Health Care Entities Expert Panel
About the Expert Panel
The Health Care Expert Panel serves the needs of AICPA members on financial and business reporting and audit and attest matters. The expert panel protects the public interest by bringing together knowledgeable parties in the health care industry to deliberate and come to agreement on key health care issues.
Learn more about the Health Care Expert Panel at the AICPA Insights blog. The article titled "What Is the AICPA’s Health Care Expert Panel and What Do They Do?" presents a comprehensive look at who the Expert Panel is and the way they operate.
Expert Panel Projects
Listen to a Podcast Discussion on FASB Accounting Standards Update No. 2018-08, Clarifying the Scope and the Accounting Guidance for Contributions Received and Contributions Made
FASB ASU No. 2018-08 was issued in June 2018 and included rapid adoption dates to align as closely as possible to the new revenue recognition adoption requirements. The standard was issued to make it easier for not-for-profit and other organizations, including healthcare entities, to evaluate whether gifts, grants or contracts should be accounted for as contributions—subject to FASB Accounting Standards Codification (ASC) 958, Not-for-Profit Entities—or as reciprocal (exchange) transactions accounted for under other topics such as FASB ASC 606, Revenue from Contracts with Customers. Further, the standard provides additional considerations for determining if a contribution is conditional. Listen to a discussion on the standard, including some questions and observations that have come up specific to the healthcare industry’s adoption of this clarified guidance around grants and contributions.
FASB Accounting Standards Update 2016-14, Presentation of Financial Statements of Not-for-Profit Entities, Replaces the Not-for-Profit Reporting Model That Has Existed for 20 Years
After more than three years of debate, comment, and revision, FASB ASU No. 2016-14 was released in August 2016. The ASU will change the way all not-for-profits (NFPs) classify net assets and prepare financial statements. To view the standard in its entirety, visit the FASB's website here.
Adoption of FASB ASU No. 2016-14 will result in significant changes to financial reporting and disclosures for NFPs. FASB believes the update will improve NFP financial statements and provide more useful information to donors, grantors, creditors, and other financial statement users. The standard is effective for annual financial statements issued for fiscal years beginning after December 15, 2017 and for interim periods within fiscal years beginning after December 15, 2018.
Firms, NFPs, and their boards of directors will soon see some changes to NFP financial statements as a result of recent FASB ASU No. 2016-14. This ASU was presented to simplify the net asset classification requirements and improve the information presented in financial statements and notes about an NFP’s liquidity, financial performance and cash flows. More information is available in the Exploring FASB’s Not-for-Profit Financial Reporting Standard: ASU 2016-14 Toolkit.
Also, the following supplemental health care disclosure examples are provided for your information:
Conduit Debt Obligations: Is Your Not-for-Profit Scoped In or Out of Accelerated Effective Dates?
NFPs with conduit bonds are often subject to the accelerated effective dates and expanded disclosure requirements required of public entities under certain FASB standards. This article discusses recent Technical Questions and Answers (TQAs) that clarify certain terms related to the definition of public business entity, as not all conduit bonds fit the characteristics that subject NFPs to these requirements.
Technical Questions and Answers
Q&A section 6400, Health Care Entities, includes AICPA Technical Questions and Answers (TQAs) that are specific to the health care industry. They are conformed and updated annually to reflect recently issued pronouncements that have become effective. Consult AICPA Technical Questions and Answers for the full text of Q&A section 6400 and all other TQAs issued by the AICPA.
The following TQAs were issued in September 2020 and revised in April 2021:
- Section 6400.63, Background to Sections 6400.64–.70 — CARES Act Provisions Specific to Health Care Entities
- Section 6400.64, Accounting for Provider Relief Fund Phase 1 General Distribution Payments
- Section 6400.65, Recognition Uncertainties Associated With Provider Relief Fund General Distribution Payments
- Section 6400.66, Period of Accounting for Provider Relief Fund General Distribution Payments
- Section 6400.67, Accounting for Uninsured Pool Portion of Provider Relief Funds
- Section 6400.68, Accounting for Payments Received Under the Medicare Accelerated and Advance Payment Program
- Section 6400.69, Accounting for Temporary Increases in Medicare and Medicaid Payments
- Section 6400.70, FEMA Public Assistance Payments to NFP Health Care Entities for Emergency Protective Measures During the COVID-19 Pandemic
The following TQAs were issued in August 2020:
- Section 6400.55, Background to Sections 6400.56–.62 — Accounting for Lease Components in Type A Life Care Contracts by Continuing Care Retirement Communities
- Section 6400.56, Embedded Lease Component Within Type A Life Care Contracts
- Section 6400.57, Determination of the Lease Term When an Embedded Lease Component for an Independent Living Unit Is Present Within Type A Life Care Contracts
- Section 6400.58, Classification of an Embedded Lease Component Within Type A Life Care Contracts
- Section 6400.59, Non-Lease Components Within the Resident Agreement of Type A Life Care Contracts
- Section 6400.60, Measurement of Lease Payments if a Lease for an Independent Living Unit Exists in a Type A Life Care Contract
- Section 6400.61, Reassessment of Lease Term Within the Resident Agreement of Type A Life Care Contracts
- Section 6400.62, Impact on a Lease Component Within the Resident Agreement of Type A Life Care Contracts When a Resident Transitions to Assisted Living or Skilled Nursing
The following TQAs were issued in April 2020:
- Section 6400.53, Accounting for Costs Incurred in Connection With the Implementation of Electronic Health Record Systems
- Section 6400.54, Financial Presentation Considerations Related to Transactions Involving Provider Taxation Programs and Similar Arrangements
Consult AICPA Technical Questions and Answers for the full text of Q&A section 6400 and all other TQAs issued by the AICPA.
FAQ Available
With assistance from a group of health care experts formed by the AICPA, an FAQ has been developed to assist financial statement preparers and audit practitioners as they work through some of the challenges they are encountering amid the pandemic.
The FAQ provides information on the following topics:
- Downturn in the Economy and Job Market Related to COVID-19 and Its Impact on Accounts Receivable and Estimate of the Transaction Price.
- Carrying Value of COVID-19 Supply Inventories.
- PPP loans, including issues related to loan forgiveness.
- Taxability of forgiveness income and expenses.
- The services CPAs are able to provide to clients related to PPP forgiveness.
- Federal Emergency Management Agency funding.
- The 2020 payroll tax deferral under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, P.L. 116-136.
- The employee retention credit.
The Healthcare Financial Management Association, through its Principles and Practices Board, published two nonauthoritative issue analyses in October 2019 related to revenue recognition under the FASB’s Topic 606. One addresses revenue recognition implications for capitation and risk sharing arrangements; the other covers provider tax programs and similar arrangements. A third nonauthoritative issue analysis related to Topic 606, on implicit price concession and bad debt considerations, was published in January 2019.
Read an article, “Opinion: FASB proposal jeopardizes health care entity financing,” about Proposed ASU (Revised), Debt (Topic 470): Simplifying the Classification of Debt in a Classified Balance Sheet (Current versus Noncurrent), which could make variable-rate debt obligations obsolete. If adopted, the proposal may cause financial statement users to be misinformed about health care entities’ financial position.
ASB Issues SAS No. 141 to Delay SAS Nos. 134 – 140 Effective Dates, Permit Early Implementation
The ASB has issued SAS No. 141, Amendment to the Effective Dates of SAS Nos. 134–140, to 1) delay by one year the effective dates of SAS Nos. 134–140 (which, among other things, substantially changes the auditor’s report) from December 15, 2020, to December 15, 2021, and 2) and also permits early implementation of this suite of standards. SAS No. 141 becomes effective upon issuance.
Visit our hub site, Recently Issued Auditing and Attestation Standards: Information and Resources, for the latest information on SAS Nos. 134 – 141.
ASB Issues SAS No. 133 on Exempt Offering Documents
The Auditing Standards Board issued SAS No. 133, Auditor Involvement with Exempt Offering Documents (AICPA, Professional Standards, AU-C sec. 945), to address the auditor’s responsibilities with respect to all exempt offerings of securities undertaken pursuant to federal and state securities laws, and similar laws governing franchise offerings. AU-C section 925, Filings With the U.S. Securities and Exchange Commission Under the Securities Act of 1933 (AICPA, Professional Standards), addresses other offerings. Prior to the issuance of SAS No. 133, the AICPA provided best practices specific to issuances of municipal securities in industry-specific auditing guidance appearing in the AICPA Audit and Accounting Guides, State and Local Governments and Health Care Entities. SAS No. 133 amends AU-C section 560, Subsequent Events and Subsequently Discovered Facts (AICPA, Professional Standards), and AU-C section 925, and becomes effective for exempt offering documents with which the auditor is involved that are initially distributed, circulated, or submitted on or after June 15, 2018.
Members of the Expert Panel
Dawn M. Stark (Chair), Plante Moran
Jay D. Adkisson, RSM US LLP
Douglas M. Coffman, West Virginia University Health System
Christina Dutch, PricewaterhouseCoopers LLP
Trent Fast, CLA (CliftonLarsonAllen LLP)
Andy Gutierrez, ProHealth Care, Inc.
Danielle Hawley, Bake Tilly Virchow Krause, LLP
Melissa Jagst, Deloitte
William “Jody” Love, KPMG LLP
Kimberly K. McKay, BKD, LLP
Lindsey Roe, EY LLP
Barbara L. Potts, SSM Health
Steven Shill, BDO
Learn more about the Expert Panel members by reading their biographies.
Expert Panel Recommended Guidance
CPE and Conferences
- Continuing Professional Education
- Conferences