Title: COVID-19 HRSA Claims Reimbursement for the Uninsured Program
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) includes the federal grant activity of Novant Health, Inc. and Affiliates (“Novant Health”) and is presented on the accrual basis of accounting.
The information in the Schedule is presented in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only the federal award activity of Novant Health, it is not intended to and does not present the financial position, changes in net assets and cash flows of Novant Health. The purpose of the Schedule is to present a summary of those activities of Novant Health for the year ended December 31, 2023, which have been financed by federal awards. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, Novant Health did not make this election and uses a negotiated indirect cost rate when charging indirect costs to federal awards.
For purposes of the Schedule, federal awards include all grants, contracts and similar agreements entered into directly between Novant Health and agencies and departments of the federal government and all sub-awards to Novant Health by non-federal organizations pursuant to federal grants, contracts and similar agreements.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, Novant Health did not make this election and uses a negotiated indirect cost rate when charging indirect costs to federal awards.
Novant Health conducted COVID-19 testing and/or provided treatment for uninsured individuals with a COVID-19 primary diagnosis on or after February 4, 2020 and as such has requested claims reimbursement under the Department of Health and Human Service (“HHS”)’s COVID-19 Health Resources and Services Administration’s (“HRSA”) Claims Reimbursement for the Uninsured Program (Assistance Listing #93.461).
HRSA announced that the program was ending and no claims could be submitted after March 22, 2022 (for testing or treatment) or April 5, 2022 (for vaccine administration). Novant Health did not receive any payments in 2023 from HRSA, and does not expect to receive any additional payments from HRSA for claims with dates of service through 2022. During 2023, Novant Health discovered that certain accounts that were paid under this program did in fact have other insurance coverage, which made them ineligible for payment under this program. Novant Health performed a detailed review of all accounts, and any account that received payment under this program, that also had other insurance coverage, was voluntarily refunded to HRSA. The total amount refunded to HRSA in 2023 was $1,649,008. These amounts are not included in the Schedule.
Title: COVID-19 Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution
Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (the “Schedule”) includes the federal grant activity of Novant Health, Inc. and Affiliates (“Novant Health”) and is presented on the accrual basis of accounting.
The information in the Schedule is presented in accordance with Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only the federal award activity of Novant Health, it is not intended to and does not present the financial position, changes in net assets and cash flows of Novant Health. The purpose of the Schedule is to present a summary of those activities of Novant Health for the year ended December 31, 2023, which have been financed by federal awards. The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, Novant Health did not make this election and uses a negotiated indirect cost rate when charging indirect costs to federal awards.
For purposes of the Schedule, federal awards include all grants, contracts and similar agreements entered into directly between Novant Health and agencies and departments of the federal government and all sub-awards to Novant Health by non-federal organizations pursuant to federal grants, contracts and similar agreements.
De Minimis Rate Used: N
Rate Explanation: The Uniform Guidance provides for a 10% de minimis indirect cost rate election; however, Novant Health did not make this election and uses a negotiated indirect cost rate when charging indirect costs to federal awards.
The Schedule includes grant activity related to HHS’s Provider Relief Fund (“PRF”) and American Rescue Plan Rural Distribution (Assistance Listing #93.498). As required based on guidance in the 2023 OMB Compliance Supplement, the Schedule includes all Period 5 funds received between January 1, 2022 and June 30, 2022 and expended by June 30, 2023 and all Period 6 funds received between July 1, 2022 and December 31, 2022 and expended by December 31, 2023, as reported to HRSA via the PRF Reporting Portal. The Schedule thus includes $15,365,417 of direct expenditures and $7,308,601 in lost revenue. Given the timing covered by Period 5 and Period 6 funds, certain of these expenses were reflected in Novant Health’s consolidated statement of operations for the years ended December 31, 2022 and 2021. Additionally, lost revenue does not represent an expenditure in the Novant Health financial statements and thus is a reconciling item between the federal expenses in the financial statements and the amount included on the Schedule.