The federal Provider Relief Fund (“PRF”) continues to render financial assistance to medical providers that offer diagnoses, testing or treatment of individuals with possible or actual cases of COVID-19. To date, the U.S. Department of Health and Human Services has distributed over $19 billion to help medical professionals prevent, prepare for, and respond to the coronavirus. PRF distributions are subject to certain terms and conditions, and reporting requirements if a specific distribution exceeded $10,000. Providers who fail to agree to the terms and conditions or fail to report in a timely manner may be subject to a request for repayment of the funds.

The Health Resources & Services Administration (HRSA) oversees compliance of the PRF, and recently issued its first round of Final Repayment Notices to medical providers. A Final Repayment Notice instructs a provider to either return the funds (referred to as the “repayment amount”) via ACH or by mail, or to request a Decision Review.

The Final Repayment Notice provides information on the HRSA’s rationale for requesting the return of the repayment amount, as well as instructions on how to avoid debt collection. If you are a medical provider and dispute the HRSA’s decision – even if you dispute only a portion of the total repayment amount – you should file a Decision Review.

The Decision Review process outlined on the HRSA website appears straightforward but it is important to keep several things in mind while preparing your response.

Read the Final Repayment Notice carefully. The Final Repayment Notice only will apply to a specific distribution. If you received more than one Provider Relief Fund distribution, note the basis for HSRA’s rationale. While a Decision Review is the only avenue to dispute the repayment amount identified in the Final Repayment Notice, it is possible that there may still be time to correct HRSA’s concerns with regard to later PRF distributions you received.

Calendar your deadline. Providers only have 60 days from the date of the Repayment Notice to draft and submit a request for a Decision Review. Plan on submitting your Decision Review request a few days before the deadline to allow time for computer glitches on either your end or with HRSA.

Gather key documents. If you did not receive a Final Repayment Notice in the first round but expect to receive one in future rounds, make sure you retain all of your key documents and keep them in a safe location. This is particularly important if your internal document retention policies could potentially result in the destruction of documents dating back to 2020 and 2021.

Be aware of your file size. The portal will only allow submissions of up to 25 MB, which should be plenty of space to submit your supporting documentation. But if you expect the need to submit large documents (for example, a large volume of excel data), be sure to keep the file size limitations in mind. The HRSA prefers that formula-based documentation be provided in Microsoft Excel or a Microsoft Excel-compatible format.

Don’t use Chrome. The HRSA Provider Relief Bureau Decision Review Request website is not compatible with Chrome. HRSA recommends using the latest desktop version of Edge or Mozilla Firefox to access the portal.

Double-check your work. Provide a written explanation of why you disagree with the HRSA’s determination clearly and concisely. Once submitted, you do not have an opportunity to edit or add to the submission.

Save a copy of your submission. Some providers may receive more than one Final Repayment Notice, and you must submit a separate Decision Review request for each Final Repayment Notice. Keeping a copy may help with each future submission, particularly if the basis for the appeal is the same.

Call to verify that HRSA received your submission received. Once submitted, call the Decision Review Provider Support Line, (844) 968-4207, to confirm that your submission was filed and received. If you submit your Decision Review request a few days before your deadline, this will allow you to resubmit if there was an issue with receipt.

Opinions and conclusions in this post are solely those of the author unless otherwise indicated. The information contained in this blog is general in nature and is not offered and cannot be considered as legal advice for any particular situation. The author has provided the links referenced above for information purposes only and by doing so, does not adopt or incorporate the contents. Any federal tax advice provided in this communication is not intended or written by the author to be used, and cannot be used by the recipient, for the purpose of avoiding penalties which may be imposed on the recipient by the IRS. Please contact the author if you would like to receive written advice in a format which complies with IRS rules and may be relied upon to avoid penalties.

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