Fix Burdensome Relief Fund Reporting, AAFP Urges

The $100 billion that Congress allocated to hospitals, physicians and other health care professionals last year in the Coronavirus Aid, Relief and Economic Security Act’s Public Health and Social Services Emergency Fund — the Provider Relief Fund — was an important win for the Academy and its members. But the mandatory online portal that regulators have established to account for these relief payments is time-consuming and somewhat technical; a “how to” manual runs nearly 30 pages. And the clock is ticking: Physicians who received more than $10,000 in aggregate during the first payment period (April 10 through June 30, 2020) could face recoupment if they fail to complete reporting by Sept. 30.

“AAFP members who have contacted us about the PRF reporting activity and its associated portal have uniformly expressed frustration with the experience and time involved,” the Academy told the Health Resources and Services Administration in an Aug. 18 letter. Particularly for family physicians in solo, small or rural practices, the reporting requirements “are overly burdensome and take valuable time away from caring for patients.”

Meanwhile, the AAFP added, “most primary care practices are overwhelmed with the latest surge of COVID-19, as well as ongoing efforts to catch families up on immunizations and other missed services as the school year begins.”

The letter was sent to HRSA Acting Administrator Diana Espinosa in response to a request for information the agency published July 26 in the Federal Register. It was signed by Board Chair Gary LeRoy, M.D., of Dayton, Ohio.

HRSA indicated in the request for comments that it expected practices to devote an average of 5.6 hours to completing PRF reporting. The Academy disputed this calculation.

“Family physicians report it takes four or more hours just to read the notes, watch the tutorials and prepare for reporting,” the letter said. “When one adds the time spent inputting the data into the portal, the amount of time quickly exceeds the 5.6 average estimated by HRSA.

“Part of the problem may be that HRSA’s current reporting requirements and associated portal assume a level of reporting capability and resource support that does not exist in many of the solo, small group and rural practices in which so many of our members serve their patients.”

Such practices, the Academy added, “are effectively small businesses with basic accounting tools, which makes it challenging to complete the reporting process.”

The letter pointed to three factors compounding these issues:

• The meaning of “due to COVID” is unclear. “We interpret it to mean any medical care provided during the pandemic, but would appreciate clarification from HRSA.”
• HRSA requests data broken out by payer, but some members don’t break out their expenditures and payments this way.
• Help line staffers have been unable to provide comprehensive assistance.

To reduce the administrative burden of PRF reporting, the Academy called on HRSA to

• clarify essential terms;
• obtain requested data from other sources when possible, such getting Medicare payment information from CMS rather than physicians;
• ensure help line staff are well-equipped to answer questions from physician practices; and
• allow physician practices to report aggregate data if they do not have data broken out by payer.