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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.


The DOL and EEOC Enter a Partnership to Strengthen Federal Employment Law Enforcement

On September 13, the U.S. Department of Labor’s (DOL) Wage and Hour Division and the Equal Employment Opportunity Commission (EEOC) entered into a Memorandum of Understanding (MOU) agreeing to work together in enforcing federal employment laws. The MOU forms a partnership between the two agencies to encourage coordination through information sharing, joint investigations, training, and outreach.

Proposed Laboratory Arrangement Draws Heightened Scrutiny from the OIG

On September 25, 2023, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) issued Advisory Opinion 23-06 (AO). The Opinion involved a proposed arrangement between an independent laboratory and other physician laboratories for the purchase of the technical component of anatomic pathology services. The OIG ultimately concluded that the arrangement at issue, if it was entered into with the requisite intent, would implicate the Federal Anti-Kickback Statute (AKS) and constitute grounds for sanctions.

SMALL BUSINESS ALERT: January 1, 2024 - Beneficial Ownership Information Reporting

Beginning on January 1, 2024, many small businesses across the United States will have to report personal information about their owners, beneficial owners, and others who own or exercise control over the company. The information will have to be reported to, and maintained by, the Financial Crimes Enforcement Network (“FinCEN”) as part of the Beneficial Ownership Information Rule. FinCEN is a bureau of the U.S. Department of the Treasury.

Health Care Inclusivity for the LGBTQIA+ Community

Healthcare providers, regardless of practice setting, should be aware of the healthcare disparities for LGBTQIA+ individuals, and ways in which they can be more inclusive of these individuals by making modifications to their practices.

Obtaining Patient Consent

Patients have autonomy to choose what can and cannot be done to their bodies. Therefore, informed consent is required before any treatments or procedures commence. This is a stark contrast to the previously recognized paternalistic approach, which relies solely on the decision-making of the provider. However, in order for patients to really choose whether or not to submit themselves to a particular healthcare service, they must actually understand what the service is. Therefore, patient consent should help the patient understand the risks and benefits, as well as any alternative treatment options.