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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.


CLIENT ALERT: Medicare Trust Fund to Run Out of Funding Beginning in 2026, Likely to See an Increase in Audits, Overpayment Demands and Extrapolations

Pursuant to a Medicare Trustee Report released on June 5, 2018, the Medicare trust fund will run out of funding beginning in 2026, which is three years earlier than previously expected. Although the Trustee’s report requests that Congress and the President act with urgency to remedy this problem, in the short term, we expect to see an increase in government payer audits, overpayment demands, and extrapolations.

CLIENT ALERT: The European Union's New Data Privacy Law Goes Into Effect

On May 25, 2018, the European Union’s (“the EU”) new data privacy law went into effect. The General Data Protection Regulation (“GDPR”) concerns the processing of personal data that can be searched according to specified criteria such as geographical scope.

CLIENT ALERT: Class Action Waivers in Employment Contracts Upheld by Supreme Court

On May 21, 2018, in a 5-4 decision and a major win for employers, the United States Supreme Court upheld the legality of waivers in employment contracts that prohibit employees from grouping claims together in collective or class actions in favor of individual arbitration proceedings. See Epic Sys. Corp. v. Lewis, ___U.S.___ (2018).

CLIENT ALERT: Prohibition on Recoupment Prior to Exhaustion of Administrative Remedies

In April, the Fifth Circuit Court of Appeals, in Family Rehabilitation, Inc. v. Azar No. 17-11337 (5th Cir. 2018), held that district courts are authorized to enjoin the Centers of Medicare & Medicaid Services (“CMS”) and its contractors from recouping alleged overpayments prior to the completion of the administrative appeal process.

CLIENT ALERT: Low Volume Appeals Settlement for RAC Appeals

In April, the Centers for Medicare & Medicaid Services (“CMS”) issued a new settlement proposal to providers with outstanding appeals at the Office of Medicare Hearings and Appeals (“OMHA”) and the Medicare Appeals Council (“MAC”). Essentially, CMS is offering to pay up to 62% of the claim to the provider for qualifying claims that are currently in the appeal process. Interested providers may submit an Expression of Interest (“EOI”) to CMS by June 8, 2018. Providers should explore this settlement opportunity and submit an EOI to receive an offer of settlement. Providers may decline the offer after the EOI is submitted. Brennan, Manna & Diamond, LLC’s Provider Relations, Audit, and Appeals Unit, a division of its Healthcare Department, is able to assist providers with filing the EOI, analyzing the outstanding claims subject to the settlement, and reviewing the Administrative Agreement that is offered by CMS.