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

Client Alert
November 24, 2020

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.

PRFProvider Relief Fundhealth care providersCOVID-19public health emergencyCARES ActBMD Healthcare & Hospital Law GroupAmanda L. WaeschKevin Cripe
Client Alert

Property Owner Protection from Tax Valuation Challenges

April 29, 2022New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.Client Alert

No Surprises Act Update: The IDR Portal is Open

April 25, 2022The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.Client Alert

Updated FAQs for the No Surprises Act - Good Faith Estimates

April 7, 2022The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.Client Alert

IMPORTANT PRF UPDATE! HRSA Allows Providers the Opportunity to Correct Missed Period 1 Reporting

April 7, 2022Late Wednesday, April 6, HRSA announced that it was going to allow providers with extenuating circumstances that prevented them from preventing a completed Period 1 Report to submit a Request to Report Late Due to Extenuating Circumstances.Client Alert

Advanced Practice Providers and Telemedicine Start-Up Surge

March 8, 2022Throughout the COVID-19 pandemic, we heard a lot about “surges” that happened all over the country regarding the virus. One of the other interesting “surges” we have followed is the “surge” in new healthcare business start-ups, particularly businesses owned by advanced practice providers, such as nurse practitioners, physician assistants, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (“Advanced Practice Providers” or “APPs”). One of the hottest areas in the healthcare start-up surge has been the creation of practices that are telemedicine focused.
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