Following the announcement Thursday that healthcare providers in 24 states had been added to the federal vaccine mandate roster, the Centers for Medicare & Medicaid Services (CMS) announced Friday that those workers must be fully vaccinated by March 15. The 24 states joined 25 others, Washington, D.C, and territories, whose workers must have at least one COVID-19 shot by January 27, and be fully vaccinated by February 28. The mandates are based on guidance issued December 28 and follow Thursday’s U.S. Supreme Court ruling removing an earlier injunction to the mandate issued by a lower federal court.

The sweeping mandate applies to workers at hospitals and other healthcare facilities, including nursing homes and other long-term care facilities, that participate in Medicare and Medicaid programs. “Regardless of clinical responsibility or resident contact, the policies and procedures must apply to … individuals who provide care, treatment, or other services for the facility and/or its residents, under contract or by other arrangement.”

The states included in the compliance memo are Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, and Wyoming. The mandate now extends to all U.S. states except Texas, where a preliminary injunction still applies.

The CMS memo warned that, “Facilities that do not meet these parameters could be subject to additional enforcement actions depending on the severity of the deficiency and the type of facility … (including) plans of correction, civil monetary penalties, denial of payment, termination, etc.”

As part of its $2.2 trillion aid package, Congress appropriated $100 billion in financial relief to healthcare providers. The funds are being distributed through the Department of Health and Human Services (HHS) to hospitals, public entities, not-for-profit entities, and Medicare- and Medicaid-enrolled suppliers and institutional providers to cover unreimbursed healthcare-related expenses or lost revenues due to the coronavirus pandemic. Funds are provided as a grant, given compliance with the criteria as listed on the HHS website, including that they cannot be used for the same expenses as proceeds from a Paycheck Protection Program (PPP) loan or Economic Injury Disaster Loan (EIDL).

HHS distributed an initial $30 billion of the $50 billion general distribution fund between April 10 and 17. While providers were not required to submit an application for these funds, they are required to verify receipt of the funds through the HHS general distribution portal.

On April 24, HHS began distributing the remaining $20 billion. Certain providers were automatically sent an advance payment based on the revenue data they submit in Centers for Medicare and Medicaid Services (CMS) cost reports. Providers who receive their money automatically still need to submit their revenue information through the HHS general fund portal.

On April 27, HHS opened the general fund portal for providers who received automatic payments to report revenue. Providers that did not receive the automatic advance may be eligible for additional funds by accessing the general distribution portal and providing IRS tax filings and estimates of lost revenues in March and April of 2020. Providers that have not already confirmed receipt of monies from the original $30 billion distribution will need to complete the verification, then reenter the portal to proceed with an additional application.

To be eligible, a provider must:

• Have received a Provider Relief Fund Payment by 5:00 pm EST, Friday April 24.
• Attest to having received the payment via the Provider Attestation Portal, and agree to the Terms and Conditions on the attestation portal.

Providers should be prepared to provide the following:

• A provider’s “Gross Receipts or Sales” or “Program Service Revenue” as submitted on its federal income tax return
• Estimated revenue losses in March 2020 and April 2020 due to COVID
• A copy of the provider’s most recently filed federal income tax return
• A listing of the Tax Identification Numbers of any of the provider’s subsidiary organizations that have received relief funds but that do not file separate tax returns

If you have questions, we’re here to help. Contact us at (330) 758 – 8613; or email me at jzarlenga@hbkcpa.com.