Overpayments, non-returned funds, and failure to verify reported losses could equate to hundreds of millions in mismanaged tax-payer dollars.
(Alexandria, Va.) – A Congressionally mandated audit of Provider Relief Fund (PRF) distributions by the Department of Health & Human Services’ (HHS) Office of the Inspector General (OIG) has finally been released and the results are alarming. The OIG found that HHS failed to “establish procedures to verify reported losses,” potentially leading to countless fraudulent payments, failed to subtract automatic payments made to multiple providers’ subsidiaries resulting in significant overpayments, and failed to require repayment of disbursements made to providers even though provider clearly indicated that they did not want to receive the relief funds.
It is potentially just the tip of the iceberg. The OIG report examined only about one-fourth of the distribution of the PRF and specifically focused on funds that went out between April and December of 2020. Even that small sample revealed $46.5 million in overpayments payments that HRSA made to 315 providers for which HHS did not subtract the automatic payments made to the providers’ subsidiary organizations. Additionally, another nearly $50 million hasn’t been repaid by 118 providers who rejected their relief payment because HHS had not at the time asked for it back.
Perhaps the most significant mismanagement, however, is HHS’s inability to verify provider losses during the period examined in this audit. The report states, “Although the application and attestation portals collected the providers’ estimated revenue losses for these months, and providers were notified by email to resubmit their applications if those losses met certain characteristics, HHS and HRSA did not require providers to submit supporting documentation for the estimated revenue losses… As a result, HHS and HRSA were unable to verify those losses.”
“Such lack of accountability and potential for fraud and abuse could have resulted in hundreds of millions of dollars in inappropriately allocated funds,” said Maggie Elehwany, Senior Vice President of Public Policy at Argentum. “To learn this at a time when assisted living frontline caregivers continue to face steep financial struggles because of the inequitable PRF funds received, is beyond frustrating.”
To date, assisted living caregivers received a smaller amount of financial relief from the PRF than any other frontline provider. Despite caring for roughly the same number of seniors as skilled nursing facilities, assisted living caregivers received about one-twelfth of the PRF as SNFs.
This report and the future audits being developed by the OIG are critical tools to ensuring accountability and securing relief that is owed to frontline caregivers in senior living communities. Argentum will provide additional information as soon as it is available. “The mismanaged funds identified in this report must be recouped and equitably distributed to assisted living front-line caregivers,” said Elehwany.
Since 1990, Argentum has advocated for choice, independence, dignity, and quality of life for all older adults. Argentum’s programs and initiatives are driven by its membership. For more information, please visit www.argentum.org
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