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Series: Audits of CARES Act Provider Relief Funds: General and Targeted Distributions to Providers

Announced on  | Last Modified on  | Series Number: W-00-24-35855
Status
Active
Agency
Health Resources and Services Administration

OBJECTIVE

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act appropriated $178 billion for the Provider Relief Fund (PRF) to support health care providers affected by the COVID-19 pandemic. In April 2020, the Health Resources and Services Administration began distributing the funds through general distributions to Medicare providers based on 2018 net patient revenue and targeted distributions for certain provider types (e.g., providers in areas particularly impacted by COVID-19, skilled nursing providers, and providers in rural areas). Providers such as hospitals may be eligible for PRF payments from the general and targeted distributions. We will select for audit a judgmental sample of providers that received general and/or targeted distributions. Our objective is to determine whether providers that received PRF payments complied with certain Federal requirements, and the terms and conditions for reporting and expending PRF funds.

There are 7 projects in this series.

Project titles will remain unpublished until projects are complete and reports are posted.

ACTIVE PROJECTS IN THIS SERIES (2)

Project A-09-23-01001 • Announced on Jan 30, 2023

Project A-02-23-01012 • Announced on Apr 5, 2023

COMPLETED PROJECTS IN THIS SERIES (5)

Four of Thirty Dental Providers Reviewed Did Not Comply With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments

Project A-02-23-01013 • Completed on November 25, 2025

Hospital Expenditures of Provider Relief Funding

Project A-02-22-01003 • Completed on June 11, 2025

Audit of Skilled Nursing Facility Relief Fund Payment (Targeted Distribution) - Providers' Use of Funds/Expenditure Reports

Project A-05-22-00012 • Completed on June 9, 2025

Home Health Agencies' Compliance with Terms and Conditions for CARES Act Provider Relief Funds

Project A-01-22-00503 • Completed on November 26, 2024

Hospices' Compliance With Provider Relief Fund Requirements

Project A-02-22-01014 • Completed on November 8, 2024

TIMELINE

  • October 12, 2021
    Series Number W-00-24-35855 Assigned
  • October 12, 2021
    Project Announced

    Hospital Expenditures of Provider Relief Funding - A-02-22-01003

  • February 16, 2022
    Project Announced

    Audit of Skilled Nursing Facility Relief Fund Payment (Targeted Distribution) - Providers' Use of Funds/Expenditure Reports - A-05-22-00012

  • April 27, 2022
    Projects Announced

    Home Health Agencies' Compliance with Terms and Conditions for CARES Act Provider Relief Funds - A-01-22-00503

  • Hospices' Compliance With Provider Relief Fund Requirements - A-02-22-01014

  • January 30, 2023
    Project Announced

    Project A-09-23-01001

  • April 5, 2023
    Projects Announced

    Project A-02-23-01012

  • Four of Thirty Dental Providers Reviewed Did Not Comply With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments - A-02-23-01013

  • November 8, 2024
    Project Complete - A-02-22-01014

    Hospices' Compliance With Provider Relief Fund Requirements has been marked as complete. This audit resulted in 2 recommendations.

  • November 26, 2024
    Project Complete - A-01-22-00503

    Home Health Agencies' Compliance with Terms and Conditions for CARES Act Provider Relief Funds has been marked as complete. Report Published

  • June 9, 2025
    Project Complete - A-05-22-00012

    Audit of Skilled Nursing Facility Relief Fund Payment (Targeted Distribution) - Providers' Use of Funds/Expenditure Reports has been marked as complete. This audit resulted in 2 recommendations.

  • June 11, 2025
    Project Complete - A-02-22-01003

    Hospital Expenditures of Provider Relief Funding has been marked as complete. This audit resulted in 2 recommendations.

  • November 25, 2025
    Project Complete - A-02-23-01013

    Four of Thirty Dental Providers Reviewed Did Not Comply With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments has been marked as complete. This audit resulted in 1 recommendation.

  • Today
    2 Audits In-Progress
  • Est FY2026
    Estimated Fiscal Year for Series Completion

5 REPORT PUBLISHED

Eleven of Thirty Selected Hospitals Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments (A-02-22-01003)

25-A-02-071.01 to HRSA - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Health Resources and Services Administration require the 10 hospitals that we determined as having used PRF payments for unallowable expenditures totaling $63 million to return the unallowable amounts to the Federal Government or ensure that the hospitals properly replace the unallowable expenditures with allowable unreimbursed lost revenues or eligible expenses, if any.

25-A-02-071.02 to HRSA - Open Unimplemented
Update expected on 06/08/2026
We recommend that the Health Resources and Services Administration require the 2 hospitals that we determined as having inaccurately calculated and reported lost revenues totaling $645.6 million to identify and return to the Federal Government any PRF payments used to offset inaccurately calculated lost revenues or replace them with allowable unreimbursed lost revenues or eligible expenses, if any.

View in Recommendation Tracker

Seven of Thirty Hospices Reviewed Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments (A-02-22-01014)

25-A-02-010.01 to HRSA - Open Unimplemented
Update expected on 02/25/2026
We recommend that the Health Resources and Services Administration require the six hospices identified in our report as having used PRF payments for unallowable expenditures, totaling $8,306,519, to return the PRF payments to the Federal Government or ensure that the hospices properly replace the unallowable expenditures with allowable unreimbursed lost revenues or eligible expenses, if applicable.

25-A-02-010.02 to HRSA - Open Unimplemented
Update expected on 02/22/2026
We recommend that the Health Resources and Services Administration work with the hospice identified in our report as having used $3,967,025 of its PRF payments for potentially unallowable expenditures to determine what amounts should have been allocated and require the hospice to return unallowable amounts to the Federal Government or ensure that the hospice properly replaces these unallowable expenditures with unreimbursed lost revenues or eligible expenses, if applicable.

View in Recommendation Tracker

Four of Thirty Selected Dental Providers Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments (A-02-23-01013)
  • Of the 30 selected dental providers we reviewed, 4 dental providers inaccurately calculated and reported $3.4 million of lost revenues. These four dental providers received a total of $14.8 million in PRF payments. The remaining dental providers used PRF payments for allowable expenses and accurately calculated lost revenues.
  • These deficiencies occurred because although dental providers attested to the PRF terms and conditions and HRSA provided continuously updated guidance to PRF recipients, some dental providers misinterpreted HRSA’s guidance on calculating patient care lost revenues and used incorrect revenue amounts in their lost revenue calculations.

26-A-02-014.01 to HRSA - Open Unimplemented
Update expected on 05/24/2026
We recommend that HRSA require the selected dental providers to return to the Federal Government any PRF payments used to offset inaccurately calculated lost revenue amounts or properly account for these lost revenues.

View in Recommendation Tracker

Ten of Thirty Selected Nursing Facilities Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments (A-05-22-00012)

25-A-05-070.01 to HRSA - Open Unimplemented
Update expected on 04/14/2026
We recommend that the Health Resources and Services Administration require the eight nursing facilities that we determined as having used PRF payments for unallowable expenditures and lost revenues totaling $2,256,504 to return the unallowable amounts to the Federal Government or ensure that the nursing facilities properly replace the unallowable expenditures and lost revenues with allowable unreimbursed lost revenues or eligible expenses, if any.

25-A-05-070.02 to HRSA - Open Unimplemented
Update expected on 04/14/2026
We recommend that the Health Resources and Services Administration work with the three nursing facilities that we determined as having used PRF payments for potentially unallowable expenditures totaling $332,562 to identify and return the unallowable amounts to the Federal Government or ensure that the nursing facilities properly replace the unallowable expenditures with allowable unreimbursed lost revenues or eligible expenses, if any.

View in Recommendation Tracker
Work Plan Type
Office of Audit Services
HHS Agencies
Health Resources and Services Administration
Issue Areas
COVID-19 Departmental Operational Issues
Target Groups
-
Financial Groups
Other Funding