Washington Watch Weekly - May 29, 2020 | ASCRS
Washington Watch

Washington Watch Weekly - May 29, 2020

House Passes Bipartisan PPP Loan Flexibility Legislation

On May 28, the House passed H.R. 7010, the Paycheck Protection Program Flexibility Act, by a vote of 417-1. The bipartisan legislation introduced by Representatives Chip Roy (R-TX) and Dean Phillips (D-MN) relaxes restrictions on how the PPP loan money can be used and extends the period that businesses must use the funds.

The bill would extend the forgiveness period for Paycheck Protection Program (PPP) loans from eight to 24 weeks, reduce payroll spending requirements from 75% of loan funds to 60% of loan funds, and extend the June 30th deadline for rehiring workers to the end of this year.

The bill now goes to the Senate, where they left for the Memorial Day recess before acting on its own version. The Senate version is similar but extends the timeframe for small businesses to spend funds to 16 weeks.

Representatives Phil Roe (R-TN) and Lou Correa (D-CA), Introduce the Coronavirus Provider Protection Act

On May 28, Representatives Phil Roe and Lou Correa introduced H.R. 7059, the Coronavirus Provider Protection Act. This bill would provide health care professionals, and the facilities in which they work, protections from COVID-19-related lawsuits. The narrowly crafted liability protections in H.R. 7059 would apply only when:

  • The act or omission occurred during the declared COVID-19 public health emergency or within 60 days of termination of the emergency;
  • The act or omission occurred while providing or arranging care;
  • The services were within the provider’s scope of licensure/certification, without regard as to whether the service fell within the usual scope of practice; and
  • The services were provided in good faith.

Additional actions covered by the bill would include those taken based on direction or guidance from any Federal, State, or local official/department/agency, as well as those taken due to a lack of resources attributable to the declared emergency.

ASCRS Joins the Alliance of Specialty Medicine in Urging CMS to Improve Access to Medicare Telehealth Beyond the COVID-19 Public Health Emergency

ASCRS joined the Alliance of Specialty Medicine in a letter to CMS Administrator Seema Verma urging CMS to implement the flexibilities and regulatory revisions to telemedicine that the agency has provided during the COVID-19 pandemic on a permanent basis.

Specifically, we ask the agency to work with the Congress and other regulatory agencies to implement the following changes on a permanent basis:

  • Maintain the updated Medicare telehealth list, to include retaining all of the services added to the Medicare telehealth list in response to the PHE for COVID-19;
  • Eliminate site-of-service payment differentials for telehealth visits, and maintain Medicare coverage and enhanced payment for “telephone” E/M services (CPT 99441 – 99443);
  • Allow key telehealth and virtual care services (e.g., virtual check-ins, e-visits, and other communication technology-based services) to be furnished to both new and established patients;
  • Preserve direct supervision revisions that allow physicians to supervise in-office clinical staff using communications technologies, when appropriate; and
  • Ensure physicians may perform telehealth services from their homes without updating their Medicare enrollment.

In addition, we ask CMS to work with Congress to remove Medicare originating site requirements and to promote changes with the Office of the Civil Rights in the Department of Health and Human Services that would enable providers and Medicare beneficiaries to continue to use non-public-facing audio and video technologies. We also urge them to encourage other payers to adopt similar policies and to reimburse providers for telehealth services at the same rate or in the same manner they reimburse for face-to-face services.

HHS Extends the Provider Relief Fund Compliance Deadline by 45 days

On May 22, the U.S. Department of Health and Human Services (HHS) announced a 45-day deadline extension for providers who are receiving payments from the Provider Relief Fund to accept the Terms and Conditions for Provider Relief Fund payments. Providers now have 90 days from the date they received a payment to accept HHS Terms and Conditions or return the funds.

All providers who have received Provider Relief Fund payments must agree to the Terms and Conditions, if they wish to keep the funds.

HHS previously announced that $50 billion of the Provider Relief Fund was allocated for general distribution to facilities and providers that bill Medicare and were impacted by COVID-19, based on eligible providers' net patient revenue. To expedite providers getting money as quickly as possible, HHS distributed $30 billion immediately, proportionate to providers' share of Medicare fee-for-service reimbursements in 2019. Then, beginning on April 24, HHS began distributing an additional $20 billion to providers based on their share of net patient revenue, and began accepting submissions from eligible providers of their financial data.

Providers will now have 90 days from the date they received a payment to accept the Terms and Conditions or return the funds. Providers that do not accept the Terms and Conditions after 90 days of receipt will be deemed to have accepted the Terms and Conditions.

Click here for more information.

SBA and Treasury Issue Rule on PPP Loan Forgiveness

On May 22, the Small Business Administration (SBA), in consultation with the Department of the Treasury, issued an interim final rule (IFR) related to loan forgiveness for the Paycheck Protection Program (PPP). The IFR retains the requirement that 75% of loan proceeds be used for payroll costs to receive full loan repayment, which has been a point of contention for the business community and may be repealed by Congress in the Paycheck Protection Program Flexibility Act. However, the SBA provides several other key clarifications to assist small business owners.

  • Since payroll cycles may not align neatly with the eight-week period eligible for forgiveness, the IFR provides flexibility to borrowers with bi-weekly or more frequent payroll cycles, by allowing them to use an alternative payroll covered period.
  • Clarifies that certain nonpayroll costs incurred during the eight weeks, but paid by the next regular billing date, will still be eligible for forgiveness even if that billing date falls outside the covered period.

SBA also provides several key clarifications related to reductions in loan forgiveness amounts.

  • Allows for full loan forgiveness, if employees are rehired or salary levels are reestablished on or before June 30.
  • No “double penalty” in that any loan forgiveness reductions due to changes in number of employees will not be not counted toward any reductions related to changes in salary.
  • Establishes the exact process a borrower must follow to avoid a reduction in forgiveness for employees who reject rehiring offers.
  • Provides leniency for employers related to employees who are fired for cause, or voluntarily resign or request a reduced schedule.

SBA clarifies that, for purposes of the PPP, a “full-time equivalent employee” means an employee who works 40 hours or more on average each week and provides two options for how to calculate employees who were paid for less than 40 hours per week. In addition, the IFR reaffirms the 60 days for the lender to review the loan forgiveness application and 90 days for the SBA to respond, clarifies that payroll costs are broadly defined as well as denoting payroll compensation for owner-employees and self-employed individuals, and provides additional information on loan forgiveness documentation.

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