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

Client Alert

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


Telehealth Flexibility Updates: HIPAA, DEA, and CMS

The Covid-19 Public Health Emergency (PHE) officially ended on May 11, 2023. But what does that mean for telehealth, a field that expanded exponentially during the PHE? Fortunately, many of the flexibilities will remain intact, at least temporarily. This client alert presents a brief overview of the timelines that providers need to follow, but for a more comprehensive review of telehealth flexibilities and when they will end

WEBINAR SERIES RECAP | Ending the Public Health Emergency + Post-Pandemic Check-Up

Some may take the position that the rest of the country already returned to a new “normal” following the COVID-19 pandemic.  But healthcare providers continue to implement COVID protocols and navigate the ever-changing healthcare regulations at both the federal and state levels.  It is important for healthcare providers to take time for a “Healthcare Check-Up” with the start of 2023 and the ending of the Public Health Emergency (“PHE”).

Sharp Rise in False Claims Act Cases - Navigating the FCA Waters

Recently, on April 18, 2023, the United States Supreme Court heard arguments regarding the FCA’s scienter, or mental state, requirement. To prove violation of the FCA, the statute requires that a defendant “knowingly” file false claims for payment. The term “knowingly” is defined within the statute to mean a person that acts with actual knowledge, deliberate ignorance, or reckless disregard. Circuit courts are split on how to interpret and apply the knowledge element of the FCA, and based on the Supreme Court’s decision, there will be a large impact on healthcare defendants and their businesses as well as anyone who contracts with, or receives money from, a federal program. A broader interpretation of the FCA would unnecessarily target and stifle healthcare, and other businesses, for simple errors in daily operations. This goes against the intended application of the FCA, which was to prevent fraudulent activity.

Areas of Opportunity in Columbus: Highlights from the Columbus Opportunity Summit

On April 27, 2023 Columbus Business First held its annual Columbus Opportunity Summit, bringing together business and economic development leaders to provide an update on how Central Ohio is preparing for expected growth in the coming years, an issue heightened by the arrival of Intel at its 1,000 acre site in Licking County, just outside of Columbus. The site will be home to two new chip factories with room to grow to a total of eight factories and is a $20 Billion investment.

BREAKING: Biden Administration Has Officially Ended the Two Remaining COVID Vaccine Mandates

As of May 1, 2023, the Biden Administration has officially ended the two remaining COVID vaccine mandates: (1) the Federal Contractor Mandate, and (2) the CMS Healthcare Provider Vaccine Mandate.