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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.


Ohio Senate Bill 225 Paves the Way for Greater Investment in Opportunity Zones and Historic Districts

Ohio Senate Bill 225 is poised to make dramatic enhancements to certain tax credit programs in Ohio, specifically those surrounding investments in “Opportunity Funds” and historic buildings. Signed into law by Governor Mike DeWine in June 2022, the Bill is positive news for real estate developers working to revitalize Ohio communities with investment and rehabilitation projects.

Ohio Board of Pharmacy COVID-19 Waiver Update

The State of Ohio Board of Pharmacy has issued waivers throughout the COVID-19 pandemic to aid licensed practitioners in their day-to-day operations. As the pandemic has continued over the years, the State of Ohio Board of Pharmacy has intermittently reviewed the various waivers. Effective August 10, 2022, some of those waivers that were once granted have been rescinded.

Ohio Chiropractors Can Now Provide Evaluation and Management Services to Medicaid Patients

The Department of Medicaid released a statement that Medicaid will cover low-and moderate level E&M services represented by CPT codes 99202, 99203, 99212, and 99213 when performed by a chiropractor. The Department of Medicaid will cover up to three E&M services per benefit year. The Department of Medicaid plans to make these changes effective by October 1, 2022.

How to Spot Indicators of Financial Difficulty in Your Company's Suppliers and Vendors to Protect Your Interests

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Supreme Court Backs HHS in DSH Payment Battle

DSH payments are statutorily required payments intended to offset hospitals’ uncompensated care costs to improve patient access to Medicare and Medicaid. The payments also serve to help the financial stability of safety-net hospitals that oftentimes treat uninsured or underinsured patients. The U.S. Department of Health and Human Services’ (HHS) specifically makes DSH payments to hospitals that serve a high number of low-income patients. The Medicare DSH adjustment is calculated based on two factors: the hospital’s Medicare patients with low incomes and those with low incomes, but not on Medicare.