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The $70 Billion Question – CARES Act Provider Relief Fund Helping Hardest Hit Hospitals First

Client Alert

HHS finally unveiled its preliminary plan for disbursement of the remaining $70 billion of CARES Act Provider Relief Funds. The initial $30 billion was disbursed to providers based on 2019 Medicare fee-for-service payments. HHS indicated that the remaining $70 billion would be disbursed to (1) providers that incurred COVID-19 expenses, (2) rural providers, (3) providers that primarily receive payments from other sources (such as Medicaid), and (4) providers that treat uninsured Americans.

How will the funds be distributed?

First, $10 billion will go to hospitals that have been impacted hardest by COVID-19. This will be based upon the total number of admitted patients who tested positive for COVID-19. Hospitals will have until April 23, 2020 at midnight to apply and should have received an email with a link to the portal (there is no website similar to the payment attestation).

Providers will need to submit the following information (HHS estimates this should take 5 minutes):

  • Tax Identification Number
  • National Provider Identifier
  • Total number of Intensive Care Unit beds as of April 10, 2020
  • Total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020 to April 10, 2020

Second, an additional $20 billion will be rolled out based on overall patient revenue. There will likely be an application or reporting mechanism. Payments will be issued on a rolling basis. Stay tuned for updates on application release or additional information.

Third, an additional $30 billion is set aside for SNFs, dentists, and providers that only service Medicaid providers.

More information can be found by following the link below.

https://www.hhs.gov/about/news/2020/04/22/hhs-announces-additional-allocations-of-cares-act-provider-relief-fund.html

For questions, contact your primary BMD Healthcare or Hospital Law attorney.


Advanced Practice Providers and Telemedicine Start-Up Surge

Throughout the COVID-19 pandemic, we heard a lot about “surges” that happened all over the country regarding the virus. One of the other interesting “surges” we have followed is the “surge” in new healthcare business start-ups, particularly businesses owned by advanced practice providers, such as nurse practitioners, physician assistants, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists (“Advanced Practice Providers” or “APPs”). One of the hottest areas in the healthcare start-up surge has been the creation of practices that are telemedicine focused.

Ohio Department of Health Releases Updated Charge Limits for Medical Records

Under Ohio law, a healthcare provider or medical records company that receives a request for a copy of a patient's medical record may charge an amount in accordance with the limits set forth in Ohio Revised Code Section 3701.741. The allowable amounts are increased or decreased annually by the average percentage of increase or decrease in the consumer price index for all urban consumers, prepared by the United States Department of Labor, Bureau of Labor Statistics, for the immediately preceding calendar year over the calendar year immediately preceding that year, as reported by the Bureau. The Director of the Ohio Department of Health makes this determination and adjusts the amounts accordingly. The list is then published, here.

No Surprises Act Compliance (Published by NAMAS, 2/25/22)

The Department of Health and Human Services published three parts to the No Surprises Act towards the end of 2021, which took effect January 1, 2022. The Act is intended to protect consumers from “balance billing,” which occurs when a patient receives a bill with a higher price than they may have anticipated because they did not have knowledge that the provider or facility was out-of-network. The purpose of this article is to note certain requirements that compliance employees will need to be aware of at their facilities, including notice and consent, good faith estimates, and public disclosures.

No Surprises Act and You (Published in the SCMS Winter 2022 Newsletter)

Legislation has been adopted by the United States Congress and the Ohio Legislature known as the “No Surprises Act” which attempts to regulate billing by professionals and facilities to patients who are not in networks with those facilities or providers at those facilities. The federal bill was triggered by some sensational news stories of patients being billed for tens of thousands of dollars for emergency care when the hospital was out of the network under the patient’s insurance plans.

Are You Impacted by the Project Labor Agreement Executive Order?

Project Labor Agreements (PLAs) are a quasi-collective bargaining agreement between employers and unions. They establish the terms and conditions of employment, including dispute resolution. They are put into place on specific projects and apply to the contractor, whether it is union or non-union. Employees hired on the project will be treated as union.