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Provider Relief Fund Phase 2 & Reporting Requirement Updates – Deadline to Request Phase 2 Funds is August 28, 2020

Phase 2 General Distribution Funding – Deadline August 28, 2020

On July 31, 2020, the Department of Health and Human Services (“HHS”) announced that certain Medicare, Medicaid (managed care and fee-for-service), CHIP, and other providers would be given another opportunity to receive additional Provider Relief Fund payments. HHS has allocated around $15 billion for Phase 2 distribution. Providers are eligible for these new distributions if they fulfill the following criteria and have not yet received a Provider Fund payment equal to approximately 2% of their revenue from patient care. 

To be eligible to apply, the provider must meet all of the following requirements:

  1. Either
    1. Billed Medicare fee-for-service during the period of Jan.1, 2019-Dec. 31, 2019; or
    2. Be a Medicare Part A provider that experienced a change in ownership and billed Medicare fee-for-service in 2019 or 2020 that prevented the otherwise eligible provider from receiving Phase 1 General Distribution payment; or
    3. Billed Medicaid / CHIP programs or Medicaid managed care plans for health-related services between Jan.1, 2018-Dec.31, 2019; or
    4. Billed a health insurance company for oral healthcare-related services as a dental service provider; or
    5. Be a licensed dental service provider who does not accept insurance and has billed patients for oral healthcare-related services; and
  2. 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 (e.g. a state-owned hospital or healthcare clinic); and
  3. Must have provided patient care after January 31, 2020 (see our blog post from April 10 on how this is broadly defined); and
  4. Must not have permanently ceased providing patient care directly, or indirectly through included subsidiaries; and
  5. 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.

HHS released this second round of General Distribution funding to help support as many providers as possible. Note that even if a provider received Phase 1 funding, they may still be able to collect Phase 2 funding if their original distribution was less than 2% of their patient care revenues. This includes providers who returned their Phase 1 checks because they were not sure if they would be able to meet the Terms & Conditions. Providers who apply for and receive Phase 2 funds are subject to the same Terms and Conditions that existed for Phase 1 funding. Providers must use the Provider Portal to request the Phase 2 funds. The deadline for these requests is August 28, 2020 at 11:59pm EST

Provider Relief Fund Reporting Requirements Update

One of the terms and conditions that providers had to agree to in order to receive Provider Relief Funds was to submit reports to HHS that are in the form specified by the Secretary of HHS. HHS was scheduled to post guidance by August 17, 2020 regarding the format of these reports. However, this date has come and gone without a full update. Instead, HHS posted a Notice entitled “General and Targeted Distribution Post-Payment Notice of Reporting Requirements” on August 14, 2020. This Notice applies to any providers who received Provider Relief Funds exceeding $10,000 in the aggregate. 

The Notice states that detailed instructions regarding reporting requirements for these providers will be “released soon,” leaving providers in a state of suspense for an undefined future period of time. However, the Notice does clarify that the reporting system will become available to recipients for reporting on October 1, 2020. The Notice also provides details regarding the timing of reports for Provider Relief Fund recipients:

  • All recipients must report within 45 days of the end of calendar year 2020 on their expenditures through the period ending December 31, 2020.
  • Recipients who have expended funds in full prior to December 31, 2020 may submit a single final report at any time during the window that begins October 1, 2020, but no later than February 15, 2021.
  • Recipients with funds unexpended after December 31, 2020, must submit a second and final report no later than July 31, 2021. 

Finally, the Notice repeatedly reminds providers to check hhs.gov/providerrelief for the latest updates. Once more specific reporting guidance is released, BMD’s healthcare team will publish another update to inform providers of these reporting requirements. In the interim, if you have any questions about Provider Relief Funds, please contact Ashley Watson at abwatson@bmdllc.com

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 . . ..”