HHS To Audit Hospitals
By: Emily H. Lineweaver
The U.S. Department of Health and Human Services (HHS) announced it will be performing a nationwide audit of hospitals that received funding from the Provider Relief Fund (PRF) to determine if hospitals complied with the balance billing requirement under the PRF’s terms and conditions. The PRF payments were intended to reimburse healthcare providers for the expenses or lost revenue they experienced attributable to COVID-19. Under the PRF’s terms and conditions, hospitals eligible for disbursement had to attest that they would “not pursue the collection of out-of-pocket payments from presumptive or actual COVID-19 patients in excess of what the patients otherwise would have been required to pay if the care had been provided by in-network providers,” or more simply referred to as: the “balance billing requirement.” The Office of Inspector General, U.S. Department of Health and Human Services (OIG) said it “will assess how bills were calculated for out-of-network patients admitted for COVID-19 treatment, review supporting documentation for compliance, and assess procedural controls and monitoring to ensure compliance with the balance billing requirement.