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Important Items Every Provider Should Know if Accepting the HHS Provider Relief Funds

On April 10, 2020, the Department of Health and Human Services (HHS) issued $30 billion to healthcare providers as part of the Provider Relief Fund under the CARES Act.  Providers will have 30 days from the date of receipt to access the HHS portal, attest to the payment, and accept the Terms and Conditions. The Terms and Conditions require providers to take substantial steps to ensure compliance. Here is what every provider should know: 

  • Providers should ensure that they attest on the HHS portal to ensure that the money allocated by HHS is consistent with the amount they received, as HHS will certainly recoup any excess amount and the provider will have an obligation to repay such excess.
  • Providers are required to follow 45 CFR 75.302 with respect to financial record-keeping. Providers must adopt a written policy that includes a documented process for ensuring proper allowability of costs and expenses in furtherance of the Provider Relief Fund Terms and Conditions. 
  • Providers are required to comply with 45 CFR 75.361-365 with respect to record retention requirements. This affords HHS a 3-year lookback opportunity to audit providers’ compliance with the Provider Relief Fund Terms and Conditions. 
  • Providers cannot “balance bill” patients for any COVID-related treatment. All providers must bill patients as if the provider is an in-network provider even if the provider is out-of-network. 
  • The Provider Relief Fund Terms and Conditions contain whistleblower protections.

We anticipate that HHS will audit providers’ compliance. Therefore, we recommend the following: 

  • Identify a compliance officer or individual who will be responsible for these funds.
  • Adopt a written policy and procedure to ensure compliance with the Terms and Conditions. This policy should be incorporated into your Compliance Plan.
  • Adopt a written compliant financial record-keeping process.
  • Adopt a written billing policy and update your Patient Financial Responsibility Form. Under the FFCRA and the CARES Act, private insurance plans are required to waive patient co-sharing payment requirements. Providers should have a documented plan for compliance.
  • Providers that received money under another federal COVID-related program (PPP, EIDL, etc.) must separately account for such funds and maintain appropriate records.

Here are some other helpful tips:

  • Providers must ensure vendors and contractors meet certain requirements in order to allocate Provider Relief Funds to these vendor/contractor expenses.
  • Providers should carefully review Confidentiality Agreements, NDAs, and Severance and Settlement Agreements to ensure that language is compliant with the Terms and Conditions.
  • Providers should carefully allocate appropriate expenses as well as properly document “lost revenues.” 
  • Providers cannot allocated expenses twice to two different funding sources.
  • Providers must develop a strategy to use the Provider Relief Funds in accordance with other COVID-related funding (e.g. PPP, EIDL, etc.)

BMD can provide you with a written policy as well as review your agreements to ensure compliance with the Term and Conditions. For questions or more information, please contact Amanda Waesch at alwaesch@bmdllc.com or 330-253-9185.

HHS Announces an Additional $20 Billion In Provider Relief Grants

The U.S. Department of Health and Human Services (“HHS”) announced an additional $20 billion in new funding for providers on October 1, 2020. Eligible providers include those that have already received Provider Relief Fund payments as well as previously ineligible providers, such as those who began practicing in 2020, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic. The new Phase 3 General Distribution is designed to balance an equitable payment of 2% of annual revenue from patient care for all applicants plus an add-on payment to account for revenue losses and expenses attributable to COVID-19.

DOL Proposes New Rule Regarding Independent Contractor Status - But How Will the Election Affect Its Future?

On September 22, 2020, the U.S. Department of Labor announced a new proposed rule regarding employee and independent contractor status under the Fair Labor Standards Act. The full text of the proposed rule is available here. The rule's drafters intend to reduce uncertainty and enhance the precision and predictability of the long-standing "economic reality" test, which currently relies on a multifactor balancing test.

Major Change to Franklin County, Ohio Eviction Process: Landlord Testimony Required

Although there is currently a nationwide temporary halt on all residential evictions through December 31, 2020 in place, the eviction process in Franklin County – which processes the highest number of evictions in the State of Ohio at approximately 18,000 a year – recently changed significantly.

UPDATE: Governor Dewine Signs HB 606 Granting Short Window of Immunity from COVID-19 Personal Injury Lawsuits

The Ohio General Assembly, in Am. Sub. H.B. No. 606, is in the final stages of passing a law that will prohibit lawsuits seeking damages from COVID-19. This includes injury, death, or loss to person or property if the lawsuits are based, in whole or in part, on the exposure to, or the transmission or contraction of the coronavirus, unless the defendant in the lawsuit acted intentionally or recklessly. In circumstances where this immunity does not apply, H.B. 606 prohibits such claims being aggregated and brought as a class action.

Revised Department of Labor FFCRA Guidance, Effective September 16, 2020

In response to attacks on the legality of the Department of Labor’s (“DOL”) Final Rule regarding the Families First Coronavirus Act (“FFCRA” or the “Act”), which took effect in April 2020, the Department of Labor issued new guidance on Friday, September 11th to formally address ongoing questions and concerns related to the COVID-19 legislation.