In the second article of a Corporate Counsel series highlighting impending scrutiny from the federal government related to COVID-19 relief funding, Bass, Berry & Sims attorneys Lisa Rivera, Brian Irving and Danielle Sloane discussed how companies in the healthcare industry can protect against future enforcement risks. “The healthcare industry must be particularly vigilant about protecting against future enforcement risks because it is a highly regulated industry facing an enforcement perfect storm—fast cash, poor guidance and retrospective review,” they said.

Congress allocated $175 billion to the U.S. Department of Health and Human Services (HHS) through the CAREDS Act Provider Relief Fund, and while HHS touted the funds as “no strings attached,” no government funding comes with no strings attached. Looking ahead, the government inevitably will review whether recipients met eligibility requirements and complied with terms and conditions for using the funds. With that in mind, healthcare companies should:

  • Monitor spending to ensure it is used in accordance with HHS guidelines.
  • Ensure that you are not supporting HHS funding justification with losses or expenses that will be covered by other relief funding (i.e. Paycheck Protection Program).
  • Pull your records together that detail your financial analysis and rationale for making decisions related to application and use of HHS funds.
  • Maintain copies of HHS and other relevant guidance as it existed when decisions were made since guidance is evolving so quickly.

As guidance and financial standing of businesses will likely continue to shift quickly, it is important to keep an eye on healthcare billing and coding teams to ensure claims have been billed in accordance with current guidance, and the leaders must continue to monitor the constant updates to ensure these evaluations are made from the most recent and accurate regulatory framework.

The articles in the series are available on the Corporate Counsel website and on the firm’s related blogs, links below: