Finding 593051 (2022-002)

-
Requirement
L
Questioned Costs
-
Year
2022
Accepted
2023-09-26
Audit: 22499
Organization: Highmark Health (PA)

AI Summary

  • Core Issue: Incorrect lost revenue calculation method was used for HHS Portal submissions, leading to inaccurate reporting for a specific TIN.
  • Impacted Requirements: Reporting must adhere to specific options for calculating lost revenues, and changes in ownership must be accurately reported.
  • Recommended Follow-up: Enhance controls over reporting submissions to ensure accurate information is provided in the future.

Finding Text

2022-002: Incorrect lost revenue option selected for the HHS Portal submissions Cluster: Not applicable Federal Agency: Department of Health and Human Resources - Health Resources and Services Administration Federal Program Name: COVID-19 Provider Relief Fund ("PRF") and American Rescue Plan ("ARP") Rural Distribution Assistance Listing Number: 93.498 Federal Award Number: Not applicable Federal Award Year: Reporting Period 4 Criteria Step Six of the Steps on Reporting on Use of Funds section of the June 11, 2021 PRF General and Targeted Distribution Post-Payment Notice of Reporting Requirements requires recipients that apply PRF payments toward lost revenues to use one of the following three options for calculating lost revenues: ? Option (i): difference between actual patient care revenues and actuals for each quarter during the period of availability. ? Option (ii): difference between budgeted (budget approved prior to March 27, 2020) and actual patient care revenues for each quarter during the period of availability; or ? Option (iii): any reasonable method of estimating revenues. Additionally, Reporting Entities that acquired or divested of related subsidiaries (change of ownership) during the period of availability must indicate the change in ownership, providing certain data points for each relevant Taxpayer Identification Number (TIN) within the reporting portal. Condition The Company submissions for each TIN within the Health Resources & Services Administrator (HRSA) reporting portal for Period 3 and Period 4, attested to the calculations of lost revenue at the individual TIN submission level. For one TIN, within the Reporting Period 4 submission, the Company attested to calculating lost revenues using Option (i); however, this particular entity ceased operations at the end of the third quarter of 2021, and did not report revenues for the second and third quarters of 2021. As a result, total lost revenues calculated within the Reporting Period 4 submission were incorrect. Additionally, for the same TIN and Reporting Period 4 submission, the Company selected ?No?, but should have selected ?Yes? to the following question within the reporting portal: Did you acquire or divest subsidiaries that are ?eligible health care providers? during the period of availability of funds? Cause Management?s understanding of the guidance was that including actual revenue for applicable TIN entity prior to cessation of operations at the end of the third quarter of 2021, was appropriate under Option (i), and mistakenly excluded the second and third quarter 2021 revenues from the reporting submission. Additionally, management inadvertently answered the following question as ?no? within the reporting portal: Did you acquire or divest subsidiaries that are ?eligible health care providers? during the period of availability of funds? Effect Option (iii) should have been utilized. Using Option (iii) would have required reporting additional information to the U.S. Department of Health and Human Services (HHS), including a narrative explaining the Company?s methodology and why it was preferable, but would not have resulted in a different conclusion that the receipt of the HHS funds was supported with lost revenue. Questioned Costs None noted. Recommendation Management of Highmark Health should update its controls over the review of reporting portal submissions to ensure information is reported accurately. Management?s Views and Corrective Action Plan Refer to Management?s Views and Corrective Action Plan at the end of the report.

Categories

Reporting

Other Findings in this Audit

Programs in Audit

ALN Program Name Expenditures
93.767 Children's Health Insurance Program $5.84M
93.498 Covid-19 Provider Relief Fund ("prf") and American Rescue Plan ("arp") Rural Distribution $1.60M
84.268 Federal Direct Student Loans $1.27M
14.231 Covid-19 Emergency Solutions Grant Program $1.12M
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $412,848
84.063 Federal Pell Grant Program $334,846
93.211 Telehealth Programs $293,692
93.247 Advanced Nursing Education Grant Program $231,735
93.959 Covid-19 Block Grants for Prevention and Treatment of Substance Abuse $223,907
84.425 Covid-19 Education Stabilization Fund $216,532
93.846 Arthritis, Musculoskeletal and Skin Diseases Research $144,256
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $120,912
93.697 Covid-19 Testing and Mitigation for Rural Health Clinics $100,000
93.889 Covid-19 National Bioterrorism Hospital Preparedness Program $93,187
93.121 Oral Diseases and Disorders Research $55,509
93.364 Nursing Student Loans $47,650
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $45,105
93.865 Child Health and Human Development Extramural Research $24,347
93.838 Lung Diseases Research $16,825
12.420 Military Medical Research and Development $16,742
84.184 Safe and Drug-Free Schools and Communities_national Programs $15,356
93.350 National Center for Advancing Translational Sciences $14,359
84.007 Federal Supplemental Educational Opportunity Grants $13,166
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $10,176
93.213 Research and Training in Complementary and Integrative Health $9,830
93.242 Mental Health Research Grants $9,149
93.393 Cancer Cause and Prevention Research $8,903
93.279 Drug Abuse and Addiction Research Programs $7,199
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $4,902
93.395 Cancer Treatment Research $2,750
93.837 Cardiovascular Diseases Research $752
47.041 Engineering Grants $-105
93.394 Cancer Detection and Diagnosis Research $-300