Auditing and Enforcement
The CARES Act PRF terms and conditions generally indicate that provider–recipients of payment distributions must promptly submit records and documentation of expenditures upon the request of HHS and fully cooperate with audits by HHS, the Office of the Inspector General (OIG), or the Pandemic Response Accountability Committee.
Explore This IssueMarch 2021
The HHS has warned that significant anti-fraud monitoring of the CARES Act PRF funds will occur, and that the OIG will provide oversight to ensure that the funds were used appropriately to comply with the applicable terms and conditions. The HHS has indicated that non-federal reporting entities who received and expended annual federal awards exceeding $750,000 in the aggregate during their fiscal year are subject to single audit requirements.
Generally, recipients of CARES Act Provider Relief Fund payments exceeding $10,000 must report certain information, including their intent, their use of the funds, and other specific data.
The record retention and potential audit lookback period is at least three years for providers who retained and expended CARES Act PRF payment distributions. Therefore, providers should take care to document expenditures accurately and in detail. Deliberate omission, misrepresentation, or falsification of any information contained in payment applications or future reports may result in criminal, civil, or administrative penalties, including, but not limited to, revocation of Medicare billing privileges, exclusion from federal healthcare programs, and related fines.
Additional PRF Considerations
The Coronavirus Public Health Emergency status was renewed by HHS, effective Jan. 21, 2021, for another 90 days. Remaining CARES Act PRF payments may be expended by healthcare providers through July 31, 2021, which is also the final reporting deadline for providers who did not expend their funds in full by the end of December 2020.
Providers may have additional opportunities to apply for CARES Act PRF payments depending on how many of them returned their PRF distributions through the end of December 2020 and based on the recent allocated funds from the Appropriations Act and any future stimulus legislation allocations.
Providers who have yet to report their CARES Act PRF distributions, who are seeking additional funding, or who are considering retaining PRF monies should consult a healthcare attorney to review each particular distribution category’s terms and conditions, documentation, and reporting requirements, and should continue to monitor PRF deadlines, which may be subject to change.
It is highly recommended that providers consult with certified accountants to review and assist in the preparation of all reporting information, especially the lost revenue and expenses calculations.
Finally, providers should continue to monitor the HHS CARES Act Provider Relief Fund website, as it is updated from time to time.