This podcast dives into the $30 billion in COVID-19 relief funding to providers under the CARES Act. Delphine O’Rourke, Partner, Duane Morris, and Aaron Cohen, Co-Practice Leader health care industry group, Citrin Cooperman, discuss compliance with the terms and conditions of receiving the funds, reporting requirements, and how to prepare for audits. From the Public Health System Affinity Group of AHLA's Hospitals and Health Systems Practice Group.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
This podcast dives into the $30 billion in COVID-19 relief funding to providers under the CARES Act. Delphine O’Rourke, Partner, Duane Morris, and Aaron Cohen, Co-Practice Leader health care industry group, Citrin Cooperman, discuss compliance with the terms and conditions of receiving the funds, reporting requirements, and how to prepare for audits. From the Public Health System Affinity Group of AHLA's Hospitals and Health Systems Practice Group.
To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.
Hello, and welcome to the A H L A COVID 19 podcast series. Today we're gonna be talking about agent Jeff's announcement on April 10th of initial 30 billion distribution from the CARES Act Provider Relief Fund, uh, for providers that have already started to be distributed. I'm Delphino O'Rourke. I'm a partner in the healthcare practice of Dwayne Morris, and I've been advising the healthcare providers on emergency management for over 15 years. And while Covid-19 presents, uh, a lot of new regulatory issues, um, we are trying to present them to you as soon as possible and in real time. Uh, and this podcast is gonna be focused on information for general counsel in-house counsel, as well as CFOs, because there's a critical component for your finance department, um, and your revenue cycle teams in this analysis. So today I'm joined by Erin Cohen.
Speaker 2:Hi, Delphine.
Speaker 1:Hi, Erin. How are
Speaker 2:You? I'm good. So, my name is Erin Cohen and I'm one of the, uh, co practice leaders at the accounting consulting firm, CI Cooperman. It's one of the top 25 accounting consulting firms, uh, in the United States. And we really focus our practice on, uh, some of the key, uh, financial issues, uh, that, that impact healthcare providers across the continuum of care. Uh, we, we do a lot of work, um, looking at, uh, cost accounting, uh, financial feasibility type of work. And, uh, the, the issuance of this, uh, 30 billion, uh, has raised, uh, a lot of questions, uh, amongst our clients, and we've been doing a lot of thinking about it. And, and Delphine and I have had a number of conversations, and, and so, Delphine, thanks for having me.
Speaker 1:No, of course, of course. Some provides some background. Um, and again, so Friday, April 10th, there's an announcement by hhs, um, of an immediate distribution of over 30 billion to provide immediate relief funding to provides in support of the nationwide Covid-19 response. Now, the 3 billion is part of the hundred billion a relief fund that was earmarked under the CARES Act that was recently passed by Congress. And it's important to note that HHS says these are payments to providers. They're not loans. However, there're credit. There's a series of conditions, and we're gonna talk about the terms and conditions and compliance with the terms and conditions. Cause if providers don't comply, then HHS can come back, audit and then request for the payment to be reimbursed. So that's gonna be part of our conversation today. And why Erin's work is so critical, not just in confirming the calculation at the outset, um, but also making sure that as you manage those funds, that you're complying with the terms and documenting and recording the way that it'll be necessary to survive an audit. Um, so, um, again, 30 million, 30 billion in distribution. I've already heard from clients that they received the payments by a direct deposit, which, um, I is unusual and we'll go into that. And some clients weren't even sure why they were receiving one. Uh, nursing home clients said, you know, we didn't even know why we were receiving this, um, without a full explanation. And they received it over the weekend. So, um, we'll, we'll start out by saying, you know, if you're the CFO or if you're in finance, or if you're legal, uh, reach out to your finance team and see if you have received a payment. Um, and we can talk about whether you think you should have and haven't, but action will be necessary within the next 30 days after receiving payment. Um, so Aaron, tell us a little bit about how this first 30 billion was allocated.
Speaker 2:So the first 30 billion, and, and, and the way that this was announced was really, uh, just late last week, um, by cms. Um, there was some confusion around whether this 30 billion was gonna be issued to all providers that, uh, have billed Medicare fee for service, uh, part A and part B, or whether it was gonna be issued just to hospitals. Uh, in the end, uh, the way this is worked is that, uh, the 30 billion was distributed to every single, uh, provider that, uh, billed Medicare fee for service part A or part B in 2019. And, um, the allocation that 30 billion was based upon the total amount of Medicare billing. So that provider, uh, billed, uh, in 2019 compared to the total, uh, reimbursed, uh, Medicare, uh, payments, uh, across the country across all providers, uh, in 2019. So that, that computation was already done, uh, prior to the disbursement. And that's why every provider, um, 26 billion of the 30 billion, uh, was distributed on Friday. And so there are a lot of providers that woke up and looked at their account and saw that that money was, was sitting there because the, uh, the computation had already been in completed.
Speaker 1:So, Aaron, I mean, looking at the language of the, let's say the press release that came out on Friday, it specifically said providers. So why was there this confusion over hospitals versus a broader, broader group of providers in your opinion?
Speaker 2:That's a really good question. Uh, there's been a lot of back and forth, um, between the American Hospital Association, uh, and HHS around, um, the best way to, uh, distribute these funds out. I think that the hospitals have felt like their enduring the brunt of, uh, of the costs, uh, associated with treating, um, covid 19 patients. And there were some articles, uh, that came out suggesting that the, uh, 30 billion, uh, that was going to be issued was, was just going to go to, uh, to hospitals. If you look at the pronouncement by, uh, CMA Verma, the CMS administrator prior to the disbursement of the fund, she was very careful to use the word healthcare providers. And so our expectation was that the distribution would be to all providers. And, and, and that is in fact what, what took place. But again, uh, there were a number of articles and a number of prognostications that it would just be to hospitals which turn not to be incorrect.
Speaker 1:So, you know, you mentioned that already 26 billion, so this is pretty quick, right? 26 billion out of 30 have already been distributed. And hs ajs is partnering with United Health Group to deliver the, the distribution. And what's unusual, and you know, we're really trying to provide practical advice is that providers will be paid via an automated clearinghouse account, whichever account they have on file with U H E or Optum Bank, um, or use for reimbursements from cms. And they'll receive a, a reimbursement that'll say HHS payment. Um, and for providers who usually receive a paper check for reimbursement from cms, they're also, I mean, literally a check is in the mail, uh, for this payment within the next few weeks, which could be significant. So from a sort of mechanical perspective, um, you know, providers have received a payment. If they haven't already, they probably will, will the mail and should be checking. And there are specific, um, sort of details from employed physicians. They won't get the, the, the reimbursement directly. It'll go to their, their employer. Um, and then we have 30 days. So they have 30 days from receipt of the payment to, to sign an attestation. And attestation is available online. There's a portal that opened, um, yesterday, so April 13th, um, to, to, um, to access the attestation and the attestation, um, provides that a, the, the calculation was accurate and, and b, that the facility is going to be able to comply with the terms and conditions. And an atest station must be returned within 30 days. Or if a facility disagrees or wants to reject it, there's a, there's a mechanism to respond. But if a facility doesn't respond within 30 days, then they're presumed to have consented. So, lack of action within 30 days, we'll say, okay, automatic acceptance of the terms and conditions. And as we mentioned at the outset, while this is not alone, it is conditional and, and the conditions are, um, are, are varied, and we're gonna talk about the conditions, and they're gonna be ro reporting requirements. And, um, the terms and conditions are now available online, uh, encourage everyone to look at them in detail. We're gonna touch on some of the, some of the major conditions that, that are gonna be relevant. Um, so Erin, how exactly was the calculation made to distribute the money to, to providers? And was there any input by providers into the calculation?
Speaker 2:So the amount of the cal, the amount that was distributed to each of the individual providers was really based solely upon the amount of their billings in 2019 Medicare fee for service. And it, the way that the calculation works out is that it's effectively 6.2% of the billings from 2019 for each provider, uh, that that was issued. And that 6.2% is really, um, computed by taking the 30 billion and, um, dividing that by 484 billion, uh, of fee for service billings in 2019 across the country. So it really was just purely based upon the, the percentage of the overall billings constituted by, uh, each individual provider, which, which is interesting because you would think that there might be more money, uh, specifically geared towards organizations that are bearing the brunt of the, uh, of the cost to care for covid 19 patients. But that, that is not the way that this worked. And frankly, uh, I haven't seen any real, uh, guidance provided by any of the provider groups indicating that this was the way that they, uh, would've suggested issuing it out. I think this was done, uh, purely from a, a practical perspective as, as the easiest way to start to get money out to the providers. And one of the, um, one of the, the big issues with the way that this was done is, as you might imagine, is that there are a number of providers that have, uh, a very heavy Medicaid population, um, like, uh, pediatric, uh, practices, uh, and, uh, and children's hospitals that really did not receive much, uh, if anything from this distribution because of the way that the, the money was, was, um, uh, calculated in, in terms of what was distributed. Now, CMS has said that that, uh, that the next tranche of money that's gonna come out will take into account, uh, Medicaid, uh, reimbursement and be more geared towards those organizations that those provider organizations that have a, a high medicaid pair mix. Um, but, um, we don't know at this point when that issuance of additional money will take place.
Speaker 1:And that also raises, you know, a, a more global question, which, um, I think a lot of providers are trying to work through, is what's the order of funds, um, you know, whether it's state funds versus FEMA funds, Medicare, Medicaid, and, and what the priorities are going to be on that. Um, so, so let's talk about the con terms and conditions of payment. Cause basically the way the mechanism is, is being set up is you receive this payment and then you decide whether you can keep it or not, right? Um, and you have to attest that you're gonna comply with terms after already receiving the funding. Um, and, and this is focused on covid-19. Um, so what's what's also interesting is that, as you noted, you know, this was based on straight calculations. So, um, arguably a provider could have not treated any covid-19 patients yet and received, um, this payment. Okay. But then one of, one of the, um, conditions is that they were currently providing testing or care for actual plausible cases of covid. So in, in that hypothetical, that that provider, um, at least for now, would be challenged to, to attest that they're complying with the terms and conditions. But more generally, what are the terms and conditions that you think are, are most relevant? I mean, there's some terms and conditions. Say for example, um, you know, the money can't be used for, you'll see there are a lot of on conditions, but as, as the core conditions, what do you think are, are critical?
Speaker 2:So one of the, um, one of the areas that we've really been focused on is precisely this issue is, is to who's eligible to keep these funds? Because what's interesting with, with the way that these funds were distributed, as, as Delphine indicated, the funds were distributed, and now the providers have to, uh, certify that they should be able to keep the funds. The eligibility, uh, has been based around the idea of providing diagnosis, testing, or care for individuals with possible or actual cases of covid 19. And there's been a lot of questions as to the, you know, how broad that is and what what precisely is covered, uh, by that, that eligibility requirement. Very interestingly, and this is, this is just within the last 24 hours, uh, HHS has provided some additional color, and they've now provided that care does not have to be specific to treating covid 19, HHS broadly views every patient as a possible case of covid 19, that would indicate that it's possible that for some of these provider groups that have not necessarily been geared towards caring for covid 19 patients, that they still may be in a position to have eligibility to, to receive these funds. Now we'll go into how they're going to, um, report costs, uh, and lost revenues associated with covid 19, which is even more complicated. Uh, but, um, but this eligibility requirement, um, HHS seems to have made, uh, it broader to be able to take in more, uh, providers than initially seemed to be the case when the terms and conditions were first issued on Friday.
Speaker 1:And Aaron, I mean, that, that's, that's potentially a game changer, um, because as we know, a lot of the financial, um, you know, hit that hospitals, for example, are experiencing is, is related to lack of elective, um, elective procedures, for example, and the normal type of volume that would occur that's either not, not permissible at this point or just, you know, and not advisable. Um, so it'll be interesting to see how, how that plays out and how the funds can be, um, part of that compensate for lost productivity, how those funds can, um, how those organizations can be eligible. Um, so Aaron, um, again, uh, quite a few terms and conditions. Um, what, what do you think are the key though for our, our CFOs and our in-house legal council to focus on, um, when they're looking at whether they're eligible and then to be able to, to survive an audit in the future and not return the funds? You know, sometimes as we know, funds are earmarked, um, they're on hold, but right now, um, right now there is such a need for cash that part of my concern is that the funds are going to be, uh, used allocated and then after reimbursed be reimbursed in the future. Um, and that will pose, um, they'll oppos financial stresses on the organization. So what do you think are the key terms and conditions to focus on in addition to, uh, providing COVID 19 in the clarification from hhs?
Speaker 2:Yeah, so there are a number of important, um, uh, certifications that you need to be making, you know, uh, on an ongoing basis, uh, in terms of how you're using the, uh, the funds. First of all, uh, you know, for all care, uh, for a possible or actual, uh, case of covid 19, providers do need to agree not to seek collection, uh, of out-of-pocket payments, uh, from a covid 19 patient that are greater, uh, than what they would've otherwise been required to pay. Uh, if the care had been provided by an in-network provider, that, that's obviously an important one. I think, you know, the real area that, that we've been focused on is the use of funds, uh, certifications. Uh, the payments, uh, will only be used to prevent, prepare for and respond, uh, to Coronavirus, uh, and that the payments are really meant to reimburse the recipient for healthcare related expenses or lost revenues, uh, that are attributable, uh, to coronavirus. And that payments won't be used to reimburse expenses or losses that have re been reimbursed from other sources or that other sources are obligated to reimburse. And that last one has been a major source of confusion because there's so many different, uh, funding opportunities to, uh, healthcare organizations and others, uh, that sort of all intersect. You, you have these, uh, P P P loans, uh, that, um, uh, some of the smaller businesses have been able to take advantage of. You have, uh, fema, uh, funding that's a possibility, uh, for nonprofit, uh, organizations that run healthcare facilities like hospitals and skilled nursing facilities. You've got other, other loan programs, uh, and, uh, there, there's a real question as to, uh, how you keep track of the funds that are received from each of these different programs and, you know, which expenses, uh, can be reimbursed by which, uh, which funds. So we've been focused on that. I think, you know, another key area, uh, to, to look at is that, uh, there are reporting requirements that no later than 10 days after the end of each calendar quarter, uh, that recipients receive more than$150,000 total in funds under the CARES Act. Um, or, or, or related, uh, coronavirus response legislation, uh, are required to, to make, um, you know, to, to send in a report to, uh, cms, uh, detailing the amount of the funds received from, from hhs, uh, as well as the amount of funds, uh, they were expended for each project or activity, and a detailed list of all projects or activities for which, uh, large covered funds were expended or, or obligated. Um, and, and so this sort of detailed reporting, uh, that's required, uh, which again, is related to the receipt of more than$150,000 in total funds under the CARES Act, uh, really provides, uh, a, a decent amount of, of, uh, effort that these providers are gonna need to provide an ongoing effort to be able to substantiate the receipt of the, uh, of the funds here.
Speaker 1:So, Erin, do you, do you have any recommendations on your practice or methodology to keep track of all these, all these funding sources? To your point, um, you can't be effectively double, triple dipping in getting, um, money under cares and then female and other sources of funding, or is it too soon to, to, um, into this process to have thoughts on, you know, just practically how does a health facility think about, um, in the midst of everything else, uh, tracking this so that it can make sure that it is providing the documentation necessary and, and not, um, unintentionally, uh, running a foul of the conditions of receiving the money?
Speaker 2:That's an excellent question, and I think that, uh, it's gonna be an ongoing exercise, uh, that will continue to, to change a bit as the, uh, as legislation continues to come out, uh, as everything continues to move quickly. But we certainly have some, some, uh, tips, you know, to, to at least start thinking about, uh, a methodology here. So, you know, one of the first things to think about is sort of the priority, uh, of, um, of funds, uh, for organizations and, um, making sure that you're keeping track of, um, which funds, uh, are being received and when. So the first question would be, do you have any insurance coverage, uh, like business interruption insurance that you can call upon? Uh, if, if that is available, then that, uh, funding, uh, from from insurance, uh, there will not be the ability to then also get funds from HHS or FEMA or other sources that that commercial insurance has, uh, been able to, uh, reimburse. The next question is, what are the available provisions under the CARES Act and do they, uh, conflict with each other? So one of the, um, um, big items that we've been looking at is the, um, paycheck protection program, the P P P, uh, loan, uh, assistance program for small employers. Can you receive that money and then also receive this money from, from the, the Provider Relief Fund? And from what we can tell, the answer is yes, you are allowed to, to receive both. Our suggestion is to try to receive as much, as much in terms of funding from the CARES Act as possible because fema, which is available to hospitals and to, um, skilled nursing facilities that are nonprofits, that funding is typically the funding of, of, of last resort. And it really is geared towards emergency medical services. I think the, the likelihood of significant funding from FEMA is probably, uh, unlikely. It, it's, it's likely the case that the funds that will be available, um, will be limited and it will be difficult to, to really be able to, uh, substantiate getting, uh, a lot of funds, uh, from, from FEMA once it's as sort of all at the end. And, and again, the application process for FEMA isn't gonna be towards the end of the, uh, of the pandemic. So this is earlier, earlier funds, uh, from the CARES Act in terms of, uh, keeping track of these costs and, and foregone revenue. Um, the first thing that should be done is the organizations should have cost centers set up, uh, to be able to capture, uh, direct costs that are related to, um, providing care, uh, to coronavirus patients or, or, or getting ready to do that. So, great example would be, uh, the PPE and, and other supplies that are, that are necessary. But we've been looking at this and thinking that there, that a, a good way of, of trying to divide out these costs throughout this pandemic would be what were the costs to prepare, uh, what were the costs to care, and what were the costs to prevent? So what, what are the costs that you're incurring or the lost revenues to prepare, uh, for, for the pandemic? A great example being for the hospitals, the decision to cancel elective surgeries to be able to get ready for a surge of covid 19 patients. Then the question is, what are the costs to care? And I think there, there's gonna need to be, um, activity based costing around the, um, the, the patients that are seen in, in the hospitals, um, you know, to look to see what their, you know, average, average cost is. Um, and then to compare that to revenue and to be able to take into account those, um, those shortfalls. And then the question is, what's being done to prevent the spread? What, what is the significant amount of work that's being done to ensure that other patients and, and, um, and visitors are not, and, and, and staff, uh, and healthcare professionals are not, uh, becoming sick? Um, by dividing the cost into those three different areas, we think it allows for an easier, uh, cost accounting, um, you know, uh, an easier accounting of, of those costs. Um, so we're still working through a precise methodology, which I think is true for, for most of the financial oriented firms to be able to go through. But, but hopefully those are some, some good, uh, and helpful tips.
Speaker 1:Um, Aaron, one of the questions that, that I've already been getting on, on relief is, so for example, in this situation, you mentioned the priority business interruption insurance is gonna pay out. Um, then, then the CARES Act, um, would, would not be available. So, but the business interruption, how would you sequence that? Because in, in this situation, if a provider received payment on Friday, they have 30 days to a test, and they might not have a determination regarding the business interruption insurance, in part, cause business continues to be interrupted. So how do you sequence those decisions? Is it best to try to get as much as possible and put them in a reserve and return them if you, if you need to? Um, because if you wait too long, a 30 billion is gonna be gone. Um, and that money, whether or not you are eligible for it, um, will, will no longer be available. So what are your thoughts on sequencing? Or is it too soon to tell?
Speaker 2:Well, one of the things that I was looking at here, uh, which is not included, which I think is, is a positive for providers, is that there is nothing in here related to an interest payment, uh, with the funds that are received here, um, in, in comparison to the Medicare Advanced Payments program, where if those were not received within a certain period of time, uh, there's a, a 10.25% interest rate that starts to run, uh, so far, um, that has not come out as being an aspect of, of, um, these pro uh, this distribution of funds. So it is hard to tell providers if they believe that they're eligible not to, you know, take the money into account because frankly, there's no, um, no immediate interest or penalties that are, that are noted in here. Now, that could certainly change. I think that when it comes to the, and, and, and that's a risk, you know, that, that providers are gonna have to, to think through. And that's why for us, a lot of our clients we're, we're telling them to the extent possible to sort of sit tight, uh, not, not our hospital clients or skills nursing facility clients that clearly have incurred a lot of costs, uh, and, and need to start using this, this money. Um, but, um, but, but really some of our, our other, uh, you know, physician practice and, you know, our, some of our clients that may have this business interruption, uh, insurance coverage opportunity may not have, um, you know, a know a ton of costs related to treating COVID 19 patients. And that would be, you know, potentially subject to, to having to pay back. Um, you know, in terms of the business interruption insurance and the timing of that, if there has not been a receipt of, of payment and there's not a clear gauge that you're going to receive that payment, it's hard to assume that that's going to take place and, and not take this money from the CARES Act. So, you know, our suggestion would be as long as you're able to, uh, certify your eligibility, that if you have to pay some amount back, you know, that that's, that that will be something that, um, needs to be taken into consideration. But we, we do think that as long as you can certify eligibility that there is legitimate access to the funds,
Speaker 1:You know, and that's, and that's gonna be to your point a, a risk analysis, um, on a lot of these. And what are you, what are you gonna go for? And, and your earlier point on fema, um, FEMA can take a while and, um, in, in many facilities, um, don't have the luxury of the time to wait for assuming that they're eligible, you know, it's point just for nonprofits don't have the luxury of waiting to see, um, what the business interruption is gonna be, what FEMA's gonna be, and really need to jump on some of these other opportunities. Um, so I'm gonna touch on and ask, you know, uh, for, for lawyers, I think if you're advising your clients, whether you're internal or external on, on this funding, there's a lot of focus on covid patients and that the funds can't be used to overlap double bid, triple dip, um, but also important to note that the provisions also apply, that you're not at the interesting token on the key ones that, um, they, the funds cannot go to executive pay. Um, so, and other conditions. So, you know, again, that's probably not what the, what you're thinking of for your covid money, but some hospital executives have taken a pay cut. Um, then there's a whole series for gun control advocacy, lobbying, abortions, um, you know, embryo research, legalization of controlled substances, a broad range needle exchange that have been tacked onto this. Um, and I would suggest paying attention to confidentiality agreements that contracts, um, you know, subject to these funds cannot have confidentiality agreements or non-disclosure agreements. Um, again, the focus is on whether or not you've provided or, um, as Erin pointed out, you know, the cost relating to preparing, caring, and preventing, but there are also, um, other conditions that you need to be certifying that your, your adherence to. So the terms and conditions are now available on the, the HHS website. Um, they're called the relief fund payment terms and conditions, and important to review all of them. Um, because down the line, especially since we're talking about significant amounts of money, um, as you can imagine based on Erin's, um, you know, description of the calculation that we can anticipate that there will be auditing. Um, in addition, we're already hearing about, you know, significant amounts of fraud and, and scams. We know on March 23rd, uh, president Trump, uh, issued executive order to empower HHS and the DOJ to go after fraud. So with this amount of money, um, you know, sort of floating around, we can definitely anticipate some, some audits on the backside. Um, so preparing, and that's been part of one, you know, one of our themes, Erin, has been, it's not just about getting the money, it's not just about a testing being eligible and then managing it. It's also to be able to, you know, have the documentation, um, to successfully report as necessary and then have the documentation in place to, um, be able to be audited and come out with a clean, clean book, uh, you know, book of health on the other side. So any practical tips on, because this will, you know, there will be additional funds coming. We don't know how long this epidemic is going to last, but we could be, you know, looking at this a year, two, three years from now with audits to look to see how this money was actually spent. So any, any practical tips on that piece in anticipation of an audit down the road?
Speaker 2:Absolutely. Uh, it is absolutely critical to really take the time now to start to go through and to document all of the activities that have led to increased costs and foregone revenue, and to trace the money that you're using from, uh, the a hundred billion dollar provider relief fund, as well as the money that you're using from the PPP loan program, as well as any other funding that, that you may be, uh, eligible for. It's gonna be critical that you can point to specific projects and specific activities that you, uh, entered into, uh, that were related to this crisis, to caring for, uh, possible or actual covid 19 patients. And that led to a reduction in your, um, your, your profitability. It is, uh, unclear at this point whether when we look at lost revenues, that there's gonna be a requirement to look at your variable costs and determine whether you're gonna have to take into account, um, a reduction potentially in variable costs associated with the lost revenue. But I do think it's important to, even at this point, to think through, uh, what, what that, uh, what those variable costs may be in case that's part of the, uh, the requirement in terms of, of, um, reporting. But it's, it's incredibly important to start keeping track of all these costs as well as to trace how you're using your money, uh, and to ensure that it follows the precise requirements, uh, of the terms and conditions so that when there is, and, and there will be plenty of audits on this, uh, in the future, um, that, that you're able to go through it. So, um, there are a lot of different provisions in the CARES Act. There are other aspects of funding, and, and we do believe that it's, it's important to make sure that you dedicate the resources, uh, to, to ensuring that you have a very solid argument for what you're reporting.
Speaker 1:So this is a lot, this is, this is a lift. I mean, obviously, you know, great, a lot of funds available, uh, a lift for our finance departments, particularly in a time when, um, they're, they're being pulled and there's a lot of stress to revise budgets to project in a completely new environment. Um, what's the greatest risk, in your opinion, for a provider accepting
Speaker 2:Money? Yeah, I, I think the biggest risk is gonna be that, um, you know, for these providers that have not incurred a lot of costs directly related to, to caring for, um, coronavirus patients that, uh, may have received a lot of money, uh, and that, um, you know, really can use the money for the business that they really hue to these terms and conditions. Because I, I, I do think that, um, it's likely that that money, uh, that that, or at least a portion of it is gonna be, uh, requests or, or, or demanded to be, to be returned. And so if you spend the money, uh, and you just assume, uh, that you'll come up with a, a good argument in the future and you no longer have access to the funds, this is something that could, you know, be a, a, a real death nail, you know, to, to the business. So, uh, our suggestion is to take these terms and conditions very seriously and to think hard about what, how you use your money, uh, that you've received, and, uh, to not just assume this is free money that you will, uh, you know, have, have an opportunity to use however you want.
Speaker 1:I mean, and, and I think that's a great point. Cause you could all, you could see already how, you know, you're, you're a large facility in an area that hasn't been hit, um, based on the calculations, this is a, this is a windfall. Um, and unless there's clear understanding that you might need to return it, so it effectively becomes a reserve, um, that you might need to return it there, there's a, a need for money. There always is a need for money, um, that the risk is that you have that financial burden going going forward. Um, so, um, Erin, in addition to be a financial expert, is an attorney, although not practicing, um, but a friend of attorneys in a lot of different ways. You know, it's important. CFOs and, and, and legal departments work closely together all the time. What are the key areas where you think it really is important to have an interdisciplinary team that includes your finance and your legal in connection with both this funding, um, but also funding in general that's coming down in connection with Covid-19, where we really need to make sure that we pause from the craziness of the day-to-day and, and, um, align on, on an approach.
Speaker 2:Well, certainly understanding how all these different programs work together, uh, and, and making sure that you've got the right legal interpretation and, and understand the regulatory impacts of all these different funding provisions. It, it is critical that, that you have legal counsel that's working with you that I I is ensuring that you're complying, you know, with the, with the requirements. And, and here is a great example of where there are a number of different terms and conditions and requirements that then connect to the financial, uh, consequences of, of getting this money in and, and, uh, the potential of being able to use it and thinking about how to account for it and, and how to, you know, the, the sources and uses of it. Uh, another area that we've really been focused on that I think it's critical that, uh, you have financial, um, expertise, you know, working with, uh, legal counsel is, uh, some of the funding issues and, and related regulatory changes around telehealth, uh, where, uh, there's an opportunity right now, uh, through some of the, uh, through, through a funding, um, a mechanism through the fcc, uh, to receive, uh, 200 million worth of funds for telehealth. And I think you've got a lot of organizations that have just started up their telehealth programs and, uh, they're just a, an array of regulatory and financial issues for them to, uh, to think through. And so we, we think working closely with our, our legal, uh, partners is, is a great way, you know, to work with our clients. And, um, you know, we, we expect that this, uh, epidemic will do nothing but, you know, um, accelerate that, uh, that trend.
Speaker 1:So, and telehealth is, you know, it's, it's a great topic and we could have another whole session on telehealth, um, because there was also such a push for telehealth before, um, regulatory obstacles being seen as one of the biggest challenges. And we've seen both through five blanket waivers, um, as well as some, um, relaxation of hipaa, uh, so that, um, you know, so that platforms such as FaceTime or, or Zoom can be used to provide telehealth services during the Covid-19 epidemic. And I think it'll be fascinating to see, um, where the pendulum swings after this on telehealth, and there's such positive response to it, whether some of those regulatory restraints, um, that existed before, um, you know, just eventually go away. Um, but at the same time, there's so many people jumping into telehealth right now, and you and I have chatted about this, um, because of the emergent need without complete focus and understanding of the regulations and the financial aspects. So, so many things to juggle right now and anything that we can do, uh, to help each other and our colleagues. So, you know, we, Erin, um, and, and I'm sure you'll do the same I offer, if anybody has questions regarding the content of this podcast, um, Bishop, feel free to reach out to me and I'm sure you would do the same. Um, if anybody has any questions as well, thank you. Thank you. Stay well and safe.