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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.

El Contrato Escrito: La Herramienta Predilecta

No existe mejor herramienta a una disputa contractual que un documento firmado por las partes en el cual se expongan las obligaciones y acuerdos entre éstas.

New State Budget Institutes Licensure Requirement for Ohio’s Hospitals

On July 1, 2021, Governor Mike DeWine signed Ohio’s final budget codified at Ohio Revised Code 3722.01 et seq., which includes a new licensing requirement for Ohio’s hospitals. For years, Ohio was the only state in the country that did not license its hospitals. This approach will now be replaced with new, detailed requirements that will require careful review and compliance. Here are some of the highlights concerning these new changes:

Healthcare Provisions in the Ohio FY 22-23 Budget

Governor Mike DeWine signed Ohio’s Fiscal Year 2022-2023 budget bill (HB 110) into law on July 1, 2021. At almost 1,000 pages and 74.1 billion dollars, the budget lays out the State’s spending for the next two years. Below are a few highlighted provisions from the budget that will be important for the healthcare industry in Ohio

Interim Final Rule for Surprise Billing

In an effort to implement the new bipartisan No Surprises Act, on July 1, 2021, the Department of Health and Human Services (HHS), along with the Departments of Labor and Treasury, issued an interim final rule to safeguard patients against unforeseen medical bills arising from out-of-network care.

President Biden Seeks to Limit Non-Compete Agreements

Today, President Biden announced he would issue an Executive Order that calls on the Federal Trade Commission (FTC) to adopt rules to curtail worker non-compete agreements. Interestingly, a week ago, the FTC approved changes to its Rules of Practice to modernize and expedite the way it issues Trade Regulation Rules. If you have followed our alerts, we predicted the elimination of non-competes would probably happen. In 2016, then-Vice President Biden was a vocal opponent against non-compete agreements. He led the Obama administration’s initiative seeking to limit or eliminate non-compete agreements. In his presidential campaign, Biden promised to “work with Congress to eliminate all non-compete agreements, except the very few that are absolutely necessary to protect a narrowly defined category of trade secrets . . ..”