Alex Azar

• Pandemic-program role: Secretary of Health and Human Services during the 2020 pandemic response: Provider Relief Fund, Strategic National Stockpile purchasing, and the CDC eviction order.
• Institution - office: U.S. Department of Health and Human Services - Type: appointed official

In the archive

• Case: Association of American Physicians & Surgeons v. Food & Drug Administration — W.D. Mich., No. 1:20-cv-00493
• Case: Brown et al. v. Azar et al. — N.D. Ga., Atlanta Division, No. 1:20-cv-03702
• Case: Chambless Enterprises, LLC v. Redfield — W.D. La., Monroe Division

HHS under Alex Azar distributed the first $30 billion of the Provider Relief Fund in April 2020 "proportionate to providers' share of Medicare fee-for-service reimbursements in 2019," with $26 billion landing in bank accounts on April 10 and the rest a week later.¹ HHS's Inspector General later found that about $2.16 billion of the $39.3 billion in automatic payments was not calculated as intended and that more than $247 million went to ineligible providers.² Landlords challenging the CDC's eviction order sued Azar in his official capacity; a federal court in Atlanta refused to block the order in October 2020.³

The Provider Relief Fund

On April 22, 2020, HHS announced the plan for the first $100 billion Congress had given it for providers. It set $50 billion aside for a general distribution to Medicare providers, $10 billion for hospitals in areas hit hardest by COVID-19 and $10 billion for rural clinics and hospitals. Part of the fund would pay for COVID-19 treatment of the uninsured at Medicare rates.¹ The first $30 billion went out by Medicare share. The remaining $20 billion topped up providers so that the $50 billion as a whole followed their share of 2018 net patient revenue.¹

"Our goal in all of the decisions we're making is to get the money from the Provider Relief Fund out the door as quickly as possible while targeting it to those suffering the most from the pandemic," Azar said in the announcement.¹

The Inspector General's October 2023 audit of the automatic payments called HHS's oversight "generally effective" for most of the approximately $39.3 billion. It found that about $2.16 billion (5.5 percent) was not properly calculated as intended. HHS also did not stop more than $247 million (under 1 percent) from reaching ineligible providers, and did not use all readily available lists to screen them out.² How the formula favored Medicare billers is in The Formula That Paid Medicare First.

Ventilators and protective gear

On March 27, 2020, the President directed the HHS Secretary to use the Defense Production Act to make General Motors accept and prioritize ventilator orders.⁴ HHS's preparedness office signed ten ventilator contracts that spring for $2.9 billion; in 2022 the Inspector General found it had not consistently awarded and monitored them as federal rules and HHS policy require.⁵ Profiles of two suppliers: General Motors and AirBoss Defense Group.

The eviction order

On September 4, 2020, the CDC halted residential evictions for non-payment of rent for tenants who signed a declaration of need. Landlords and the National Apartment Association sued Azar, in his official capacity, and other officials in the Northern District of Georgia, calling the order unlawful.⁶ On October 29, 2020 the court denied a preliminary injunction, reasoning that Congress had given the Secretary broad power to issue regulations to prevent the spread of communicable disease.³ The Eleventh Circuit later dismissed the landlords' appeal as moot after the final order in Alabama Association of Realtors v. HHS, issuing its mandate on January 6, 2022.⁷

Related profiles

• Seema Verma: Medicare administrator, whose billing data drove the first distribution.
• Steven T. Mnuchin: Treasury Secretary in 2020.

Sources

1. U.S. Department of Health and Human Services, "HHS Announces Additional Allocations of CARES Act Provider Relief Fund," Apr. 22, 2020 (Internet Archive copy). Original: https://web.archive.org/web/2020id_/https://www.hhs.gov/about/news/2020/04/22/hhs-announces-additional-allocations-of-cares-act-provider-relief-fund.html ↩
2. HHS Office of Inspector General, "HHS's Oversight of Automatic Provider Relief Fund Payments Was Generally Effective but Improvements Could Be Made," A-02-20-01025, Oct. 2023. ↩
3. Order denying preliminary injunction, Brown v. Azar, No. 1:20-cv-03702-JPB (N.D. Ga.), Oct. 29, 2020. Original: https://archive.org/download/gov.uscourts.gand.280996/gov.uscourts.gand.280996.48.0_1.pdf ↩
4. Memorandum on an Order Under the Defense Production Act of 1950 Regarding General Motors Company, Mar. 27, 2020 (Daily Compilation of Presidential Documents, DCPD-202000197). Original: https://www.govinfo.gov/content/pkg/DCPD-202000197/html/DCPD-202000197.htm ↩
5. HHS Office of Inspector General, "HHS Did Not Fully Comply With Federal Requirements and HHS Policies and Procedures When Awarding and Monitoring Contracts for Ventilators," A-02-20-02002, Sept. 2022. Original: https://oig.hhs.gov/documents/audit/6519/A-02-20-02002-Complete%20Report.pdf ↩
6. Complaint, Brown v. Azar, No. 1:20-cv-03702 (N.D. Ga.), Sept. 8, 2020. ↩
7. Eleventh Circuit order dismissing appeal as moot, Brown v. Azar, No. 20-14210, issued as mandate Jan. 6, 2022. Original: https://archive.org/download/gov.uscourts.gand.280996/gov.uscourts.gand.280996.72.0.pdf ↩