CARES Act Funding Creates Dilemma for Some Healthcare Providers

On March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security (CARES) Act which provides $100 billion in relief funds to hospitals and other healthcare providers who are on the front lines of the COVID-19 response.

Many providers have been receiving these funds without having applied for them. However, in order to keep the monies, providers must attest to the Terms and Conditions. After reading through some of the provisions, some are now concerned about whether to accept the funding or send it back.

Among some of the key provisions:

• The recipient must certify they are not currently terminated from participating in Medicare, Medicaid or other federal healthcare programs and do not currently have Medicare billing privileges revoked.

• The recipient must certify that the payment is used only to prevent, prepare for and respond to COVID-19 and/or its complications and that the patients identified on the claim form were uninsured individuals at the time the services were provided.

• The recipient must certify that the money will not be used to reimburse expenses or losses that have been reimbursed from other sources, or that other sources are obligated to reimburse. If the recipient receives reimbursement for those services from another source, the recipient must return to HHS the portion of the payment that duplicates payment or reimbursement.

• The recipient will not include costs for which payment was received in cost reports or seek uncompensated care reimbursement through federal or state programs for items or services for which payment was received.

• The recipient must submit reports as the Secretary of Health and Human Services determines are needed to ensure compliance with conditions.

• The recipient acknowledges that any deliberate omission, misrepresentation, or falsification of any information contained in a request for reimbursement or future report may be punishable by criminal, civil, or administrative penalties, including but not limited to, revocation of Medicare billing privileges, exclusion from federal healthcare programs, and/or the imposition of fines, civil damages, and/or imprisonment.

• Any recipient receiving more than $150,000 in total funds under the CARES Act, Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act, or any other act primarily making appropriations for the coronavirus response and related activities, shall submit to the Secretary of HHS and the Pandemic Response Accountability Committee a report no later than 10 days after the end of each calendar quarter.

• The recipient shall maintain appropriate records and documentation to substantiate payments and must promptly submit copies of those records and documentation upon request. The recipient also agrees to fully cooperate in all audits to ensure compliance with terms and conditions.

• The recipient acknowledges that all payments are final and there will be no adjustments.

• The recipient will not engage in balance billing or charge any type of cost sharing for any items or services provided to those who are uninsured and receiving care or treatment for a positive diagnosis of COVID-19 for which the recipient receives a payment from the Relief Fund. The recipient shall consider payment received from the Relief Fund to be payment in full for such care or treatment.

It’s important to note that recipients must access the attestation portal and sign the attestation confirming receipt of funds and agree to the terms and conditions of payment. If you do not return the payment within 30 days, it will be viewed as having accepted the terms and conditions.

This is an ever-changing situation and the information presented here is not meant to be a complete picture of what is taking place. HHS has set up a website where information is being updated. You can find that by clicking here.

The Health Law Offices of Anthony C. Vitale is monitoring developments and can assist you in navigating this ever-changing landscape. We have shifted to remote business protocol, but our attorneys and staff are available to assist you. You can find our contact information here.