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News Alerts

MEDICARE PROGRAM REVALIDATIONS

Volume 21.01 We continually receive questions regarding Medicare enrollment revalidations.  CMS has temporarily ceased revalidation efforts for all Medicare providers or suppliers.  During the public health emergency, CMS will not issue any ...

CLARIFICATION ON USE OF PRF TO REPAY MEDICARE ADVANCE PAYMENTS

Volume 21.03 On October 8, 2020, CMS issued a Press Release announcing that COVID-19 Provider Relief Funds (“PRF”) could be used to repay obligations incurred because of the Accelerated and Advance Payment program.  We have received numerous ...

CARE FUND REPORTING PORTAL OPEN FOR REGISTRATION

Volume 21.02 As you probably know, earlier today the Health Resources & Services Administration (“HRSA”) has opened the Provider Relief Fund Reporting Portal for registration, but not for reporting the use of Provider Relief Funds ...

COST REPORTING UPDATES COST REPORT EXTENSIONS

Volume 21.01 On January 5, 2021, CMS has updated the list of cost report filing extensions as follows: For all cost reports with cost reporting periods ended on March 1, 2020 through December 31, 2020, providers are granted an additional ...

CONSOLIDATED APPROPRIATIONS ACT OF 2021 (OMNIBUS AND CORONAVIRUS RELIEF BILL)

Volume 20.40 The Omnibus and Coronavirus Relief Bill was passed by Congress on December 21, 2020.  The Bill, over 5,000 pages, titled The Consolidated Appropriations Act, 2021 (Omnibus and Coronavirus Relief Bill) will directly or indirectly ...

MEDPAC CONTINUES TO PURSUE 20% CAP REDUCTION

Volume 20.16 At the recent meeting of the Medicare Payment Advisory Commission (“MedPAC”), the matter of wage adjusting the Medicare Aggregate Payment Limitation (“CAP”) and reducing the CAP by an arbitrary 20% was again discussed as MedPAC ...

CAN LOST REVENUE FROM FUNDRAISING BE CHARGED TO PRF?

Volume 20.39 There has been substantial confusion throughout the healthcare industry regarding expenses and lost revenues which will be eligible for justification of Provider Relief Funds.  With every update from the U.S. Department of ...

WILLIAM T (“Ted”) CUPPETT TO PRESENT FOR HEALTH FINANCIAL SYSTEMS

Volume 20.38 Health Financial Systems (“HFS”) will be holding its virtual 2020 User Meeting on December 7-10, 2020. Ted Cuppett will be presenting on Wednesday, December 9, 2020 on “Preparing for Reporting the Use of Provider Relief ...

CMS FINALIZES RULES INTENDED TO UPDATE PHYSICIAN SELF-REFERRAL REGULATIONS

Volume 20.37 Section 1877 of the Social Security Act ("the Act"), also known as the physician self-referral law or “Stark Law” prohibits: A physician from making referrals for certain designated health services (“DHS”) payable by ...

PPP LOAN FORGIVENESS TAX IMPACT WILL BE IN 2020

Volume 20.36 Many healthcare providers are taxable entities and secured PPP loans.  These providers, like other businesses, were taken off guard when the IRS determined that qualifying expenses would not be deductible once loan forgiveness ...

PROVIDERS NEED TO PREPARE NOW FOR REPORTING USE OF PROVIDER RELIEF FUNDSPROVIDERS NEED TO PREPARE NOW FOR REPORTING USE OF PROVIDER RELIEF FUNDS

Volume 20.35 The Department of Health and Human Services (“HHS”) has released updated guidance on reporting the use of Provider Relief Funds (“PRF”).  The updates provide some clarification regarding the upcoming reporting. Providers can ...

REPAYMENT TERMS FOR MEDICARE ADVANCE PAYMENTS MODIFIED

Volume 20.34 CMS successfully paid more than 22,000 Part A providers, totaling more than $98 billion in accelerated payments.  This included payments to Part A providers for Part B items and services they furnished.  In addition, more than ...

ADDITIONAL MEDICARE PROVIDER ENROLLMENT SCRUTINY

Volume 20.33 While healthcare providers deal with the COVID-19 PHE, preparing to deal with HHS reporting on the use of Provider Relief Funds, and many other ongoing issues, silently on May 22, 2020, CMS rolled out Transmittal 10146, which ...

PROVIDER RELIEF FUNDING PHASE 3

Volume 20.32 The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced $20 billion in new funding for providers on the frontlines of the coronavirus pandemic. Under ...

REVISED HOME HEALTH AGENCY COST REPORT RELEASED (FORM 1728-20)

Volume 20.07 The Centers for Medicare & Medicaid Services (“CMS”) has released the revised Home Health Agency Cost Report, Form CMS-1728-20.  The updated Cost Report will be effective for cost reporting periods beginning on or after ...

PROVIDER RELIEF FUND REPORTING REQUIREMENTS RELEASED

Volume 20.31 HHS has finally issued general reporting requirements for the use of Provider Relief Funding.  This document provides information on provider reporting guidelines, including intent, use of funds, and data elements requested. The ...

CMS UPDATES MEDICAID HOSPICE PAYMENT RATES

Volume 20.15 On September 14, 2020, CMS released Medicaid payment rates for FY 2021 (beginning October 1, 2020).  The Medicaid hospice payment rates are calculated based on the annual hospice rates established under Medicare.  These rates ...

HHS REPORTING FOR USE OF CARES ACT PROVIDER RELIEF FUNDING?

Volume 20.30 Previously, the U.S. Department of Health and Human Services (“HHS”) issued Notice of Reporting Requirements relating to the use of Provider Relief Funds.  HHS informed providers that forms would be available in mid-August 2020 ...

CMS RELEASES GUIDANCE ON CERTAIN COVID-19 PHE RELATED ITEMS ON COST REPORT SUBMISSIONS

Volume 20.29 On August 26, 2020, CMS issued an update on COVID-19 Frequently Asked Questions (FAQs) on some cost report issues.  The following summarizes current CMS guidance. Reporting Provider Relief Funding – All providers are to report ...

COMPLIMENTARY WEBINAR – CONSOLIDATION IN HOME HEALTH & HOSPICE: KEY TRANSACTIONAL CONSIDERATIONS

Volume 20.28 Tomorrow at 1:00 p.m. (Thursday, August 13, 2020), Provider Healthcare Partners, along with The Health Group, LLC will be hosting a complimentary webinar on issues relating to home health and hospice mergers and acquisitions.

CMS PROPOSES TO TAKE AWAY ECONOMIC BENEFIT OF PPP LOANS TO CERTAIN RURAL PROVIDERS

Volume 20.27 Recently the U.S. Centers for Medicare & Medicaid Services (“CMS”) sent the following notice to Critical Access Hospitals (“CAH”) and Rural Health Clinics (“RHC”): “To prevent the duplication of benefits from the federal government...

2020-2021 MEDICARE HOSPICE PAYMENT RATES FINALIZED

Volume 20.14 On July 31, 2020, the U.S. Centers for Medicare & Medicaid Services (“CMS”) released the final FY2021 hospice payment rule (“Rule”).  The national hospice payment rates, subject to geographical application, and the hospice ...

HHS SETS SCHEDULE FOR REPORTING USE OF PROVIDER RELIEF FUNDS

Volume 20.26 Congress appropriated funding to reimburse eligible health care providers for health care related expenses or lost revenues attributable to coronavirus. The Health Resources and Services Administration (HRSA) is administering ...

CMS TO RESUME “REVIEW CHOICE DEMONSTRATION”

Volume 20.06 Effective March 29, 2020, certain claims processing for the Review Choice Demonstration (“RCD”) for Home Health Services were paused in Illinois, Ohio, and Texas, because of the COVID-19 pandemic. During the pause, home health ...

COST REPORT FILINGS EXTENDED AGAIN

Volume 20.25 Cost report filings for the cost reporting period ended December 31, 2019 have been further extended from July 31, 2020 until August 31, 2020.  This information has been posted on the CGS website.  Expect further postings from ...

PROVIDER RELIEF FUND RECIPIENTS – NO QUARTERLY REPORTING?

Volume 20.24 The Health Group, LLC never thought that the U.S. Department of Health and Human Services (“HHS”) would be able to develop a format for reporting use of Provider Relief Funds in time to meet the initially scheduled July 10, 2020 ...

SBA RELEASES UPDATED PPP LOAN FORGIVENESS APPLICATION AND REVISED INTERIM FINAL RULE

Volume 20.23 The U.S. Small Business Administration (“SBA”) has released its updated Loan Forgiveness Application. Additionally, certain borrowers may qualify for the new Alternative Loan Forgiveness Application. The Loan

WILL YOU BE SUBJECT TO AUDIT AS A RESULT OF PROVIDER RELIEF FUNDING?

Volume 20.22 The Health Resources and Services Administration (HRSA) has announced the Provider Relief Fund will be subject to Single Audit requirements. Provider Relief Funding was provided to fund COVID-19 PHE expenses or lost

THE HOSPICE COST REPORT AND COVID-19 PHE EXPENSES

Volume 20.13 The Hospice Cost & Data Report (“Cost Report”) was substantially modified in 2014 to facilitate the accumulation of hospice costs by level of care (“LOC”), as well as capture other information, which can be used in ...

EXPECT EXPANDED PPP LOAN FORGIVENESS

Volume 20.21 Last night, the U.S. Senate passed the House version of Paycheck Protection Program (PPP) legislation (“Paycheck Protection Flexibility Act”).  The legislation will triple the time allotted for PPP loan recipients to spend the ...

HHS PROVIDES ADDITIONAL CLARIFICATION REGARDING PROVIDER RELIEF FUNDS

Volume 20.20 The U.S. Department of Health & Human Services has released additional information regarding, among other things, the appropriate use of Provider Relief Funds.  According to HHS: “The term “health care related expenses ...

OIG TO REVIEW HOW PROVIDER RELIEF FUNDS WERE DISTRIBUTED

Volume 20.19 The U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) has added “Audit of CARES Act Provider Relief Funds-Distribution of $50 Billion to Health Care Providers” to the OIG Work Plan.  It ...

SBA RELEASES PPP LOAN FORGIVENESS APPLICATION

Volume 20.18 On Friday, May 15, 2020, the SBA released the PPP Loan Forgiveness Application.  A copy of the application and instructions is available here. The Application sets forth the documentation required to verify expenses for ...

COVID-19 PHE SERVICE MODIFICATION (WHAT COULD BE THE LONG-TERM IMPACT?)

Volume 20.05 Home health providers, like other providers, are dealing with a vast array of service changes resulting from the COVID-19 PHE.  Strategic planning for the future must include consideration of the permanent service and revenue ...

COVID-19 PHE EXPENSES (SEPARATELY IDENTIFED IN THE ACCOUNTING RECORDS)

Volume 20.11 In support of the Provider Relief Funding received by hospices, COVID-19 PHE incremental expenses incurred are now required reporting on a quarterly basis.  These expenses, as well as lost revenues, will be reported as a use of ...

UPCOMING NHPCO WEBINAR ON PPP AND CARES ACT FUNDING

Volume 20.10 The National Hospice and Palliative Care Organization (“NHPCO”) is offering a webinar intended to address the legal, accounting, and financial reporting aspects of the PPP SBA Guaranteed Loan Program and the Provider Relief ...

REPORTING TELEHEALTH COSTS

Volume 20.09 To better address the needs of patients during the COVID-19 PHE, hospices can provide telehealth services to patients receiving routine home care if feasible and appropriate.  Additionally, face-to-face encounters can now be ...

PROPOSED HOSPICE PAYMENT RULE RELEASED

Volume 20.08 The U.S. Centers for Medicare & Medicaid Services (“CMS”) has released the proposed 2021 Hospice Wage Index and Payment Rate Update, which is scheduled for publication in the Federal Register on April 15, 2020. This ...

IMMEDIATE CHANGES TO NEW YORK HOME CARE COST REPORTS AND PROCESS

Volume 20.04 The New York Department of Health is launching a new Web-Based Tool for Home Care cost reports, set to be published mid to late March 2020, that providers will be required to complete using fiscal year 2019 cost and utilization ...

RAP SUPPRESSION FOR HHA OWNERSHIP CHANGES

Volume 20.03 With the implementation of PDGM, newly certified home health agencies (new providers), certified after January 1, 2019, are not entitled to receive partial episode payment based on a Request for Anticipated Payment (“RAP”).  ...

UPDATED, REVISED HOME HEALTH AGENCY COST REPORT ISSUED

Volume 20.02 The U.S. Centers for Medicare & Medicaid Services (“CMS”) has provided Notice on February 24, 2020 regarding the updated Home Health Agency Cost Report (“CMS-1728-19”).  Additionally, the forms and instructions are available ...