Alerts
Aug 20, 2020
HHS Extends Deadline and Expands Eligibility Requirements for Provider Relief Fund Applications
The United States Department of Health and Human Services (“HHS”) recently announced that eligible healthcare providers who wish to obtain a grant from the Coronavirus Aid, Relief, and Economic Security (“CARES”) Provider Relief Fund (the “Provider Relief Fund”) now have until August 28, 2020 to submit the necessary documentation. In addition, Medicare Part A providers who were previously excluded from requesting relief due to a change of ownership in 2019 or 2020 are now eligible for grants.
The Provider Relief Fund was established under the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act in order to provide monetary relief to healthcare professionals and facilities experiencing loss of revenues due to the COVID-19 pandemic. The relief is capped at 2% of the provider’s overall patient revenue. Under earlier criteria, these grants were available to healthcare providers who were able to show that they provided diagnosis, testing or care for individuals with possible or actual cases of COVID-19 after January 31, 2020, and were either Medicare fee-for-service providers during the 2019 calendar year; Medicaid/CHIP providers from January 1, 2018 to December 31, 2019; or dental providers who directly billed health insurance companies or patients for oral health services. Qualified providers must also have filed a federal income tax return for fiscal years 2017, 2018 or 2019 or be exempt from the requirement to file a federal income tax return. In addition, the providers could not have permanently ceased providing patient care directly or indirectly through subsidiaries.
Under the old criteria, a Medicare Part A fee-for-service provider that had experienced a change of ownership in 2019 and 2020 and obtained a new tax identification number (“TIN”) would not qualify for relief, as the new TIN would prevent it from providing the necessary tax or revenue information for verification. The old owner may have received the funds through an earlier distribution, but the rules prevented any transfer to the new owner. Under the new criteria, Medicare Part A providers that experienced a change in ownership and billed Medicare fee-for-service in calendar year 2019 and 2020 can submit appropriate documentation for relief in their own names. In addition, HHS clarified that providers who received an earlier payment could apply for further relief if their previous payments did not amount to 2% of annual revenues from patient care.
The funds are subject to certain Terms and Conditions. If the Terms and Conditions are met, payments do not need to be repaid. The recipient provider must either attest to the Terms and Conditions within 90 days of receipt of the funds or return them. If the money is not returned, the Terms and Conditions will be deemed accepted.
The Terms and Conditions state that Provider Relief Fund payments will only be used to prevent, prepare for and respond to COVID-19 and shall reimburse the recipient only for healthcare related expenses or lost revenues that are attributable to COVID-19 and were used to prevent, prepare for and respond to COVID-19.
HHS interprets healthcare related expenses attributable to COVID-19 broadly to cover a range of items and services purchased to prevent, prepare for and respond to coronavirus, such as: supplies or equipment used to provide health care services for possible or actual COVID-19 patients; workforce training; developing and staffing emergency operation centers; reporting COVID-19 test results to federal, state, or local governments; building or constructing temporary structures to expand capacity for COVID-19 patient care or to provide health care services to non-COVID-19 patients; and acquiring additional resources, including facilities, equipment, supplies, healthcare practices, staffing and technology to expand or preserve care delivery.
Loss of revenue due to COVID-19 includes losses associated with fewer outpatient visits; canceled elective procedures or services; or increased uncompensated care. Providers can use Provider Relief Fund payments to cover any cost that the lost revenue otherwise would have covered, so long as that cost prevents, prepares for or responds to COVID-19, such as employee or contractor payroll, employee health insurance, rent or mortgage payments, or equipment lease payments.
HHS will require providers to report on the use of the funds and providers are subject to audits which may lead to HHS recoupment and other penalties for non-compliance.
For more information, contact Divya Srivastav-Seth at dss@spsk.com or 973-540-7855.
DISCLAIMER: This Alert is designed to keep you aware of recent developments in the law. It is not intended to be legal advice, which can only be given after the attorney understands the facts of a particular matter and the goals of the client.
