health and Human Services (HHS) Secretary Alex Azar renewed the public health emergency (PHE) declaration effective January 21, 2021 due to the COVID-19 pandemic. The renewal lasts for the duration of the emergency or 90 days and may be extended again by the Secretary.
ASOA Webinar - 2021 Medicare Physician Fee Schedule Final Rule/Quality Payment Program: What Ophthalmic Practices Need to Know Webinar – Wednesday, January 27, 2021, 2:00 – 3:00 PM Eastern
Webinar Synopsis:
Join ASCRS Director of Government Relations, Nancey McCann, and Jennifer Gallihugh, ASOA Senior Manager of Strategic Initiatives, for this webinar to review the 2021 Medicare Physician Fee Schedule Final Rule, including changes to the 2021 Quality Payment Program and MIPS. The webinar will detail Medicare payment policies for 2021, including the recent changes enacted as part of the Consolidated Appropriations Act, 2021 (Omnibus/COVID relief package) that was signed into law on December 27, 2020.
Objectives:
Participants will understand the impact of 2021 Medicare physician payment and quality reporting policies on ophthalmic practices.
ASOA members receive discounted registration for the webinar, "2021 Medicare Physician Fee Schedule Final Rule/Quality Payment Program: What Ophthalmic Practices Need to Know" on Wednesday, January 27, 2021. Please make sure you are logged in using your ASOA.org credentials before registering for this event so that your discount can correctly be applied.
Can't make this webinar on the scheduled date and time? Register, and we will send you a link to the recording and slides after the session concludes.
Attendance at this webinar provides 1 Category A COE credit.
Details
Date: Wednesday, January 27, 2021
Time: 2:00 - 3:00 pm Eastern
Duration: 1 hour
ASOA Premier Member Price: FREE
ASOA Essential Member Price: $59.00
Nonmember Price: $199.00
Note: In order to register, use your ASOA website credentials to log in when prompted. If you have not logged in to ASOA recently, please use the Forgot Password function to establish your login.
