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Hospice News:

Provider Review Fund Fraud Goes Under The Microscope

The first reporting deadline for Provider Relief Fund usage may now be moved to Sept. 30, with three more deadlines following, but you need to make sure you are staying diligent about recording the relevant data.

Why? The HHS Office of Inspector General has updated its Work Plan, adding PRF payments made to providers during Phases 1, 2, and 3 of the General Distribution to its audit to-do list, according to the summary for Active Item W-00-21-35873. With about $92 billion distributed over these three phases now under the federal watchdog’s scruinty, providers have added incentive to get their ducks in a row.

“We will perform a series of audits … to determine whether payments were: (1) correctly calculated for providers that applied for these payments, (2) supported by appropriate and reasonable documentation, and (3) made to eligible providers,” the Work Plan summary explains at https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000587.asp.

Plus: In addition to new reporting deadlines and increased scrutiny, more PRF money seems to be coming. Under the newly released reporting timeframe, “Period 4 sets the table for a potential Phase 4 tranche of remaining PRF dollars to be distributed in 2021 and used for all of 2022,” points out finance consultant Domenic Segalla with advisory, tax and accounting firm Withum Smith + Brown in New York City. “Stay tuned for more on that,” Segalla says in online analysis.

The Phase 4 distribution period in the new reporting timeframe includes payments between July 1, 2021 and Dec. 31, 2021, “suggesting that additional payments are anticipated,” say attorneys with law firm Hall Render in online analysis. But for now, “there is still no word from HHS on how it intends to distribute the approximately $24 billion remaining in the PRF, including the $8.5 billion appropriated by the American Rescue Plan Act of 2021 for rural providers,” they say.

Resources: An 11-page notice with the new reporting dealdines is at www.hhs.gov/sites/default/files/provider-post-payment-notice-of-reporting-requirements-june-2021.pdf, a 59-page FAQ document is at www.hhs.gov/sites/default/files/provider-relief-fund-general-distribution-faqs.pdf, and the PRF portal is at https://prfreporting.hrsa.gov.

 

 

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