When CMS Administrator Seema Verma assured providers that they could accept federal COVID-19 grant money with “no strings attached,” she might have been better advised to add an asterisk and a disclaimer.
A closer look at the fine print, in the form of terms and conditions from HHS for providers accepting the money (a $30 billion fund was established as part of the Coronavirus Aid, Relief and Economic Security Act, aka the CARES Act), shows there are some strings to be aware of.
Several of the terms and conditions have attracted concerns from attorneys. The legalese includes statements that even though providers aren’t actually filing healthcare claims for payment, and didn’t apply for grants, they aren’t allowed to keep any money they aren’t legally eligible for and could be on the hook for “reverse false claims.”
The HHS language says providers can only use the grant money to “prevent, prepare for, and respond to coronavirus” and for healthcare expenses or losses “that are attributable to coronavirus.” To document such expenses and losses, it may be advisable for providers to pull up patient volumes from past years to compare them with 2020.
Attorneys generally advise that providers come up with some way to document their good-faith efforts to comply with the HHS terms and conditions, so as to avoid any possible risk of being litigated under the False Claims Act. Claiming the grant obligates providers to track how they spend the money as part of quarterly reports to the government, and there is possibility of future audits to consider.
Sean’s action items for practices
The bottom line is that some strings are attached – 10 pages of strings if you read the fine print and the end result could be years of OIG investigations. The important steps to take for practices accepting the money include putting that money into a separate account and carefully documenting expenditures to ensure they fall within the HHS terms and conditions for healthcare-related expenses.
As the information seems to be changing on a weekly if not daily basis, you may want to consider waiting to attest to the money in case new guidance emerges. You have until 30 days after depositing the money to attest, so there’s no rush to do so. Because any patient your practice sees could potentially be infected by COVID-19, there is some flexibility in terms of the restrictions, but that doesn’t mean you shouldn’t take precautions.
Sean M. Weiss is a Partner and serves as VP/Chief Compliance Officer for DoctorsManagement, LLC based in Knoxville, TN. DoctorsManagement, LLC services more than 20,000 clients nation-wide and has been in existence since 1956. Weiss serves as an Investigator and expert witness in Federal and State cases as well as an expert or lead in Administrative Law Judge Hearings. During his 25-year career, Weiss has engaged in more than 200 cases working with law firms and health systems across the country. Weiss serves as a third-party compliance and regulatory officer for more than a dozen health care organizations across the country of varying sizes. For more information on Sean M. Weiss or DoctorsManagement, LLC visit us online at www.doctorsmanagement.com or contact us directly at 800.635.4040. You can also follow Sean on his biweekly Blog on LinkedIn (Sean M. Weiss “The Compliance Guy”) or at www.thecomplianceguyblog.com
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