Healthcare CFOs Take on More Than Finance

Healthcare CFOs Take on More Than Finance

Geopolitical unrest, inflation, the COVID aftermath, skyrocketing gas and oil prices, supply chain challenges, the Great Resignation, and more hallmarks of living in 2022 are disrupting most industries, including healthcare. Chief Financial Officers (CFOs) are playing pivotal roles to help ensure short- and long-term success in the changing economic landscape.  Here’s how…

A McKinsey & Company 2021 survey shows over the last five years CFO responsibilities have dramatically expanded to include investor relations, post-merger integration, board engagement, procurement, and digital activities. CFOs in healthcare face additional, unique challenges that are further shaping their roles.

Healthcare CFOs are facing a burnt-out workforce and critical labor shortages (we’re talking nurses, medical assistants, and lab technicians); cannibalization of primary care services thanks to major retail chains’ entry into the market; supply chain disruptions impacting operations (not something you want when it comes to healthcare); and complete realignment of healthcare delivery due to explosive growth in telehealth. That’s in addition to handling and accounting for stimulus money, while managing compliance.

To navigate these challenges, the role of CFO is evolving beyond finance. According to the Healthcare Financial Management Association (HFMA) CFO of the Future survey, respondents indicate they will spend almost 25% of their time on strategy in the next three years to include a variety of actions like:

  • Filling gaps and complimenting existing resources by expanding healthcare systems regionally via satellite operations.
  • Promoting wellness and addressing the whole person.
  • Enhancing the patient experience.
  • Evaluating and refining capital investment strategy to ensure investments are in the right business lines, care, and products.
  • Enhancing or creating an environmental, social, and governance (ESG) strategy.
  • Automating and creating data warehouses to facilitate faster decision-making; eliminate non-value-added work; and upskill the existing workforce to do more strategic work.
  • Identifying opportunities for new revenue sources.
  • Focusing on cost structure to understand the cost of each step in the care process and increasing profitability through strategic cost reduction.
  • Better managing and measuring labor costs and productivity.
  • Playing a larger role in shaping recruiting, retention, and rewards strategies and programs (to address the Great Resignation and its aftermath and influence the people side of the business).
  • Outsourcing revenue cycle activities to reduce the cost of care and improve efficiency and effectiveness.
  • Renewing focus on contract negotiations and value-based contracts.
  • Completing transactions like reorganizations, mergers and acquisitions, joint ventures, carve-outs or divestitures, and Special Purpose Acquisition Companies (SPACs).

According to the 2022 BDO Healthcare CFO Outlook Survey, the healthcare industry is “boldly investing in the future, even in a time of uncertainty,” with nearly 70% of organizations expecting to increase profitability. To achieve goals, 59% of respondents say leadership will be the most critical CFO competency for success in the coming years.

If your business is looking for a partner to handle or advise on finances, tax, or auditing matters so your finance people and operations are freed up to focus on more strategic demands, give RBT CPAs a call. We have extensive experience partnering with healthcare organizations in the Hudson Valley and beyond.

Why You Need to Update Your Cybersecurity Now

Why You Need to Update Your Cybersecurity Now

The war in Ukraine is closer than you think. Recently, the  White House warned malicious attacks could be just a few keystrokes away, making it critical for local governments to close their digital doors, put their shields up, and protect people, data, and infrastructure from the disruption a cyberattack can cause. What’s even more worrisome is that Russia is just one part of a much larger problem – the U.S. saw a 917% increase in ransomware attacks of government operations between 2020 and 2021, and last year over 2,300 local governments, schools, and healthcare providers were victims of ransomware attacks.

While it may seem like cyber criminals would be more likely to target banks or global companies over local school districts or government offices, these soft targets are attractive because they haven’t had the funding or resources to build up their defenses. What’s more, financial gain isn’t the main goal of cyberattacks – disruption is. (Imagine the chaos that can be caused by something as simple as blocking access to emergency contact information for students at a public school?)

Cyberattacks can impact everything from emergency services (including 911 call centers) to tax collections, building permits, clean water, waste disposal, and more. Going after local governments is attractive to cyber criminals because of the low hanging fruit available, like Social Security Numbers and voter and tax payment information.

Recently, the U.S. Cybersecurity and Infrastructure Security Agency (CISA) – a component of the Department of Homeland Security – issued advisories indicating government, election, energy, water, and a few other organizations are likely targets. All organizations – small and large – are urged to step up security and be prepared to respond to and mitigate the impact of potential cyberattacks.  That includes training employees to help prevent attacks and conducting drills to make sure everyone knows what to do if an attack should occur.

With the approval of the $1.2 trillion Infrastructure Investment and Jobs Act (IIJA) there’s over $1 billion for improving state, local and tribal cybersecurity. Planning for and managing those funds will happen at the state level, where Governor Kathy Hochul recently announced a proposed budget of $62 million to build up cybersecurity. So, it’s important to stay in the know about what New York’s Chief Information Officer, Chief Information Security Officer, and NYS Joint Security Operations Center are up to.

In the meantime, it’s easy to agree that more needs to be done to stand up to cyberattacks. The tough questions are “What?” and “How?” Recently, the Hudson Valley Pattern for Progress kicked off a series of cybersecurity live virtual events to answer those questions and included a review of free resources available to support local governments, including:

To free you up to focus on cybersecurity, RBT CPAs is available to handle all of your tax and accounting needs. We work with local construction companies, governments and school districts throughout the Hudson Valley. Give us a call today.

The Pros and Cons of College Mergers & Acquisitions

The Pros and Cons of College Mergers & Acquisitions

With growing frequency, colleges and universities across the U.S. are turning to mergers and acquisitions to address fiscal challenges, low enrollment, a shrinking population, tough competition, stagnant state funding, a shift to online learning, and more. A 2020 survey of college and university presidents showed more than 16% explored a merger or acquisition the prior year (the percentage is likely higher, but not reported due to confidentiality). While mergers and acquisitions may not be right for every institute of higher education, the associated pros and cons warrant consideration.

Data from the National Center for Education Statistics shows the higher education industry continues to shrink, even before the anticipated demographic cliff hits in 2025. (Learn more about college and university closings, mergers, and acquisitions by state using Higher Ed Dive’s tracking tool.)  This has a profound impact on costs, revenue, alumni relations, and future planning.

College closings and mergers by state
Each state is colored by how many of its public and private nonprofit colleges have closed or merged, or have announced plans to, since 2016. Click on a state to filter the list.

College Closings and Mergers

So, what factors are enticing so many college presidents and boards of trustees to consider a merger or acquisition?

Mergers and acquisitions can can offer efficiencies and economies of scale, allowing for shared services, campuses, affiliations, partnerships, and branding, as well as staff redeployment. They can help promote growth, by expanding degree and class offerings, entering new markets, and filling new/emerging needs in the local community and society overall (i.e., technical training for manufacturing and construction). There’s also opportunity to increase value for students and prospects while improving competitiveness for the institution(s), as a result of greater brand recognition, an expanded alumni base, broader internships and job placement opportunities, enhanced technology, increased networking potential, and more.

What’s more, mergers and acquisitions can help a college or institution expand its geographic footprint inside the U.S. and out. Plus, they enable fast acquisition of offerings, infrastructure, technology, and facilities by employing a “buy” rather than a “build” strategy.

On the other hand, there are some downsides to consider. Research suggests mergers and acquisitions lead to tuition and fee increases of five to seven percent. Although there are initial savings achieved through economies of scale (no need for duplicate staff or duplicate facilities and equipment), this represents one-time savings versus ongoing.

There’s also concern that mergers and acquisitions can lead to the potential loss of an institution’s identity and in-person learning, as well as enrollment. Alternative curriculum or approaches to education that give students options based on the way they learn may suffer. It’s like replacing a local establishment with a big box store. If students or prospects believe a merger or acquisition is being driven primarily by an institution’s financial issues, there can be a negative impact on applications and income.

Mergers and acquisitions of higher education institutions have unique challenges that aren’t shared by the corporate world. Accrediting bodies, faculty and alumni can all have an impact, as can national, state, and local governments. According to Statista, almost 79 percent of higher education spending comes from private sources like alumni who, at times, have led to a merger being called off.

As is the case for many industries, the COVID pandemic and ensuing changes (i.e., the unprecedented adoption of online learning) are facilitating disruption in higher education. As leadership of these institutions chart their paths forward, consideration of the pros and cons of mergers and acquisitions should be part of their planning. As noted by the Teachers Insurance and Annuity Association of America (TIAA), “Rather than a last resort, mergers and acquisitions can be part of a proactive strategy to help realize institute of higher education missions.”

If you need help understanding the tax and accounting implications of mergers and acquisitions, call RBT CPAs. We’re also available to handle all your tax and accounting needs, so you can focus on what’s important to your institution – learning and the future.

There’s One More Thing You Can Do to Help Students Before Graduation…

There’s One More Thing You Can Do to Help Students Before Graduation...

No doubt, your seniors have started the countdown to the end of their high school career and start of what’s next. If what’s next includes higher education, there is one more thing you can do to help your students – let them know about local scholarship opportunities now.

Businesses big and small offer scholarships to give back to the communities where they operate and where their employees live. Numerous family foundations also offer scholarships and grants. Since the pool of candidates for these awards is often limited, students may stand a better chance of receiving this form of financial assistance than larger, national scholarships.

As an educator, you benefit from satisfying the innate desire to help educate the up-and-coming generation, fostering good will in the community (right before budget voting season), and having another valuable metric to show the value your school and its counselors deliver. (There are other reasons for promoting local scholarships – like the tremendous cost of higher education and the burden student loans put on families and students. See more in one of our previous thought leadership articles.)

Following is a list of digital platforms where you – and your students – can learn about scholarship opportunities. For platforms covering a smaller geographic area, become acquainted with the scholarships available and share a summary with your graduating seniors and their families. Think about whether you know students who match the criteria for a local scholarship; then, let them know about it via a personalized message.

For larger platforms, share the URLS with students and parents. Go a step further by holding weekly office hours dedicated to helping students search and apply for scholarships. You could also consider conducting a virtual training session via ZOOM.

Finally, engage your teachers by sharing information about local scholarships and scholarship platforms. Many have written reference letters for their students and probably know some who would benefit.

Here are some of our top picks for digital scholarship platforms covering our area:

  • The Community Foundations of the Hudson Valleyfeatures almost 70 scholarships and grants for students in Orange, Dutchess, Putnam, Sullivan, and Ulster counties. What’s more, each week there’s a free virtual scholarship support workshop to help students, teachers, guidance counselors and parents/guardians learn about the universal application, receive tips, and get answers to questions (click here to register.) The deadline to apply appears to be April 1 for most scholarships – review individual guidelines on the site to confirm.
  • The Chamber Foundationhas proudly awarded over a half-million dollars in scholarship funds to students from Dutchess, Putnam, Orange, and Ulster counties since 2001. The deadline to apply is April 1.
  • Rockland Community Foundationlists more than 30 scholarships for local students. Apply through the Foundation’s new online portal. There are varying deadlines, and some have already passed so be sure to take a look ASAP.
  • Mid-Hudson Scholarship Fund has a few scholarships, including ones for students planning to attend SUNY New Paltz. Deadline to apply is March 31.
  • comis a statewide platform listing more than 2.7 million scholarships. An applicant creates a profile, and the site narrows down which scholarships and grants they may be interested in.

Also remind students who are considering attending college locally to check out prospective school’s websites, which include information and links to scholarships and grants. For example, click on each school’s name to see the resources on its website: SUNY Dutchess, SUNY New Paltz, and SUNY Ulster.

While helping your students, there’s something you can do to help yourself — connect with one of our dedicated RBT professionals and let us handle your tax and accounting needs so you’re free to focus on what you do best – educating up-and-coming generations. Contact us today.

Telehealth Is Calling: What Answering Does to Tax Obligations

Telehealth Is Calling: What Answering Does to Tax Obligations

COVID-19 prompted explosive growth for the telehealth industry, which provided safe access to care at a perilous time. Federal and state laws were relaxed and now government at all levels are being called on to create comprehensive telehealth legislation for the long-term. In the meantime, a variety of federal, state, and local laws are running the show, and can have a variety of implications on tax obligations.

Study after study shows patients, medical practitioners, investors, and more are on board for making telehealth a standard part of the health care delivery model. From big box stores to online retailers to national pharmacy chains, many are jumping on the bandwagon and disrupting traditional health care with new and innovative hybrid digital, in-person and even mobile models. Insurance companies are getting on board, with the introduction of plans covering digital first care at no cost to the patient. Mergers and acquisitions are fueling interest and growth. Even the U.S. Department of Health & Human Services provides best practice guides to help get telehealth initiatives off the ground.

Still, certain states – like New York – are slow to warm up to the telehealth boom, enacting strict rules on their operation. Perhaps that’s due to concerns about potential erosion of state medical board standards and controls. No doubt, the financial implications of allowing out-of-state providers to give telehealth care to NY residents can create a potential negative economic impact to in-state medical providers. There are also state, payroll and income taxes to consider.

As a health care practice or practitioner physically located in New York, you’re subject to New York state taxes. By jumping on the telehealth bandwagon, you may be liable for taxes in states where your patients receive virtual care and/or in states where your providers reside. Unfortunately, the rules vary by state, making the process for determining when and where you have an obligation to pay taxes more complex.

In general, a state can impose a tax on a taxpayer when “nexus” is present. In some states, nexus is triggered by a physical presence. So, if you hire a physician in another state to provide telehealth services, you likely triggered a tax return filing obligation in that state. Then there’s economic nexus, which applies in states like New York. When a certain amount of revenue is reached and a certain number of transactions completed, economic nexus is triggered. In New York, nexus is triggered by $500,000 in revenue and 100 transactions in the last four quarters. It’s important to note that thresholds vary by state and can be as low as $100,000 for revenue.

There’s also a potential for information and data services taxes, and taxes on medical equipment depending on a state’s rules. Finally, payroll taxes will likely have to be filed in all states where telemedicine providers reside.

While the pressure is on Washington to finalize sweeping legislation within the next two years, medical practices and providers who have expanded into the world of telehealth must comply with the myriad of laws governing related tax implications in place today.

Remember, your partners at RBT CPAs are here to help ensure you meet all your tax obligations, understand how your health care delivery model will impact taxes going forward, and be prepared should an audit be required. Contact your local office for assistance.

SLFRF Final Rule: Key Changes and Clarifications

SLFRF Final Rule: Key Changes and Clarifications

The U.S. Treasury kicked off the year by providing the much-welcomed Final Rule for State and Local Fiscal Recovery Funds (SLFRF) on January 6, with final guidance on allowable uses, documentation, and reporting requirements. This replaces the interim Final Rule issued in May 2021.

Overall, the final rule affords greater flexibility and simplicity largely in response to feedback received during the comment process. An overview of the final rule was issued by the U.S. Treasury. Key changes and clarifications, which undoubtedly give local leaders peace of mind to move ahead, include:

  • Replacing Lost Public Sector Revenue: The final rule makes it easier to calculate lost revenue, with a standard allowance of $10 million. This is in lieu of determining an allowance using a revenue loss calculation. Recipients that select the standard allowance may use that amount – in many cases their full award – for government services, with streamlined reporting requirements.
  • Broader Use of Funds: The final rule clarifies that funds can be used for capital expenditures that support an eligible COVID-19 public health or economic response. For example, recipients may build certain affordable housing, childcare facilities, schools, hospitals, and other projects. In addition, eligible programs and services are expanded to include childcare, early learning, and services to address learning loss during the pandemic in impacted communities, as well as certain community development and neighborhood revitalization activities for disproportionately impacted communities.
  • Presumes Broader Impact without Analysis: With the final rule presuming an expanded set of households and communities to be “impacted” and “disproportionately impacted” by the pandemic, the need for additional analysis has been eliminated.
  • Government Hiring: The final rule allows for a broader set of uses to restore and support government employment, including hiring above a recipient’s pre-pandemic baseline, providing funds to employees that experienced pay cuts or furloughs, avoiding layoffs, and providing retention incentives.
  • Premium Pay: The final rule delivers more streamlined options to provide premium pay, by broadening the share of eligible workers who can receive premium pay without a written justification while maintaining a focus on lower-income and frontline workers performing essential work.
  • Water, Sewer & Broadband Infrastructure: The final rule significantly broadens eligible broadband infrastructure investments to address challenges with broadband access, affordability, and reliability, and adds additional eligible water and sewer infrastructure investments, including a broader range of lead remediation and stormwater management projects.

While the final rule takes effect April 1, 2022, recipients can choose to take advantage of its flexibilities and simplifications now, even ahead of the effective date. Treasury will not take action to enforce the interim final rule to the extent that a use of funds is consistent with the terms of the final rule, regardless of when the SLFRF funds were used. (For more information on compliance, consult the Statement Regarding Compliance with the Coronavirus State and Local Fiscal Recovery Funds Interim Final Rule and Final Rule, on the U.S. Treasury’s website.)

For many, the final rule is a green light to move full speed ahead. Remember, December 31, 2024, is the last day funds can be spent (although that extends to December 31, 2026, for contracts finalized by December 31, 2024). If you have questions or need assistance, please contact RBT CPA professionals dedicated to helping government clients.

The True Cost of Forgetting Finance in the Classroom

The True Cost of Forgetting Finance in the Classroom

Apparently, you can put a price tag on financial literacy.

According to a poll by the National Financial Educators Council, lack of financial knowledge cost the average American $1,389 in 2021, creating a national price tag of $352 billion. That’s just the tip of the iceberg.

During the best of times, neglecting to address finance as a fundamental learning requirement of all high school students in the United States has far-reaching implications across society, affecting everything from poverty levels and crime, business productivity, health and health care, life expectancy, and more.

Add a global pandemic and an ensuing financial crisis, and the actual cost of failing to educate Americans about basics like saving, budgeting, and investing becomes more apparent, with a dramatic increase in reliance on the government for everything from food to rent to income.

While we’re still navigating the pandemic and learning to live a new normal alongside COVID and its variants, the truth is we won’t know the cost of failing to educate and prepare Americans for “a rainy day” for generations.

We do know the most vulnerable—namely children—are the hardest impacted.

We live in one of the wealthiest countries in the world and yet we have the third highest poverty rate among Organization for Economic Cooperation and Development (OECD) countries. 27.5% of people in America are classified as low income and 16.1% of our population under the age of 18 are below the poverty line. According to the U.S. Census Bureau, poverty in America is increasing, and it’s affecting those under age 18 at a higher rate.

Ironically, it is those same children who can break the cycle of poverty if they are given the tools and know-how in the form of financial literacy. America has a long way to go to make this happen.

Just six states require a stand-alone financial education course in high school. Another 15 embed personal finance into other courses. That includes New York, which has been given a “D” by The Nation’s Report Card on Financial Literacy. (No doubt this contributed to the majority of our nation’s adults not having enough savings to cover even one month of living expenses when COVID lockdowns began.)

With school districts and states scrambling to cover added costs for remote learning; cleaning and equipping facilities to support social distancing guidelines; COVID testing and tracing; getting food to low-income students; and even having enough staff to cover the basics in education, adding finance to the high school curriculum may not appear to be a priority but especially in light of what we’ve learned and experienced as a result of COVID, we have to ask: how can we afford not to add it to the course curriculum?

Hudson Valley Community College is leading the way with a six-week stand-alone personal finance course designed to help students set clear financial goals, make investment decisions, increase financial security, and build savings for retirement. As per the course description, students will learn the essentials of personal bookkeeping and recordkeeping to support lifelong financial planning and decision-making.

Should high schools in the Hudson Valley follow the community college’s lead?

We think so. Our school systems have evolved to address physical and mental wellness in the early grades, recognizing the long-term impact it has on our country’s health care, financial, and other social systems. The pandemic and society’s lack of financial preparedness puts a spotlight on the need to expand our school’s definition of wellness from just mental and physical to include financial wellness. Our RBT partners can help, by bringing their experiences teaching financial planning at the college level to local high schools, with support available for everything from advising on curriculum to facilitating classes or webinars TRUE? Yes

While your administration evaluates how well your district is supporting students’ current and future financial preparedness and wellness, remember to account for how COVID funds were allocated and spent in your district, and how new costs will be covered going forward, with the tax planning services from your partners at RBT.

Sources: Next Gen Personal Finance, National Financial Educators Council, US Census Bureau, Hudson Valley Community College,

How much of the $1.5 Billion School Meal Program Funding will NY See?

How much of the $1.5 Billion School Meal Program Funding will NY See?

To ensure kids are ready to learn and engage, they need regular access to nutritious meals.

Often, this responsibility falls on school districts. Did you know that hunger affects approximately one in six children in New York State? As your district is likely experiencing, the ongoing supply chain disruption brought on by the pandemic has created a multitude of additional obstacles to navigate in the quest for providing consistent, healthy food options for students. Help is on the way thanks to the USDA in the form of federal funding, and your school district may receive financial relief before the end of the month.

School meal programs have always operated on extremely tight budgets, and pandemic school closures and financial losses left many programs on shaky ground. The School Nutrition Association (SNA) 2021 Supply Chain Survey results found over 98% of programs report shortages of menu items, supplies, and packaging, as well as menu items being discontinued by their manufacturers. The additional work replacing and finding new items as well as securing alternative vendors is taking a toll on school nutrition staff, and nearly all respondents (95%) indicated staff shortages. Severe supply chain and staffing challenges add to financial difficulties for school meal programs, with virtually all respondents (97%) reporting higher costs, compared to contracted bids.

At the end of December, Agriculture Secretary Tom Vilsack announced that the Biden-Harris Administration is providing up to $1.5 billion to states and school districts to help school meal program operators deal with the challenges of supply chain disruptions brought on by the pandemic.

How much will New York State receive?

Below, we break down the numbers and take a deeper dive into how the funding will be distributed. New York State will receive:

  • $88,094,032 total
  • $59,455,807 of the $1 billion in Supply Chain Assistance funds
  • $16,747,064 for USDA foods purchases
  • $11,891,161 for local food for schools cooperative agreement in NY State

With funding made available through USDA’s Commodity Credit Corporation, USDA will provide $1 billion for schools to purchase food for their meal programs through cash payments – known as Supply Chain Assistance funds. In total, the Supply Chain Assistance Funds are expected to provide a boost in resources for up to 100,000 schools across all 50 states, D.C., Puerto Rico, Guam, and the U.S. Virgin Islands, including public, tribal, charter schools, and nonprofit private schools.

How can the Supply Chain Assistance funding be used?

Supply Chain Assistance funding can be used by school districts to purchase unprocessed and minimally processed domestic food such as fresh fruit, milk, cheese, frozen vegetables, and ground meat. Each state will allocate the funds to schools based on student enrollment, with a minimum amount per district to ensure that small schools aren’t left behind. To strengthen local food supply chains, states have the option of using up to 10% of the Supply Chain Assistance funds to make bulk purchases of local food and then distributing these foods to schools for use in their meal programs. States also have the option of targeting the funds to areas of highest need by limiting distribution to school districts where a quarter or more of students are from low-income households.

Through the Agricultural Marketing Service (AMS)’s new Local Food for Schools Cooperative Agreement Program, USDA will award up to an additional $200 million to states for food assistance purchases of domestic local foods for distribution to schools. This program will strengthen the food system for schools by helping to build a fair, competitive, and resilient local food chain and expanding local and regional markets with an emphasis on purchasing from historically underserved producers and processors.

USDA will also purchase about $300 million in 100-percent domestically grown and produced food products, for states to distribute to schools to offset the impact of disruptions to their normal supply chains. States will be able to order these additional foods within the coming weeks, with deliveries to occur as soon as possible.

The School Nutrition Association said the funds will help schools manage higher costs and provide students with more American-grown food. We hope this development comes as welcome financial relief to your school district and helps to alleviate some of the financial and logistical burdens the continued supply chain issues have caused. Questions about the rollout of the funding, or want to set up a personalized conversation about your district’s needs? Feel free to contact our dedicated team of professionals at RBT who specialize in helping government clients. We look forward to providing you with personalized services and answering industry-specific questions.

Sources: USDA, School Nutrition, SNA, Hunger Solutions NY

Understanding Your Role as a Trustee

Understanding Your Role as a Trustee

The trustee is responsible for the safekeeping of a plan’s investments and needless to say – it’s a critically important role. While operating in good faith is a baseline duty expected of all trustees, not all trustees understand what they can be liable for or the true extent of their respective duties.

What can a trustee be liable for?

A trustee can be liable for their mistakes, depending on the terms of the trust. For example, neglecting to file income tax returns, missing opportunities to sell or to take other actions and precautions concerning assets held by the trust, failing to keep proper insurance on real estate, and so on can all result in liability for the trustee for the gross neglect of duties. Trustees must always remain objective concerning the interests of trust beneficiaries and comply with all provisions of the trust document while serving under the heightened standard of care.

Trust accounts are to be given annually to qualified beneficiaries, showing beginning and ending balances and what was received and paid out. Technically, trust accounts should also show book values and some market values. But these formalities are often overlooked in favor of reporting of basic financial activity. Providing tax returns and account statements is often deemed sufficient accounting, but local practice should be consulted.

Trustees typically use service organizations — such as bank trust departments, data processing service bureaus, insurance companies or other benefits administrators — in some capacity to assist in plan administration: They may outsource investment processing, recordkeeping and/or benefit payments, or claims processing as a way to reduce costs or increase efficiencies in administering employee benefit plans. You should be aware that the hiring of a service organization to perform any or all of the duties noted above is a fiduciary function. In addition, as part of your fiduciary responsibilities, you are required to periodically monitor the service organization to ensure it is properly performing the agreed-upon services. In its publication Meeting Your Fiduciary Responsibilities, the DOL points out that one way fiduciaries can demonstrate they have carried out their responsibilities properly is to document the processes used. Remember documentation is your friend! There is truly no such thing as being too organized, keeping too many records, or being too diligent when it comes to documenting financially sensitive or relevant information.

Each employee benefit plan is unique and requires specific monitoring, recordkeeping, and reporting. Given the complexity of this responsibility, it’s obvious that a trustee is going to need legal and accounting advice to make suitable decisions, properly document transactions, account for funds coming in and funds going out of the trust, and properly file tax returns. If you have questions or concerns, please do not hesitate to contact our dedicated team of RBT professionals today.

Source: AICPA

New Law Addresses Pending Medicare Cuts

New Law Addresses Pending Medicare Cuts

Of the ten counties that encompass the Hudson Valley, all but Putnam, Rockland, and Westchester are categorically considered rural, according to the U.S. Census Bureau. Unsurprisingly, rural residents often encounter barriers to healthcare that limit their ability to obtain the care they need. Certainly, the past year and a half tested the limit of patients, as well as overwhelmed hospitals, and physicians too. Luckily, Congress took action earlier this month to delay financial cuts that would have exacerbated already existing healthcare disparities in rural (and urban) areas and would have affected reimbursement to hospitals and physicians. If you’re not familiar with the “Protecting Medicare and American Farmers from Sequester Cuts Act” (doesn’t exactly roll off the tongue, we know) here is your opportunity to familiarize yourself with this critically important law that’s gained attention and support from many medical professionals.

On Friday, December 10, 2021, the President signed the “Protecting Medicare and American Farmers from Sequester Cuts Act,” into law, addressing several Medicare provider payment cuts slated to go into effect on January 1, 2022. The legislation includes helpful provisions for hospitals and providers. Specifically, the Act will:

  • Extend the 2% Medicare sequester moratorium until March 31, 2022, re-implementing 1% cuts in the second quarter of 2022, and reinstating the 2% cut subsequently, funded by backend increased sequester cuts in fiscal year 2030.
  • Adjust the Medicare Physician Fee Schedule (PFS) conversion factor by 3.00% in calendar year 2022.
  • Delay Protecting Access to Medicare Act (PAMA)-related cuts to clinical laboratory services and the next round of private payer data reporting by one year until January 1, 2023, with the phase-in extended through 2025.
  • Delay implementation of the Medicare Radiation Oncology Model until 2023; and
  • Delay application of 4% cuts to Medicare and other federal programs resulting from statutory Pay-As-You-Go- (PAYGO) Act requirements until calendar year 2023.

The American Medical Association (AMA) and many others had urged Congress to act to avoid cuts from taking effect at the start of 2022. Many have since spoken out with relief in support of the law. The American Clinical Laboratory Association, which represents Labcorp and Quest Diagnostics, issued a statement applauding the passage of the Act. The American College of Radiology (ACR) also applauds the news but urged lawmakers to look beyond what they described as “short-term” fixes.

Rick Pollack, president, and CEO of the American Hospital Association, said, “The AHA is pleased that the House has recognized that now is not the time to make cuts to hospitals and physicians under the Medicare program. By eliminating a 2% Medicare reduction until April 2022 and stopping the 4% Statutory Pay-As-You-Go (PAYGO) Medicare cuts from taking effect in early 2022, providers on the front lines of the fight against COVID-19 will not face additional imminent financial jeopardy as they continue to care for patients and communities.”

As hospitals and physician practices continue to recover from and navigate the emotional and financial impact of the COVID-19 public health emergency, our team is here to assist in every step along the way. Here at RBT CPAs, we understand the diverse and complicated world of healthcare. Our team of healthcare experts brings industry expertise in reimbursement, regulatory compliance and audit, accounting, and tax services. We will continue to keep you notified of timely news that matters to you and your team, but if you’d like to connect and receive individualized services, please contact us today. If you would like to submit feedback or topic ideas for future articles our team produces, please feel free to

Sources: White House,, GYNA