Healthcare Worker Bonus – The Series

If you’re like us, you have certain TV shows that you are totally invested in and can’t wait until the next episode comes out.  Unless you are a masochist, that is probably not the case with respect to the weekly regulation updates coming out from DOH on the Healthcare Worker Bonus (“HWB”).  Even so, this past Wednesday, August 31st, with little fanfare, trailers, or coming attractions, some additional FAQ’s were added to the HWB portal to provide “clarification” on how the program works.  Furthermore, a few adventurous providers did apply for bonuses for the first vesting period, and of course, there were issues in uploading the Excel worksheet.  Also, the format of the portal has changed, the FAQ’s are now in the upper right-hand corner.

New FAQ’s:

The FAQ’s clarified the use of contract workers and their eligibility for the HWB.  Staff placed by a staffing agency at a Qualified Employer are not eligible for the bonus.  The DOH stated that Qualified Employers should submit claims for bonuses only for individuals they employ directly or indirectly on a permanent basis. Contracted temporary staff that are employed or contracted by a staffing agency or other intermediary entity on a temporary basis are not eligible for the HWB program.  Prior FAQ updates had made this clarification blurry by allowing for permanent contracted staff to be eligible.

The FAQs also once again re-iterated the employer eligibility criteria, stating an employer must meet the 4 following criteria:

1. They are a Medicaid enrolled provider.
2. They bill for Medicaid services (either through FFS, managed care of a 1915(c) waiver)
3. Employee at least one eligible employee
4. Meet one of the three criteria

1. Included in the list of provider and facility types in the statute OR

2. Are subject to a certificate of need (CON) process OR

3. Provider serves at least 20% Medicaid enrollees

The DOH provided some favorable flexibility to staff pushing the $125,000 salary envelope. When you look at employee salary, you should look at both annual base salary and the amount employee made in a vesting period (which are half year). For employers that are submitting claims for more than one vesting period (which would be the case for most submitting in October), employers should determine the wage eligibility across the full year rather than each individual vesting period; this allows an employee that makes more than $62,500 in one period but less than $62,500 in the following to be eligible for bother periods. The example provided is an employee has gross wages of $63,000 in the first vesting period (therefore ineligible) and $60,000 in the second vesting period (for $123,000 total) they would be eligible for both periods. Note the FAQ states this relief is currently available when submitting claims for more than one period at a time, but we would not be surprised if it were expanded in the future. Conversely, if an employee’s annual base salary is over $125,000 for a year, but earn less than $62,500 in a vesting period, they are entitled to a bonus for the period where their salary is below $62,500.

Furthermore, salary, for purposes of the HWB, is not based upon rate of pay, but earnings during a vesting period.  For example, if an hourly employee makes $100 per hour, but only works 20 hours per week, even though the rate of pay annualizes to over $125,000 salary, since they only earned $52,000 for the vesting period, they would be entitled to a $500 bonus for the period (20 hours per week).

As we discussed last week, if an employer has multiple companies that are linked under one MMIS number, the companies are combined for HWB filing.  This means that if an employee moves between linked companies, you would count all of the hours for all of the companies in calculating their bonus and determining if they met the continuous employment test.  These FAQ updates the past 2 weeks have made it much clearer how multiple entity employers should act for this program, so long as the MMIS IDs are linked.

Things we’re seeing:

The regulations require an employee to have continuous employment during the vesting period.  As a result, it is important to look at the date of hire as well as the date of termination to determine eligibility.  We have worked with several providers who hired staff during the vesting period, the employee provided the minimum average of 20 hours per week over a 26-week period but was still ineligible because they did not provide 26 weeks of continuous service.  Note the excel filing asks for the date of hire.

Filing Issues:

Some of the early adopters of the HWB, those brave enough to meet the September 2nd  filing date (don’t forget, the portal will reopen October 1st  for you to submit the first vesting period through October 31st) ran into some filing headaches.  DOH uses a data reader, so when you submit your bonus analysis using the Excel template provided by DOH, you need to make sure that the data is in the exact format required.  Some issues we heard from providers who filed (or tried to):

1. Make sure that there is no stray information on the spreadsheet. Some providers have reported that the template has pre-populated rows numbering up to 5000 lines.  You need to delete the number in any lines not being used.
2. The vendor titles work from a drop down menu, make sure you use the drop down and select title (rather than type), because if the titles don’t match, the submission will be rejected.

Finally, following in the footsteps of EI, OPWDD has directed OPWDD funded providers to reach out to the portal with any questions they may have unless they involve getting an SFS number.

So that pretty much wraps things up for this episode and season 1 … and like any good murder mystery series, we are left with a lot of unanswered questions … stay tuned for the trailers (and likely spoilers) over the next few weeks as we head toward the season 2 premiere in October.

Kenneth R. Cerini, CPA, CFP, FABFA

Managing Partner

Ken is the Managing Partner of Cerini & Associates, LLP and is the executive responsible for the administration of our not-for-profit and educational provider practice groups. In addition to his extensive audit experience, Ken has been directly involved in providing consulting services for nonprofits and educational facilities of all sizes throughout New York State in such areas as cost reporting, financial analysis, Medicaid compliance, government audit representation, rate maximization, board training, budgeting and forecasting, and more.

Edward McWilliams, CPA

Partner

Ed is a Partner in the firm’s tax and business advisory practice focusing on providing services to middle market private companies across different industries as well as to early stage startups. Ed has over a decade of experience providing tax and business consulting services to these companies of different sizes and across different industries, bringing a broad and diverse knowledge base and strategic solutions to the many complex issues that businesses face.