A number of hospices did not comply with requirements of the Provider Relief Fund (PRF) program during the COVID-19 pandemic.
The $178 billion PRF was established in 2020 to help health care providers replace revenue lost due to altered utilization patterns and higher costs. The U.S. Health Resources and Services Administration (HRSA) administered the program.
The U.S. Department of Health & Human Services Office of the Inspector General (OIG) reviewed the PRF records for 30 hospices and found that, of those, seven either failed to accurately calculate lost revenue or used the grant program’s dollars to cover unallowable expenses. OIG recommended that HRSA take steps to recoup the inappropriately spent or miscalculated funds.
“These deficiencies occurred because although HRSA provided the PRF terms and conditions and updated its guidance to PRF recipients, the hospices did not always maintain documentation for expenses reported, correctly interpret HRSA guidance, have procedures to verify the accuracy of lost revenue calculations, or track expenses funded by PRF payments,” OIG indicated in a report. “As a result, hospices did not always use their PRF payments for expenses or lost revenues attributable to COVID-19 or maintain sufficient supporting documentation for costs that were allocated to their PRF payments.”
For PRF, HRSA required providers to ensure that the payments were used for prevent, prepare for, or respond to COVID-19; used for health care-related expenses or lost revenues attributable to COVID-19; and not used to cover expenses or losses reimbursed by other funding sources or to pay salaries in excess of a certain threshold.
This audit of hospices is one of several examining how health care providers in different settings used the PRF funds they received.
The seven hospices that were found to be noncompliant received a combined $98.1 million in PRF payments. Six of those hospices claimed a total of $8.3 million of unallowable PRF expenditures and inaccurately reported $1.5 million of lost revenues, and one hospice claimed $4 million in expenditures that may not have been allowable.
OIG called on HRSA to recover the misspent funds.
“We made two recommendations to HRSA, including that it require the selected hospices to return any unallowable expenditures to the Federal Government or ensure that the hospices properly account for these expenditures,” the OIG report indicated. “HRSA concurred with our recommendations.”
