Finding Text
Assistance Listing Number, Federal Agency, and Program Name – 93.498, U.S. Department of Health and Human Services, Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution (PRF)
Federal Award Identification Number and Year – N/A, 2023
Pass-through Entity – N/A – Direct funded
Finding Type – Material weakness and material noncompliance with laws and regulations
Repeat Finding – Yes; 2022-001 and 2021-001
Criteria – per the Provider Relief Fund General and Targeted Distributions Post-Payment Notice of Reporting Requirements dated June 11, 2021, recipients may choose to apply PRF payments toward lost revenue using one of three options, up to the amount:
Option i: of the difference between actual patient care revenue;
Option ii: of the difference between budgeted (prior to March 27, 2020) and actual patient care revenue; or
Option iii: calculated by any reasonable method of estimating revenue
Condition – The guidelines relating to the reporting of lost revenue for the Provider Relief Fund were not followed.
Questioned Costs – None
Identification of How Questioned Costs Were Computed – N/A – Refer to context below for additional information.
Context – The Period 4 reporting submission for lost revenue did not follow the acceptable options provided by the Department of Health and Human Services. Recipients may choose to apply Provider Relief Fund payments toward lost revenue using one of three options: (i) up to the amount of the difference between actual patient care revenue, (ii) up to the amount of the difference between budgeted (if approved prior to March 27, 2020) and actual patient care revenue, or (iii) up to the amount calculated by any reasonable method of estimating revenue. The System used option ii to calculate lost revenue but the budgeted amounts used in the submission for several periods were not approved by March 27, 2020; therefore, option ii was not allowable. The System should have used option iii to report lost revenue. Additionally, it was identified that the revenue information included in the lost revenue calculation for calendar year 2022 utilized the incorrect months and revenue other than revenue that was patient-related.
Cause and Effect – Appropriate review of the reporting submission was not completed to ensure the report followed the required guidelines. As a result, the report submitted was inaccurate and the amount of lost revenue included in the portal submission was understated.
Recommendation - We recommend the System implement controls, including levels of review, to ensure reports are completed and submitted in accordance with the guidelines established by HHS.
Views of Responsible Officials and Planned Corrective Actions – The System will review and enhance its PRF reporting process by implementing controls to ensure reports are completed and submitted in accordance with the guidelines established by HHS.