HOUSTON – Firm founder Ashish Mahendru recently spoke to the challenges physician group practices continue to grapple with as it relates to Provider Relief Fund (PRF) payments. His commentary was featured in the Part B News article “Did You Get COVID Relief Funds? Prepare to Pay it Back, Make ‘Good Faith’ Efforts?” from DecisionHealth – Medical Practice Resources. (subscription required)

The article references how in April 2020, the Department of Health and Human Services (HHS) began issuing payments under the PRF to health care providers, including group practices, using funding appropriated by Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act. To accept an PRF payment, HHS required physician practices and other providers to agree to terms and conditions that govern the allowed and prohibited uses of funding. The terms and conditions also require recipients to report information to HHS on use of funding and be aware that they will be subject to future auditing.

So what do you do if you think any of your PRF payments were inappropriate?

According to Mr. Mahendru, recipients of Provider Relief Fund payments have the burden to establish proper usage. If the recipient is aware of inappropriate usage of funds, then the liability for that may attach, which could include criminal, civil, or administrative penalties, including revocation of Medicare billing privileges.

“Depending on the circumstances, if HHS questions how the funds were spent, there is a process to address the question directly with HHS, but HHS guidance also establishes that its decisions are final with no particular appeals process,” he adds. “Time, however, will tell if further review is available beyond HHS’s internal decision-making.”

Since opening Mahendru P.C. in 2001, Mr. Mahendru has successfully handled a broad range of cases in both state and federal courts. To learn more about his work in matters involving healthcare, employment, and other business and commercial matters, click here.