Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

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

Explosive Growth in Pot of Gold Opportunity for Bank (and Other) Cannabis Lenders Driving Erosion of the Barriers

Our original article on bank lending to the cannabis industry anticipated that the convergence of interest between banks and the cannabis industry would draw more and larger banks to the industry. Banks were awash in liquidity with limited deployment options, while bankable cannabis businesses had rapidly growing needs for more and lower cost credit. Since then, the pot of gold opportunity for banks to lend into the cannabis industry has grown exponentially due to a combination of market constraints on equity causing a dramatic shift to debt and the ever-increasing capital needs of one of the country’s fastest growing industries. At the same time, hurdles to entry of new banks are being systematically cleared as the yellow brick road to the cannabis industry’s access to the financial markets is being paved, brick by brick, by the progressively increasing number and size of banks that are now entering the market.

2021 EEOC Charge Statistics: Retaliation & Impact of Remote Work

The U.S. Equal Employment Opportunity Commission (EEOC) released its detailed information on workplace discrimination charges it received in 2021. Unsurprisingly, for the second year in a row, the total number of charges decreased as COVID-19 either shut down workplaces or disconnected employees from each other. In 2021, the agency received a total of approximately 61,000 workplace discrimination charges - the fewest in 25 years by a wide margin. For reference, the agency received over 67,000 charges in 2020, and averaged almost 90,000 charges per year over the previous 10 years.

Ohio’s Managed Care Overhaul Delayed – New Implementation Timeline

At the direction of Governor Mike DeWine, the Ohio Department of Medicaid (ODM) launched the Medicaid Managed Care Procurement process in 2019. ODM’s stated vision for the procurement was to focus on people and not just the business of managed care. This is the first structural change to Ohio’s managed care system since the Centers for Medicare & Medicaid Services' (CMS) approval of Ohio’s Medicaid program in 2005. Initially, all of the new managed care programs were supposed to be implemented starting on July 1, 2022. However, ODM Director Maureen Corcoran recently confirmed that this date will be pushed back for several managed care-related programs.

Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.

Property Owner Protection from Tax Valuation Challenges

New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.