2022-001 - Other Matter - Noncompliance Federal agency: U.S. Department of Health and Human Services (HHS) Federal program title: COVID-19 Provider Relief Fund (PRF) - Period 2 and 3 Assistance Listing No.: 93.498 Criteria: Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act and are to be used to prevent, prepare for, and respond to coronavirus. Recipients are required to report use of funds to HHS through the Health Resources and Services Administration (HRSA)Reporting Portal. The reporting is to be prepared using accurate financial information and be in accordance with reporting requirements. Condition: The Corporation elected to report total revenue/net charges from patient care utilizing the actual-to-actual reporting method, which computes lost revenues based on a comparison of certain calendar year 2020, 2021, and 2022 actual revenues to calendar year 2019 actual revenues. The Corporation's net charges from patient care includes certain Medicaid supplemental payments, which are often recognized near or at the end of the fiscal year due to the timing of the release of payment amounts and information from the Georgia Department of Community Health. For Period 3 Provider Relief Fund reporting to HHS, Phoebe Physician Group, Inc. (PPG) revised its net charges from patient care by allocating the Medicaid supplemental payments across all months in fiscal years 2021 and 2022, which impacted certain quarters of calendar years 2020, 2021, and 2022. The revenues for calendar year 2019, which serve as the base year for the lost revenue calculation, were not updated to allocate the Medicaid supplemental payments across the fiscal year to make them consistent with the reporting of calendar years 2020, 2021, and 2022. Cause: PPG?s allocation of the Medicaid supplemental funding was inadvertently overlooked for calendar year 2019 and was therefore not applied consistently to all relevant periods for Provider Relief Fund reporting to HHS. Effect: The lack of consistency in the reporting of net charges from patient care increases the risk that the lost revenues could be computed incorrectly. Questioned costs: There are no questioned costs as the lost revenues computed using the corrected net charges from patient care after consistently applying the allocation of Medicaid supplemental payments to calendar year 2019 exceeded the amounts claimed as lost revenues for all reporting periods, both individually and in the aggregate. Context: PPG?s net charges from patient care are understated by approximately $395,000 in both the first and second quarter of calendar year 2019 and overstated by approximately $1,447,000 for the third quarter of calendar year 2019. PPG?s lost revenues reported through Period 3 totaled approximately $13,913,000. The correction to the base year of 2019 results in lost revenues through Period 3 totaling approximately $13,814,000. The total lost revenues claimed through Period 3 approximated $10,945,000. Therefore, considering the necessary revisions above, the computed lost revenues exceed the amounts claimed as lost revenues for all reporting periods, both individually and in the aggregate. All of these issues relate to the Medicaid/Children?s Health Insurance Program (CHIP) key line item of the reporting to HHS. Recommendation: We recommend the Corporation continue to review submissions to ensure consistency of calculations and amounts reported across all applicable periods. Views of responsible officials of the auditee: Management of the Corporation agrees with this finding. See management?s corrective action plan.
2022-001 - Other Matter - Noncompliance Federal agency: U.S. Department of Health and Human Services (HHS) Federal program title: COVID-19 Provider Relief Fund (PRF) - Period 2 and 3 Assistance Listing No.: 93.498 Criteria: Provider Relief Funds were provided under the Coronavirus Aid, Relief, and Economic Security Act and are to be used to prevent, prepare for, and respond to coronavirus. Recipients are required to report use of funds to HHS through the Health Resources and Services Administration (HRSA)Reporting Portal. The reporting is to be prepared using accurate financial information and be in accordance with reporting requirements. Condition: The Corporation elected to report total revenue/net charges from patient care utilizing the actual-to-actual reporting method, which computes lost revenues based on a comparison of certain calendar year 2020, 2021, and 2022 actual revenues to calendar year 2019 actual revenues. The Corporation's net charges from patient care includes certain Medicaid supplemental payments, which are often recognized near or at the end of the fiscal year due to the timing of the release of payment amounts and information from the Georgia Department of Community Health. For Period 3 Provider Relief Fund reporting to HHS, Phoebe Physician Group, Inc. (PPG) revised its net charges from patient care by allocating the Medicaid supplemental payments across all months in fiscal years 2021 and 2022, which impacted certain quarters of calendar years 2020, 2021, and 2022. The revenues for calendar year 2019, which serve as the base year for the lost revenue calculation, were not updated to allocate the Medicaid supplemental payments across the fiscal year to make them consistent with the reporting of calendar years 2020, 2021, and 2022. Cause: PPG?s allocation of the Medicaid supplemental funding was inadvertently overlooked for calendar year 2019 and was therefore not applied consistently to all relevant periods for Provider Relief Fund reporting to HHS. Effect: The lack of consistency in the reporting of net charges from patient care increases the risk that the lost revenues could be computed incorrectly. Questioned costs: There are no questioned costs as the lost revenues computed using the corrected net charges from patient care after consistently applying the allocation of Medicaid supplemental payments to calendar year 2019 exceeded the amounts claimed as lost revenues for all reporting periods, both individually and in the aggregate. Context: PPG?s net charges from patient care are understated by approximately $395,000 in both the first and second quarter of calendar year 2019 and overstated by approximately $1,447,000 for the third quarter of calendar year 2019. PPG?s lost revenues reported through Period 3 totaled approximately $13,913,000. The correction to the base year of 2019 results in lost revenues through Period 3 totaling approximately $13,814,000. The total lost revenues claimed through Period 3 approximated $10,945,000. Therefore, considering the necessary revisions above, the computed lost revenues exceed the amounts claimed as lost revenues for all reporting periods, both individually and in the aggregate. All of these issues relate to the Medicaid/Children?s Health Insurance Program (CHIP) key line item of the reporting to HHS. Recommendation: We recommend the Corporation continue to review submissions to ensure consistency of calculations and amounts reported across all applicable periods. Views of responsible officials of the auditee: Management of the Corporation agrees with this finding. See management?s corrective action plan.