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Did You Receive More than $750,000 in Provider Relief Funds?

Client Alert

The Provider Relief Funds (“PRF”) - authorized under the CARES Act - have been a vital tool for health care providers during the COVID-19 public health emergency. These funds have allowed providers to stay open and continue to offer care during these pressing times. While helpful, these funds do come with several important obligations. First, fund recipients are required to comply with certain record-keeping requirements as well as comply with certain balance billing prohibitions. See our Client Alert. Second, fund recipients are required to report their intent, use of funds, and other data elements, which helps promote transparency to the federal government. Please see our Client Alert on provider relief fund reporting requirements. Third, and perhaps a new concept for many providers, fund recipients of more than $750,000 must undergo a “single audit” to ensure program compliance and appropriate use of funds.

A single audit analyzes how an organization spends federal funds. Under the PRF, providers have two audit options: (1) a single audit on the financial statements of the entity; or (2) a program-specific single audit on just the revenue and expenditures related to PRF payments.

The federal government has an interest in certifying disbursed funds are properly used and put towards their intended purpose. Auditors review a wide range of criteria, including eligibility, cash management and engaging in allowable expenses. Reviewers will examine all documentation related to the use of PRF dollars, including, but not limited to, invoices, contracts, balance sheets, and other accounting records. To help expedite the audit process, providers are encouraged to keep organized and detailed documentation and track every cent of spending. Providers should be ready to connect an expense to the intended purpose of the funding. BMD has created a Provider Relief Fund Policy as well as a spreadsheet to assist providers in tracking expenses, revenues, and appropriate use of PRF.

A single audit is often due within 9 months after the end of the audit period. Since the PRF covers the 2020 calendar year, a single audit related to these funds should be completed by September 2021. Extensions may be granted on a case-by-case. Providers should anticipate an audit to take anywhere between 3-7 days.

Please contact BMD Healthcare and Hospital Law Member, Amanda Waesch at alwaesch@bmdllc.com or 330-253-9185 if you have any questions regarding PRF audits, which audit type might be best for your practice, or any other general CARES Act and PRF questions.


New Florida Law: Patient Overpayments Must Be Refunded Within 30 Days

Effective January 1, 2026, Florida Senate Bill 1808 requires health care facilities and practitioners to refund patient overpayments within 30 days after an overpayment is identified. The law applies to overpayments tied to claims submitted to government programs or private insurers and introduces fines and disciplinary consequences for noncompliance. Providers should review billing and payment practices now to prepare for the new requirements.

USCIS Policy Change Impacting Work Authorization: Advisory for Employers and Human Resources

USCIS has issued a policy memorandum pausing immigration benefit processing for individuals from 19 high-risk countries and requiring a re-review of certain previously approved cases. This change may affect work authorization, employment verification, and workforce stability. Employers and HR teams should review impacted employees and update compliance procedures.

CMS Releases CY 2026 Medicare Physician Fee Schedule Final Rule with Key Payment and Telehealth Updates

CMS issued the CY 2026 Medicare Physician Fee Schedule Final Rule on October 31, 2025, with changes effective January 1, 2026. The Final Rule includes increases to the conversion factor, a new efficiency adjustment, updates to practice expense methodology, permanent telehealth policy changes, revised payment for skin substitutes, expanded rules for Part B drugs and biologicals, enhanced policies for Rural Health Clinics and Federally Qualified Health Centers, and new care management and behavioral health services.

Ohio Department of Medicaid Updates: Key Changes to Physician Reimbursement Rates in Early Parenthood

The Ohio Department of Medicaid has proposed amending Ohio Administrative Code Rule related to covered Medicaid reimbursements for physicians. Beginning on January 1, 2026, they are proposing an increase to rates for prenatal care, childbirth, and infant care and provider visits.

Name, Image, and Likeness Agreements in Healthcare

For example, some healthcare providers have begun to utilize "Name, Image, and Likeness" agreements to promote the brand they have created through their healthcare practice.  We have seen the most healthcare NIL activity with longevity and wellness providers, as well as orthopedics.