UNITED STATES DISTRICT COURT

DISTRICT OF PUERTO RICO 

In re: 

THE FINANCIAL OVERSIGHT AND 

MANAGEMENT BOARD FOR PUERTO RICO, 

as representative of

THE COMMONWEALTH OF PUERTO RICO, et al., 

Debtors.1

PROMESA 

Title III 

No. 17 BK 3283-LTS 

Re: ECF Nos. 18602, 21005, 22400, 

22682

(Jointly Administered) 

JOINT STATUS REPORT CONCERNING

COMMUNITY HEALTH FOUNDATION OF P.R. INC.’S MOTION FOR

ALLOWANCE AND PAYMENT OF ADMINISTRATIVE EXPENSE

To the Honorable United States District Court Judge Laura Taylor Swain:

The Commonwealth of Puerto Rico (the “Commonwealth”), by and through the Financial 

Oversight and Management Board for Puerto Rico (the “Oversight Board”), as the 

Commonwealth’s representative pursuant to section 315(b) of the Puerto Rico Oversight, 

Management, and Economic Stability Act (“PROMESA”),2 and Community Health Foundation of 

P.R. Inc. (“CHF” and, together with the Oversight Board, the “Parties”), respectfully submit this 

 1 The Debtors in these Title III Cases, along with each Debtor’s respective Title III case number and the last four 

(4) digits of each Debtor’s federal tax identification number, as applicable, are the (i) Commonwealth of Puerto 

Rico (Bankruptcy Case No. 17 BK 3283-LTS) (Last Four Digits of Federal Tax ID: 3481); (ii) Puerto Rico Sales 

Tax Financing Corporation (“COFINA”) (Bankruptcy Case No. 17 BK 3284-LTS) (Last Four Digits of Federal 

Tax ID: 8474); (iii) Puerto Rico Highways and Transportation Authority (“HTA”) (Bankruptcy Case No. 17 BK 

3567-LTS) (Last Four Digits of Federal Tax ID: 3808); (iv) Employees Retirement System of the Government of 

the Commonwealth of Puerto Rico (“ERS”) (Bankruptcy Case No. 17 BK 3566-LTS) (Last Four Digits of Federal 

Tax ID: 9686); (v) Puerto Rico Electric Power Authority (“PREPA”) (Bankruptcy Case No. 17 BK 4780-LTS) 

(Last Four Digits of Federal Tax ID: 3747); and (vi) Puerto Rico Public Building Authority (“PBA”) (Bankruptcy 

Case No. 19-BK-5523-LTS). (Title III case numbers are listed as Bankruptcy Case numbers due to software 

limitations).

2 PROMESA has been codified in 48 U.S.C. §§ 2101–2241.

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joint status report pursuant to the Order Setting Deadline for a Status Report Concerning 

Community Health Foundation of P.R. Inc.’s Motion for Allowance and Payment of Administrative 

Expense [ECF No. 22682], stating as follows:

Status Report

I. What Issues, If Any, Remain in Dispute in Connection with the Motion3

1. The issues that remain in dispute consist of three categories of facts: 1) the “PPS” 

rates for the years 2020 and 2021; 2) the number of eligible Medicaid visits for calculation of the 

wraparound payment due to CHF, if any; and 3) the dollar amount of fee-for-service (“FFS”) and 

other payments received by CHF. 

2. With respect to the PPS rates, CHF agrees with the Oversight Board’s methodology 

for calculating the PPS rate, as set forth in the Objection of the Financial Oversight and 

Management Board for Puerto Rico to the Motion of Community Health Foundation of P.R. Inc. 

for Allowance and Payment of Administrative Expense [ECF No. 21005] (the “Objection”) ¶¶ 12-

14. The PPS rates for 2017 through 2019 are therefore agreed upon by the Parties. However, CHF 

proposed in its Reply to Objection of the Financial Oversight and Management Board for Puerto 

Rico to the Motion of Community Health Foundation of P.R. Inc. for Allowance and Payment of 

Administrative Expense [ECF No. 22400] (the “Reply”), that the applicable PPS rate be increased 

for years 2020 and 2021 in light of asserted changes to CHF’s scope of services. See id. ¶¶ 9-13; 

see also Declaration of Nilda Santiago in Support of Reply to Objection of the Financial Oversight 

and Management Board for Puerto Rico to the Motion of Community Health Foundation of P.R. 

Inc. for Allowance and Payment of Administrative Expense [ECF No. 22400-1] (the “Santiago 

 3 The “Motion” refers to Community Health Foundation of P.R. Inc.’s Motion for Allowance and Payment of 

Administrative Expense [ECF No. 18602].

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Declaration”). The Commonwealth is in the process of evaluating CHF’s proposed increases to 

its PPS rate for 2020 and 2021 in light of changes to CHF’s scope of services. Accordingly, the 

PPS rates for 2020 and 2021 have not been resolved.

3. With respect to the number of eligible Medicaid visits, the Parties have not resolved 

certain discrepancies in the data that CHF has provided in support of its Motion. CHF has provided 

data relating to these visits to the Oversight Board, but, the Commonwealth’s position is that it has 

not confirmed those visit counts based on information it currently has available. 

4. With respect to the FFS payments, the Parties have not resolved the discrepancy 

between CHF’s calculations as contained in the chart identified as Exhibit 5 of the Reply and the 

amounts contained in the documents attached as Exhibit F of the Objection as to FFS payments 

received by CHF. 

II. What Documentation in Support of CHF’s Request for Payment, if any, Is 

Required by Either Party to Resolve the Outstanding Issues in the Motion

5. With respect to the PPS rates, the Oversight Board has requested, and CHF shall 

provide its audited financial statements for the years ended 2019 and 2020 and its financial 

statement for the year ended 2021,

4 supporting their change in scope of services calculations, if 

any, beyond the documents attached to the Santiago Declaration. 

6. With respect to visit counts, the Oversight Board requested, and CHF shall provide, 

1) any available additional sources of visit data that are needed to provide complete support for 

the visits CHF claims, and 2) appropriate documentation evidencing that CHF’s visit data includes 

only Medicaid visits and that such visits are attributable only to CHF, rather than any of its 

affiliates.

 4 CHF expects to provide an audited financial statement for the year ended 2021, on or before December 31, 2022. 

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7. With respect to FFS payments, the Oversight Board has requested, and CHF will 

provide, access to the records CHF obtained from the managed care organizations (“MCOs”) 

which were used to prepare the charts identified as Exhibit 4 and Exhibit 5 of the Reply 

demonstrating payments CHF has received from managed care organizations. 

8. With respect to the data and information set forth in paragraphs 6 and 7, the 

provision of such information, if necessary, shall be subject to a confidentiality agreement 

appropriately restricting use of any confidential or personally identifiable information.

9. In order to verify the information provided by CHF, the Commonwealth intends to 

request additional documents and information from the MCOs with whom CHF contracts. The 

Commonwealth will provide these documents to CHF in accordance with the timetable set forth 

below. 

III. Proposed Schedule and Methodology for the Exchange and Review of the 

Documentation, and the Timeline for the Issuance of any Determinations by the 

Puerto Rico Department of Health Necessary to Resolve the Issues Underlying 

the Motion

10. The Parties’ contemplated schedule and methodology for the exchange and review 

of the documentation is as follows: 

• CHF shall provide responsive documents to the Oversight Board by November 9, 2022.

• To the extent that any data CHF provides may contain confidential or personally

identifiable information, CHF, the Oversight Board, and/or any other necessary party will 

enter into an agreement to properly restrict access to any such information prior to 

exchange of any such data. CHF has furnished to the Oversight Board a draft Business 

Associate Agreement for its review. The Parties expect to have executed said agreement 

by November 4, 2022. 

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• The Puerto Rico Department of Health (“PRDOH”) and Puerto Rico Health Insurance 

Program (by its Spanish acronym, “ASES”) are in the process of requesting the documents 

and information discussed in paragraph 9 above. Following its receipt of such documents 

and information, PRDOH and ASES, as assisted by the Puerto Rico Fiscal Agency and 

Financial Authority, the Oversight Board, and/or their advisors, shall conduct a review of 

that information and the information provided by CHF and issue a determination as to 

whether it validates CHF’s supporting documents and determine what wraparound 

payment, if any, is owed to CHF. If PRDOH is unable to validate the documents or 

determine what wraparound payment is owed to CHF based on those materials, PRDOH 

shall state with specificity what additional documents must be provided and/or the reason 

for its inability to validate. Such analysis shall be provided by November 16, 2022.

• To the extent additional documents beyond those described in paragraph 9 are determined 

to be required and are in the possession or control of third parties (parties other than the 

Commonwealth or the Parties) involved in calculating any of the foregoing, the 

Commonwealth shall request such documents from the third parties as soon as possible 

after such determination is made.

IV. Adjournment of Hearing

11. In light of the above, the Oversight Board and CHF request that the hearing in 

connection with the Motion, which is currently scheduled to be heard on November 2, 2022, be 

adjourned to the Omnibus Hearing scheduled on December 14, 2022.

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Dated: October 28, 2022 

San Juan, Puerto Rico

Respectfully submitted, 

O’NEILL & BORGES LLC

By: /s/ Hermann D. Bauer

Hermann D. Bauer 

USDC No. 215205

250 Muñoz Rivera Ave., Suite 800 

San Juan, PR 00918-1813

Telephone: (787) 764-8181

Facsimile: (787) 753-8944

Email: hermann.bauer@oneillborges.com 

PROSKAUER ROSE LLP

By: /s/ Brian S. Rosen 

Martin J. Bienenstock* 

Brian S. Rosen*

Julia DAlonzo

Eleven Times Square 

New York, NY 10036

Telephone: (212) 969-3000

Facsimile: (212) 969-2900

Email: mbienenstock@proskauer.com 

brosen@proskauer.com

 jalonzo@proskauer.com

* admitted pro hac vice

Attorneys for the Financial Oversight and 

Management Board and as Representative of the 

Commonwealth

CORDOVA-AYUSO LAW OFFICE 

LLC

By: /s/ [DRAFT]

Lucas A. Córdova-Ayuso, Esq.

USDC-PR No. 226805

P.O. BOX 194021

San Juan, PR 00919-4021

Tel.: (787) 230-0463

Email: lac@calawpr.com

Counsel for Community Health Foundation 

of P.R. Inc. 

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