AMGA Opposes Provider Relief Fund Reporting Changes; HHS Guidelines Do Not Capture Extent of Loses for Healthcare Providers
Alexandria, VA – AMGA today recommended that the Department of Health and Human Services (HHS) reinstate earlier reporting requirements for the Provider Relief Fund (PRF), which reimburses healthcare providers for expenses and lost revenues associated with the 2019 novel coronavirus (COVID-19). HHS in September modified how providers should calculate lost revenue. The new standard will create an inaccurate accounting of the financial situation facing AMGA members.
“Earlier guidance allowed our members to use ‘any reasonable method’ to determine their expenses and losses due to COVID-19,” said AMGA President and CEO Jerry Penso, M.D., M.B.A., in a letter to HHS. “Now, HHS is changing that calculation to one that will not capture the extent of their losses. AMGA members are still facing severe financial headwinds as they continue to deal with new COVID outbreaks and a difficult economic outlook. Changing the rules in the middle of this pandemic just adds to our members’ existing burdens. HHS should reinstate the earlier standard.”
In its September guidance, HHS modified reporting guidelines to require that providers calculate lost revenue by comparing 2019 and 2020 net operating income. Previously, providers could measure lost revenue with any “reasonable” method, including comparing budgeted revenue with actual revenue. While seemingly innocuous, this change will not account for year-over-year growth in the number of clinicians in a group practice or physician salary reductions, which would make loses appear smaller than they actually were. Given that PRF support is based in part on provider losses, this inadvertently may deny PRF aid to a group practice because of a quirk in the accounting requirements.
AMGA detailed its concerns with the new standard in a letter to HHS, which is available here.
AMGA is a trade association leading the transformation of health care in America. Representing multispecialty medical groups and integrated systems of care, we advocate, educate, innovate, and empower our members to deliver the next level of high performance health. AMGA is the national voice promoting awareness of our members’ recognized excellence in the delivery of coordinated, high-quality, high-value care. More than 175,000 physicians practice in our member organizations, delivering care to one in three Americans.
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