The American Medical Group Association (AMGA) is imploring the Department of Health and Human Services (HHS) to nix changes to how providers report data to get COVID-19 relief funding, arguing the new system will hinder medical groups' ability to get the vital money.
AMGA’s letter, sent Wednesday to HHS, focuses on how providers must calculate their revenue to determine how much money they should get from a $175 billion relief fund passed by Congress as part of the CARES Act.
HHS had required providers to simply calculate lost revenues caused by the COVID-19 pandemic using any reasonable method. This included looking at the difference between budgeted and actual revenue.
But HHS made a major change in a Sept. 19 guidance on how it defines revenue loss for a new tranche of funding.
“HHS is changing the definition to a year-over-year loss of operating income, including expenses,” the AMGA letter said. “This will prevent our members from comparing budgeted to actual revenue.”
Comparing the net operating income in 2020 with 2019 would be problematic to the AMGA’s members, the letter said.
“For example, examining the data in this manner does not account for year-over-year clinician growth within a group practice,” the group said. “Under the proposed formula, when additional providers join a medical group, it may appear that revenue grew for the group. However, the increase in volume is a result of the new clinicians joining and not due to growth in volume of services delivered.”
AMGA is worried this change would inadvertently deny relief funds to clinicians and group practices that otherwise would qualify for it if not for the accounting change.
“Changing the definition also will require those providers that relied on earlier guidance to reevaluate how this modification affects their use of [relief fund] money, creating an unnecessary administrative burden and likely additional financial stress on our nation’s healthcare providers,” the letter said.
AMGA wants HHS to install the earlier guidance that allowed providers to determine their COVID-19 losses by looking at budgeted versus actual revenue.
“Our members are still in the midst of fighting the COVID-19 epidemic,” the letter said. “Accessing and using [provider relief fund] dollars will enable them to continue to serve their communities.”
So far HHS has distributed more than $100 billion in funding to providers, with special allocations being delivered to COVID-19 hot spots, rural hospitals and safety net facilities.
Provider groups have implored Congress to deliver more relief funding as the COVID-19 pandemic continues to suppress patient volumes and slam finances. But talks on a new relief package before the Nov. 3 presidential election remained stalled in Congress.