Provider Relief Funds: CHOW Developments and Other Updates

As Provider Relief Fund (PRF) recipients look towards the end of the first PRF reporting period on September 30, 2021, the Department of Health & Human Services (HHS) and Health Resources & Services Administration (HRSA) have made important updates, including those related to changes of ownership. Below is a summary of these updates. For additional updates, PRF recipients should now look to the new HRSA website, mentioned in the second bullet below.

• HHS and HRSA Scale Back FAQs Related to CHOWs: HHS and HRSA have used an informal “Frequently Asked Questions” webpage to help guide PRF recipients in the use and reporting of PRFs. However, the FAQs do not have the force of law and are not subject to the same scrutiny or administrative process as, for example, regulations. The downside is that, while FAQs can be quickly posted, they can also be quickly deleted, typically without explanation. We have previously published articles about FAQs addressing CHOWs. However, many of the FAQs have since been deleted, including what was a very helpful chart laying out when PRFs may be transferred during a CHOW and what party is responsible for reporting on the funds. Unfortunately, it is unclear how the deletion impacts the guidance. For example, it is unclear whether deletion constitutes a retraction of the FAQ, which could affect providers who relied on the now-deleted guidance.

• HHS PRF Website Shifts to HRSA: For most of the COVID-19 pandemic, information related to PRFs was found on an HHS website. In August 2021, the page was shifted to a HRSA web address. While HRSA is an agency within HHS, the move is still notable as it reflects the status of HRSA as the agency tasked with managing PRFs. In a recent August 26, 2021 stakeholder briefing, HRSA made a note to all providers listening that the previous HHS PRF website no longer existed.

• Phase 4 Funding – ASHA Meets With White House Domestic Policy Council: On August 27, 2021, the American Seniors Housing Association (ASHA) announced that it met with members of the White House Domestic Policy Council and Office of Management and Budget to discuss PRFs. ASHA stated that it used the opportunity to make the case for a Phase 4 allocation to healthcare providers, underscoring the immediacy of the industry’s need for financial relief.

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The Arnall Golden Gregory Change of Ownership (CHOW) team leads all regulatory aspects of healthcare transactions for investors, operators, managers, capital partners, and developers of every size in all 50 states.  The team streamlines the regulatory process so that clients close their transactions on or ahead of schedule. Whether obtaining licensure and Medicare/Medicaid approvals, structuring transactions to expedite closings, anticipating issues to minimize cash flow disruption, negotiating regulatory terms in deal documents, creatively resolving diligence issues, or advising on CHOW guidelines and compliance, the team provides extensive experience and practical solutions. To date, the CHOW team has served as primary regulatory counsel in transactions valued at more than $25 billion.​