WASHINGTON, D.C. – According to the American Association for Homecare, HHS has announced that the period to attest to receipt of payments from the Provider Relief Fund and accept the related Terms & Conditions has been extended from 30 to 45 days from the date the funds were received. For example, suppliers who received payment on April 10, 2020 will now have until May 24 to submit their attestation. See the HHS press release for additional details.

CMS has also added several new questions and answers to their FAQs related to the relief, including:

• What should a provider do if a General Distribution payment is greater than expected or received in error? (Added 5/6/2020)Providers that have been allocated a payment must sign an attestation confirming receipt of the funds and agree to the Terms and Conditions within 30 days of payment. Generally, if a provider does not have or anticipate having COVID-related lost revenues or increased expenses equal to or in excess of the relief payments received, they should return the funds. If a provider believes it was overpaid or may have received a payment in error, it should reject the entire General Distribution payment and submit the appropriate revenue documents through the General Distribution portal to facilitate HHS determining their correct payment. If a provider believes they are underpaid, they should accept the payment and submit their revenues in the provider portal to determine their correct payment.
• What is the definition of individuals with possible or actual cases of COVID-19? (Added 5/6/2020)Unless the payment is associated with specific claims for reimbursement for COVID-19 testing or treatment provided on or after February 4, 2020 to uninsured patients, under the Terms and Conditions associated with payment, providers are eligible only if they provide or provided after January 31, 2020, diagnoses, testing or care for individuals with possible or actual cases of COVID-19. HHS broadly views every patient as a possible case of COVID-19. Not every possible case of COVID-19 is a presumptive case of COVID-19. For clarification as it relates to presumptive COVID-19 cases, refer to the Frequently Asked Question that defines a presumptive case of COVID-19.
• What oversight and enforcement mechanisms will HHS use to ensure providers meet the Terms and Conditions of the Provider Relief Fund payments? (Added 5/6/2020)Failure by a provider that received a payment from the Provider Relief Fund to comply with any term or condition can subject the provider to recoupment of some or all of the payment. Per the Terms and Conditions, all recipients will be required to submit documents to substantiate that these funds were used for increased healthcare-related expenses or lost revenue attributable to coronavirus, and that those expenses or losses were not reimbursed from other sources and other sources were not obligated to reimburse them.  HHS will have significant anti-fraud monitoring of the funds distributed, and the Office of Inspector General will provide oversight as required in the CARES ACT to ensure that Federal dollars are used appropriately.
• How can I return a General Distribution payment I received under the Provider Relief Fund? (Added 5/6/2020)Providers may return their General Distribution payment by going into the attestation portal within 30 days [per HHS 5/7 update on the deadline extension, we assume this would now be “45 days”] of receiving payment and indicating they are rejecting the funds. The CARES Act Provider Relief Fund Payment Attestation Portal will guide providers through the attestation process to reject the funds. As explained in the attestation portal, to return the money, the provider would need to contact their financial institution and ask the institution to refuse the received Automated Clearinghouse (ACH) credit by initiating an ACH return using the ACH return code of “R23 – Credit Entry Refused by Receiver.” If a provider received the money via ACH they must return the money via ACH. If a provider was paid via paper check, after rejecting the payment in the attestation portal, the provider should destroy the check if not deposited or mail a paper check to UnitedHealth Group with notification of their request to return the funds.
• What are the reporting requirements for providers attesting to receipt of Provider Relief Fund payments and when will reporting begin? (Added 5/6/2020)All providers receiving Provider Relief Fund payments will be required to comply with the reporting requirements described in the Terms and Conditions and specified in future directions issued by the Secretary. The specific reporting obligations imposed on providers receiving $150,000 or more from any Act primarily making appropriations for the coronavirus response and related activities, which is a statutory requirement, begins for the calendar quarter ending June 30. The Secretary may request additional reports prior to that date. HHS will provide guidance in the future about the type of documentation we expect recipients to submit. Additional guidance will be posted at gov/provider-relief/index.html.

Twelve new questions were added in total – see the updated FAQs here.  AAHomecare will continue to seek clarification from HHS and CMS on requirements and procedures related to relief provided by the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act.

See AAHomecare’s overview of the relief funds authorized by recent COVID-19 stimulus legislation for additional perspective.