AMA asks for delay in Provider Relief Fund clawbacks

The American Medical Association and more than 30 other medical groups want the Health Resources and Services Administration to give providers more time to report on the Provider Relief Funds dollars they received before the government takes the money back.

Providers that got more than $10,000 in COVID-19 relief funding from HRSA between April 10, 2020, and June 30, 2020 had to report how they used the money by Nov. 30, 2021. HRSA distributed more than $42 billion during this first phase.

In early March, HRSA notified providers that missed the deadline that they’ll have to repay the relief funds within 30 days. If the funds aren’t returned, HRSA will initiate the recovery of all funds not reported on during the period, according to a March 10 letter obtained by Modern Healthcare.

These providers need more time to comply and many were unaware of the reporting deadline, the AMA and the other organizations wrote HRSA Administrator Carole Johnson Thursday. “As we are very connected to our members, we would like to work with HRSA on best ways to identify and reach the remaining practices that have not reported to bring them into compliance,” the letter says.

HRSA would not confirm how many notices it sent or how much money went unreported fpr Period 1. The agency said it conducts frequent outreach to providers and provider associations on Provider Relief Fund reporting process, including about the risk that funds would be reclaimed if they were not used or properly reported.

Providers already got a 60-day grace period after the Sept. 30 reporting deadline for the first tranche of funds. HRSA also opened the reporting portal for another additional week in December.

But the medical associations argue more time is warranted. Some practices say they weren’t contacted about the reporting requirement. And medical offices were short-staffed because employees contracted COVID-19 or lost employees to other jobs, including workers who would have been responsible for reporting to HRSA, the letter says.

Figuring out how to repay the government on short notice would significantly challenge providers, said Shari Erickson, chief advocacy officer and senior vice president of governmental affairs and public policy for the American College of Physicians.

“I think that’s a reasonable ask. These practices have been through a lot throughout the pandemic, trying to keep their doors open and providing access to care for their patient populations, and they obviously want to continue to do that,” Erickson said.

The American College of Physicians wants HRSA to use multiple methods of communication to inform practices about Provider Relief Fund reporting in the future, including telephone, mail and fax.

Providers may also have been confused about who needed to report, said Claire Ernst, director of government affairs for the Medical Group Management Association. The original terms say any recipient of more than $150,000 must document how they used the money. Later documents, released before the end of the reporting period, say providers that got at least $10,000 must report.

The noncompliance notices seem to mostly have been sent to smaller and rural practices, according to the medical groups letter, which does not include any organizations representing hospitals or other types of healthcare providers.

Providers may be on the hook for significant amounts of money. One Medical Group Management Association member could have to return $200,000, Ernst said.

In general, the PRF reporting requirements are overly burdensome and take time away from patient care during a pandemic, American Academy of Family Physicians spokesperson Julie Hirschhorn said.

Providers expressed confusion about the reporting requirements ahead of the initial deadline, including about what counted as incremental expenses related to COVID-19 and whether funds could be used to cover telehealth costs.

But provider associations say this should be a one-time problem. Period 1 money was directly deposited to Medicare-enrolled providers, whereas subsequent rounds required applications. The Period 2 reporting deadline is March 31.

Congress appropriated $178 billion for the Provider Relief Fund, all of which has been spent or set aside for pending distributions, according to HRSA. The American Hospital Association has asked Congress for an additional $25 billion in pandemic relief.