Many HMA practices received deposits in their banking accounts today that were linked to CMS and were labeled “PREAUTHORIZED CREDIT US HHS Stimulus HHSPAYMENT". We understand this money is part of the funds being made available to Medicare providers pursuant to the CARES Act.
Physician practices and hospitals have begun receiving notices and actual payment from the US Department of Health and Human Services distribution of $30 billion of the CARES Act Relief Funds. These are payments to healthcare providers, are not intended to be loans, and should not need to be repaid, as long as group leaders can attest to certain qualifications as discussed below. Billing entities who received Medicare fee-for-service reimbursements in 2019 are eligible for this initial distribution. If your organization qualifies, you should automatically receive payment soon. For more details, CLICK HERE.
Attorney Ken Bartholomew, Chairman of the Health Law group at Rath, Young and Pignatelli, P.C. in Concord NH (CLICK HERE) has been providing the following advice to his physician clients. This is not intended to be legal advice; you should consult your own counsel if you have questions or concerns.
“While it is true that the funds are not a loan, and therefore not subject to repayment, there are some limitations on use of the funds. Within 30 days after receipt, you will be required to complete and file a certification CLICK HERE. He notes the following items in particular from the certification:
- The Recipient certifies that it billed Medicare in 2019; currently provides diagnoses, testing, or care for individuals with possible or actual cases of COVID-19; is not currently terminated from participation in Medicare; is not currently excluded from participation in Medicare, Medicaid, and other Federal health care programs; and does not currently have Medicare billing privileges revoked.
- The Recipient certifies that the Payment will only be used to prevent, prepare for, and respond to coronavirus, and shall reimburse the Recipient only for health care related expenses or lost revenues that are attributable to coronavirus.
- The Recipient certifies that it will not use the Payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.
With respect to the last paragraph, I view this as prohibiting you from using these funds to reimburse items that will be covered by the Paycheck Protection Plan (SBA PPP) loan funds. Another condition is that you must treat all patients seeking treatment for COVID-19 as in-network patients. Also note that you will be required to provide detailed reports to HHS about how you are spending the funds.”
One final note, if a provider receives payment and does not wish to comply with the associated Terms and Conditions, the provider must contact HHS within 30 days of receipt of payment and then remit the full payment to HHS as instructed.
HMA clients will need to work with their legal counsel to ensure that they comply with the conditions and are able to appropriately attest to them. Please feel free to contact your HMA consultant if you have any questions.