Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

July 20 is Important Deadline for HHS Fund Distributions to Medicaid and CHIP Providers

Client Alert
June 19, 2020

On June 10, 2020, the U.S. Department of Health and Human Services (“HHS”) released details on the distribution of more CARES Act Provider Relief Fund payments. After allocating $50 billion to Medicare providers through its General Distribution fund, HHS has now announced that it will distribute $15 billion to eligible Medicaid and CHIP providers who apply by the deadline through a Targeted Distribution. Applicants must apply through the Enhanced Provider Relief Fund Payment Portal. The application form itself can be found on the HHS website and is due by July 20, 2020.

In order to qualify for part of the Targeted Distribution for Medicaid and CHIP providers, practices and individual practitioners must meet all of the following requirements:

  1. Must not have received payment from the $50 billion General Distribution; and
  2. Must have directly billed Medicaid (or Medicaid Managed Care Plans) for healthcare-related services during the period of January 1, 2018, to December 31, 2019, or (ii) own (on the application date) an included subsidiary that has billed Medicaid for healthcare-related services during the period of January 1, 2018, to December 31, 2019; and
  3. Must have either (i) filed a federal income tax return for fiscal years 2017, 2018 or 2019 or (ii) be an entity exempt from the requirement to file a federal income tax return and have no beneficial owner that is required to file a federal income tax return. (e.g. a state-owned hospital or healthcare clinic); and
  4. Must have provided patient care after January 31, 2020; and
  5. Must not have permanently ceased providing patient care directly, or indirectly through included subsidiaries; and
  6. If the applicant is an individual, have gross receipts or sales from providing patient care reported on Form 1040, Schedule C, Line 1, excluding income reported on a W-2 as a (statutory) employee.

Note that if a provider received a General Distribution payment and returned it, they will not be eligible for this Targeted Distribution.

The final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients the provider serves. Payments will be allocated based on this formula:

Payment Allocation = 2% (Gross Revenues x Percent of Gross Revenues from Patient Care)

The provider requesting an allocation will specify in their application whether they want to base this calculation on calendar year 2017, 2018 or 2019 revenues. Payments will be disbursed on a rolling basis, as information is validated by HHS. Providers who qualify should apply as soon as possible to ensure they meet the July 20th deadline and do not get stuck waiting for validation.

Once a provider is approved for and receives Targeted Distribution funds, they will have 90 days to accept the payment and attest to certain Terms & Conditions. The Terms & Conditions are very similar to the General Distribution attestations, but recipients of the Targeted Distribution funds should read through them carefully to ensure they can truthfully attest to each one. If a provider finds they cannot satisfy one of the Terms & Conditions they should return their payment back to HHS within the 90-day period following receipt of the payment.

Also like the General Distribution funds, the Targeted Distribution funds may only be used to reimburse the provider for health care expenses incurred in the prevention, preparation for, and response to coronavirus or for lost revenues attributable to coronavirus. Providers may not use the Targeted Distribution funds to pay for expenses or losses that have been reimbursed from other sources. Additionally, the Targeted Distributions Funds are characterized as federal grants, which require the provider to take the following steps:

  • Adopt a policy regarding the proper use of the funds, procedure for ensuring proper use of the funds, and appointment of a compliance officer.
  • Ensure proper maintenance of records and documentation of expenditures as HHS can audit over a 3-year lookback period.
  • If the provider has received Paycheck Protection Program or other coronavirus-related funds, the provider must submit separate reports and account for each pool of funds separately.

For those interested, HHS is hosting complimentary webcasts next week. Click here for more information.

If you need assistance in determining whether you qualify for a Targeted Distribution or have questions about the application, please contact BMD Health Law Attorney Ashley Watson at abwatson@bmdllc.com. If you received Provider Relief Funds from either the General Distribution or Targeted Distribution, please contact Amanda Waesch at alwaesch@bmdllc.com or 330-253-9185 for questions related to the HHS Provider Relief Fund Policy.

HHSCARES ActProvider Relief FundGeneral Distribution fundMedicaidCHIPTargeted DistributionEnhanced Provider Relief Fund Payment PortalBMD Healthcare & Hospital LawAshley WatsonAmanda L. Waeschhealthcare providers
Client Alert

Ohio House Bill 537: Proposed Regulations for Midwives and Birthing Centers

January 28, 2026House Bill 537, introduced in the Ohio House of Representatives, proposes a comprehensive regulatory framework for certified nurse-midwives, certified midwives, licensed midwives, and traditional midwives. The legislation would clarify scope of practice, establish licensure standards, and impose new requirements for freestanding birthing centers and home births. Healthcare providers and facilities should be aware of the proposed changes and their potential operational impact.Client Alert

Proposed Health Information Privacy Reform Act Expands Protections Beyond HIPAA

January 26, 2026The Health Information Privacy Reform Act (HIPRA) seeks to extend privacy protections to health data not covered under HIPAA, including data collected by apps and wearables. HIPRA introduces broader definitions of protected health information, strengthens privacy and security requirements, establishes patient notification rights, and sets national de-identification standards. Companies processing health data should monitor developments to ensure compliance.Client Alert

Medicare Updates on Skin Substitutes: LCDs Withdrawn, Payment Changes Take Effect

January 23, 2026Medicare’s planned Final Local Coverage Determinations (LCDs) for skin substitutes were withdrawn in late December 2025, meaning previous coverage rules remain in effect. The 2026 Medicare Physician Fee Schedule introduces a single payment rate of approximately $127.14 for these products. Providers should review implications for diabetic foot and venous leg ulcer treatments.Client Alert

Understanding the Seven Core Elements of an Effective Healthcare Compliance Program

January 22, 2026The Affordable Care Act requires healthcare providers participating in Medicare, Medicaid, and CHIP to maintain an effective compliance program. Guidance from the Department of Health and Human Services and the Office of Inspector General outlines seven core elements that form the foundation of these programs, from written policies and compliance oversight to auditing, training, and corrective action. This alert highlights each element and explains how practices can tailor compliance programs to their size and risk profile while meeting federal expectations.Client Alert

Preventing a Board Investigation

January 21, 2026Healthcare professionals in Ohio are subject to licensing board investigations that can lead to disciplinary action. Staying compliant with regulations, documenting carefully, and operating within your professional scope can help prevent issues. If contacted by a board, working with an attorney is critical to protect your license and rights.
Older posts
Newer posts