Section 5001 (Division A, Title V) of the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) passed by Congress earlier this year established the $150 billion Coronavirus Relief Fund (“Relief Fund”).  Under this provision of the Act $150 billion was made available by the U.S. Department of the Treasury to states, tribal governments, and certain units of local government for specified uses related to the COVID-19 pandemic. Under the Relief Fund’s distribution formula Mississippi received $1.25 billion, Tennessee received $2.6 billion, and Louisiana’s distribution was $1.8 billion.

In the closing days of this year’s extended Regular Session, the Mississippi Legislature passed House Bill 1782, distributing $129,725,000 in funds received by the state from the Relief Fund.  Governor Reeves vetoed certain sections of the bill, leaving the remainder to become law.  The following provisions may be of particular interest to healthcare providers.

• $30.2 million to the Mississippi Development Authority to provide funds for “purchasing personal protective equipment (PPE) and providing for COVID-19 testing for staff for protection against COVID-19 from current patients and to have sufficient PPE and testing in preparation for expected new cases during the continuation of the current COVID-19 public health emergency later this year.” Relief Funds to be made available include:
  • $300,000 to be made available to ambulatory surgery centers, for a maximum of $4,000 per recipient;
  • $452,000 for assisted living facilities, not to exceed $4,000 per recipient;
  • $88,000 for Alzheimer’s/dementia units, not to exceed $4,000 per recipient;
  • $2,110,000 for nursing home facilities, not to exceed $10,000 per recipient;
  • $5,632,000 for independent dentists not employed by a hospital, not to exceed $4,000 per dentist or $40,000 per practice group;
  • $7,125,000 for independent physicians, independent nurse practitioners, and independent optometrists not employed by a hospital, not to exceed $2,500 per recipient (limited to 2,850 recipients) and $25,000 per practice group of physicians.

• $91.9 million to the Mississippi State Department of Health to be made available for certain pandemic expenditures, including:
  • $1.5 million to Federally Qualified Health Centers for “expenses in addressing the continuation of the current COVID-19 public health emergency and treating patients with COVID-19;”
  • $1 million to rural hospitals for “expenses in addressing the continuation of the current COVID-19 public health emergency and treating patients with COVID-19;”
  • $80 million to hospitals for “necessary expenditures incurred due to the COVID-19 public health emergency.” Distribution to be made using a formula based on the total number of hospitalized COVID-19 patients that the hospital treated as of June 21, 2020, and the number of Mississippi licensed hospital beds in the hospital.  Hospitals will receive the lesser of the formula amount or the amount of “necessary expenditures incurred by the hospital due to the COVID-19 public emergency. . . .”
  • $1 million to “hospitals that have more than twenty-five (25) hospitalized COVID-19 patients as of June 21, 2020, “but were unable to receive a rural provider payment from the U. S. Department of Health and Human Services because of being located in a county that is part of a metropolitan statistical area and not being designated as a critical access hospital.”

Hospitals receiving funds must provide monthly reports to the MDA with “detailed information about the allowable expenses of the hospital related to treating COVID-19 patients.”

At the time of this posting, the two state agencies in charge of these Relief Funds were in the process of developing regulations to govern distribution to recipients.  We will update this article when more information becomes available.  In the meantime, it is important to also note that HB 1782 incorporates certain conditions that govern the receipt and expenditure of Relief Funds under the CARES Act, including a requirement that the recipient has not received and will not receive reimbursement for the expense in question from any source of funds including insurance proceeds (but not including other Relief Funds).  Other important Relief Fund conditions include:

• Funds must be used for necessary expenditures. According to Treasury guidance, Funds can be used for expenditures incurred to “directly . . . respond to the emergency” or for “second-order effects” of the emergency.   However, Relief Funds cannot be used for a future emergency — they can only be used to respond to the current
• Funds must not be accounted for in the most recent state budget. The budget most recently approved, as of March 27, 2020 (as specified in the Act), was the FY 2020 budget.  However, Treasury guidance also makes it clear that even if there is a matching current budget line item, costs can be covered with Relief Funds if “the cost is for a substantially different use from any expected use of funds in such line item, allotment, or allocation.”
• Expenses must have been incurred from March 1 – December 31, 2020. Treasury guidance sums up this requirement, in the context of the previous requirements, this way: a state “may use payments from the Fund only to cover previously unbudgeted costs of necessary expenditures incurred due to the COVID–19 public health emergency during the covered period.” Costs are considered to have been incurred if performance of the service or delivery of the good occurs during the covered period. Payment of funds need not have incurred during that time (but should be made within 90 days, thereof).

HB 1782 also provides that if Relief Funds distributed to recipients are eventually disallowed by the Office of Inspector General they must be repaid to the state.  A full copy of the bill is available on the Mississippi Legislature’s website, accessible through this link: http://billstatus.ls.state.ms.us/2020/pdf/history/HB/HB1782.xml.