WASHINGTON – U.S. Senators Tom Carper and Chris Coons (both D-Del.) joined Senators Amy Klobuchar (D-Minn.) and Tina Smith (D-Minn.) to announce that following their letter earlier this month to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, the Administration has updated requirements to preserve providers’ access to funding from the Provider Relief Fund (PRF) created as a response to the coronavirus pandemic.

“Our health care workers and hospital staff are frontline heroes in this pandemic,” said Senator Carper. “We need to make sure that hospitals and health care providers throughout our state,  especially those that serve vulnerable populations, have the resources they need to keep our communities healthy and safe. Today’s announcement helps ensure that these front line health care providers can continue to focus on managing this public health crisis.”

“Since the start of this pandemic, support for our health care systems has been a top priority. I’ve been working with my colleagues and with HHS to expand support for our health care providers – including a delegation effort to secure Nanticoke Hospital’s eligibility for $1.6 million in relief,” said Senator Coons. “I welcome this new announcement that HHS will ensure providers can access the assistance they need and ensure that quality health care remains accessible up and down our state. This move will help smaller providers stay afloat and continue essential services in our communities.”

“As we continue to face challenges from the pandemic, rural areas are in need of critical support,” Senator Klobuchar said. “This announcement is welcome news and we must continue to work with rural hospitals and health systems in Minnesota and around the country to help ensure that they can continue to serve low-income, elderly, and severely ill patients through this difficult time."

“We need to help health care providers in small towns and rural areas stay afloat so they can continue their critical work during COVID-19,” Senator Smith said. “Some health care providers are having to lay people off while anticipating surges in patients this winter. This puts them in an impossible position. The last thing we should do is change the requirements for the Provider Relief Fund, which may force some health care providers to return funds they have already received."

HHS is allowing more flexibility for providers in using PRF proceeds so that they can continue to respond to all of the challenges posed by the coronavirus pandemic. This will help to protect patients’ access to care and prevent providers — especially rural hospitals and hospitals that serve high-numbers of low-income, elderly, and severely ill patients — from being forced to return PRF funds that they have already received. 

HHS released initial reporting requirements in June for providers receiving PRF funds that directed these entities to define lost revenue as “any revenue that you as a health care provider lost due to coronavirus,” but HHS released updated reporting requirements on September 19 that directed providers to instead use changes in their net operating income to calculate lost revenue – a substantial change from the initial June guidance that was expected to reduce the amount of lost revenues that providers are able to report. That shift in reporting requirements would have changed the terms of the relief as hospitals and health systems initially understood them and likely created further uncertainty for providers at a time when they are already facing serious financial challenges.

Earlier this month, Senators Carper, Coons, Klobuchar and Smith, along with 18 colleagues, wrote a letter to the U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, expressing concerns about that change in reporting requirements for hospitals and health systems that receive relief funds from the Provider Relief Fund (PRF). That change could have forced providers to return relief funding that they had already received. Rural hospitals and hospitals that serve high numbers of low-income, elderly, and severely ill patients — could have been particularly burdened by the additional reporting requirements, due to their already thin financial margins.

Senators Carper, Coons, Klobuchar and Smith were joined on the letter by Senators Michael Bennet (D-CO), Tammy Duckworth (D-IL), Jeff Merkley (D-OR), Doug Jones (D-AL), Bernie Sanders (I-VT), Jack Reed (D-RI), Mazie K. Hirono (D-HI), Tammy Baldwin (D-WI), Joe Manchin (D-WV), Kyrsten Sinema (D-AZ), Patrick Leahy (D-VT), Dick Durbin (D-IL), Richard Blumenthal (D-CT), Gary Peters (D-MI), Chris Van Hollen (D-MD), Angus King (I-ME), Sheldon Whitehouse (D-RI), and Ed Markey (D-MA).

Full text of the October 9 letter can be found here and below.

Dear Secretary Azar:

We write to express our concerns regarding the recent change in reporting requirements for health care providers that have received emergency relief through the Provider Relief Fund (PRF) and to respectfully request that you reinstate the original reporting requirements for determining lost revenue that the Department of Health and Human Services (HHS) first released in June of this year.

As you know, the CARES Act established the PRF to reimburse health care providers for health care-related expenses or lost revenue due to the coronavirus pandemic. The PRF has been critical in helping hospitals and health care systems across the country navigate the serious financial challenges posed by this pandemic, preventing many providers from being forced to permanently close their doors.

As a condition for receiving PRF funds, the CARES Act required these recipients to submit reports and maintain documentation to certify their compliance with program requirements. In June, HHS released initial guidance outlining some of these reporting requirements and directed providers to calculate lost revenue by comparing actual 2020 revenue with budgeted 2020 revenue or with 2019 revenue. On September 19, HHS released updated reporting requirements that directed providers to use net operating income to calculate lost revenue—a substantial change from the directions issued in June.

We have heard from hospitals and health systems in our states who are concerned that this change in the definition of lost revenue will force them to return funds to HHS that they have received from the PRF. In particular, rural hospitals and those that serve high numbers of low-income, elderly, and severely ill patients—which already operate on thin financial margins—may be especially impacted by this change.

We are concerned that this change in reporting requirements changes the terms of the relief as providers initially understood them based on the initial June guidelines—further exacerbating the financial challenges and uncertainty that these systems continue to grapple with as a result of the pandemic. Therefore, we respectfully request that you reinstate the original June requirements for determining lost revenue in order to prevent unnecessary financial uncertainty for hospitals and health care providers and to prevent them from being forced to return PRF funds that they have already received.

Thank you for your time and attention to this important measure. We look forward to working with you to continue supporting our hospitals and ensuring that this pandemic does not cause further, long-term disruptions to Americans’ access to care.

Sincerely, 

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