Following Letter from Bennet, Colleagues, HHS Expands Relief for Rural Health Care Providers

Earlier This Month, Bennet Urged the Administration to Preserve Rural Health Care Providers’ Access to Pandemic Relief Funding

Denver – Colorado U.S. Senator Michael Bennet announced that following a letter he and his colleagues sent earlier this month to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar, the Trump Administration has expanded relief eligibility for rural health care providers and updated requirements to preserve providers’ access to funding from the Provider Relief Fund (PRF) created as a response to the Coronavirus Disease 2019 (COVID-19) pandemic.

“Rural health care providers across the state have been working around the clock to support their communities during this crisis on shrinking budgets,” said Bennet. “I’m glad to see this expanded relief eligibility for rural health care providers so they can access the support they need. We’ll keep working to sustain these providers for the long haul so that they can continue to serve their communities through and beyond this pandemic.”

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.

Bennet has continued to call for investments in rural health care providers during the pandemic. In May, Bennet introduced legislation to reduce interest rates and modify repayment obligations for health care providers who have sought financial assistance through Medicare’s Accelerated and Advance Payments Program amid COVID-19 which was expanded under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This provision was signed into law in September. In May, Bennet introduced legislation to extend the Rural Community Hospital Demonstration Program for an additional five years, ensuring these essential hospitals do not face further budget instability during such challenging times. In April, Bennet joined members of the Colorado Congressional Delegation in calling for the Small Business Administration to provide regulatory certainty and ensure that Critical Access Hospitals (CAHs) and Rural Health Clinics (RHCs) are eligible for certain CARES Act assistance, particularly through the Paycheck Protection Program. In March, Bennet introduced the Immediate Relief for Rural Facilities and Providers Act, legislation to address the impending crisis facing our health care system as the spread of the COVID-19 increasingly strains hospitals and providers across the country.

In addition to Bennet, the letter was signed by U.S. Senators Amy Klobuchar (D-Minn.), Tina Smith (D-Minn.), Tammy Duckworth (D-Ill.), Jeff Merkley (D-Ore.), Doug Jones (D-Ala.), Chris Coons (D-Del.), Bernie Sanders (I-Vt.), Jack Reed (D-R.I.), Mazie K. Hirono (D-Hawaii), Tammy Baldwin (D-Wis.), Joe Manchin (D-W.Va.), Kyrsten Sinema (D-Ariz.), Patrick Leahy (D-Vt.), Dick Durbin (D-Ill.), Richard Blumenthal (D-Conn.), Gary Peters (D-Mich.), Chris Van Hollen (D-Md.), Angus King (I-Maine), Sheldon Whitehouse (D-R.I.), Ed Markey (D-Mass.), and Tom Carper (D-Del.).

The text of the October 9 letter is available 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,