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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

Ohio Department of Health Releases Updated Charge Limits for Medical Records

March 7, 2022Under Ohio law, a healthcare provider or medical records company that receives a request for a copy of a patient's medical record may charge an amount in accordance with the limits set forth in Ohio Revised Code Section 3701.741. The allowable amounts are increased or decreased annually by the average percentage of increase or decrease in the consumer price index for all urban consumers, prepared by the United States Department of Labor, Bureau of Labor Statistics, for the immediately preceding calendar year over the calendar year immediately preceding that year, as reported by the Bureau. The Director of the Ohio Department of Health makes this determination and adjusts the amounts accordingly. The list is then published, here.Client Alert

No Surprises Act Compliance (Published by NAMAS, 2/25/22)

March 7, 2022The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives a bill with a higher price than they may have anticipated because they did not have knowledge that the provider or facility was out-of-network. The purpose of this article is to note certain requirements that compliance employees will need to be aware of at their facilities, including notice and consent, good faith estimates, and public disclosures.Client Alert

No Surprises Act and You (Published in the SCMS Winter 2022 Newsletter)

March 3, 2022Legislation has been adopted by the United States Congress and the Ohio Legislature known as the “No Surprises Act” which attempts to regulate billing by professionals and facilities to patients who are not in networks with those facilities or providers at those facilities. The federal bill was triggered by some sensational news stories of patients being billed for tens of thousands of dollars for emergency care when the hospital was out of the network under the patient’s insurance plans.Client Alert

Are You Impacted by the Project Labor Agreement Executive Order?

February 28, 2022Project Labor Agreements (PLAs) are a quasi-collective bargaining agreement between employers and unions. They establish the terms and conditions of employment, including dispute resolution. They are put into place on specific projects and apply to the contractor, whether it is union or non-union. Employees hired on the project will be treated as union.Client Alert

No Surprises Act Update: Federal Judge Strikes Portions of the No Surprises Act

February 25, 2022In a win for providers, a Texas federal court granted the Texas Medical Association’s (TMA) motion for summary judgment and struck down portions of a federal rule that establishes a reimbursement rate arbitration process between payors and providers under the No Surprises Act (NSA).
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