Economic Relief Resources
April 20, 2020
Many organizations, government agencies and elected officials are working to address the economic toll of the COVID-19 pandemic. To help you navigate the flood of information, we’ve distilled it down into what we hope are useful key categories. NCMS staff continues to vet and add resources to this page to ensure the latest and most credible content.
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Loans to keep your practice going
In late March, Congress passed and the president signed the Coronavirus Aid, Relief and Economic Security or CARES Act, a $2 trillion stimulus package, the largest in the nation’s history. Two programs funded by the CARES Act will help doctors and other small businesses meet payroll and fund their business operations during the COVID-19 pandemic.
Paycheck Protection Program
Economic Injury Disaster Loan Program
Getting Paid for Your Work Now
The CARES Act Provider Relief Fund
The Department of Health and Human Services (HHS) announced the initial delivery of $30 billion in provider funding as part of the $100 billion Coronavirus Aid, Relief, and Economic Security (CARES) Act. Immediate relief funds began being delivered on Friday April 10 to Medicare enrolled hospitals, physicians and PAs based on their share of 2019 Medicare fee-for-service (FFS) reimbursement. The funds do not need to be paid back.
HHS indicates that “providers will be distributed a portion of the initial $30 billion based on their share of total Medicare FFS reimbursements in 2019. Total FFS payments were approximately $484 billion in 2019.” HHS adds that providers “can estimate their payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments they received by $484,000,000,000, and multiply that ratio by $30,000,000,000.”
Additional Disbursements – HHS indicates it is working rapidly on additional targeted distributions, focusing on practices in areas impacted by COVID-19, practices with lower shares of Medicare FFS reimbursement or who predominantly serve Medicaid, and for COVID-19 care for the uninsured.
More information, including the process HHS will use to deliver the funds, can be found in this HHS press release and fact sheet. The HHS website also has information on the Provider Relief Fund.
Medicare’s Accelerated and Advance Payment Program
The Centers for Medicare and Medicaid Services (CMS) released another $10 billion in Medicare Accelerated and Advance Payments to physicians on Friday, April 10, bringing the week’s total to over $40 billion. These funds are intended to help keep physicians afloat during the disruption in medical services caused by the COVID-19 pandemic.
The funds, authorized in Phase 3 of the COVID-19 response (i.e., the CARES Act), will be repaid through offsetting future Medicare claims. The offsets begin 120 days after disbursement of the funds.
The NCMS is working with the AMA and others to reduce the offset percentage, allowing doctors to keep more of their current Medicare billings and use those funds to recover from the disruption. In addition, the NCMS is supporting elimination of the interest charges on funds retained after the initial advance period.
Learn more here.
This Fact Sheet from the Centers for Medicare and Medicaid Services (CMS) has information on how to submit a request through its Accelerated/Advance Payment Process.
ICD-10 coding guidance from the CDC (2/20/2020)
NC Commercial insurers
For questions, concerns or input on issues around NC Medicaid and Covid-19 use this email address: firstname.lastname@example.org.
Financial and Practice Management Tools
Medical Practice Financial Template
As revenue decreases, it will be important to closely examine your monthly expenses. If your practice management system is not able to automatically produce a dashboard report, consider utilizing a one-page financial worksheet to get an at-a-glance view of your practice’s financial health. Consider adding comments into the worksheet to explain unusual variances (e.g. vacations and payor problems). This financial worksheet example combines productivity, collections, and expenses into one document. (Courtesy Texas Medical Association).
General Practice Management Guidance for COVID-19
NCMS Business Alliance member Poyner Spruill has compiled numerous resources for employers:
NCMS Business Alliance member Curi has compiled a helpful page of resources, including additional information on telemedicine, practice workflows, disaster planning, helpful webinars and more. Access Curi’s COVID-19 Resource page.
The Internal Revenue Service has this useful list of actions this agency has taken to give relief during the COVID-19 pandemic. Access that information. Included in that list are details on:
- The Employee Retention Credit, designed to encourage businesses to keep employees on their payroll. The refundable tax credit is 50 percent of up to $10,000 in wages paid by an eligible employer whose business has been financially impacted by COVID-19. Learn more.
- Families First Act Act provided paid sick leave and expanded family and medical leave for COVID-19 related reasons and created the refundable paid sick leave credit and the paid child care leave credit for eligible employers. Learn more.
Employers and Unemployment
Paid Sick & Family Leave
Congress passed legislation March 18 (to be enacted no later than April 2, 2020) that created a federal paid sick leave requirement for COVID-19 needs and expanded the Family and Medical Leave Act to include a paid leave component for employees caring for children whose schools or child care facilities were closed because of the virus outbreak. Here are some of the key provisions to consider.
Tax Implications and Tax Deferrals
For individuals, the April 15th tax filing and payment deadline for 2019 returns has been moved to July 15th. First quarter estimate payments for 2020 are also moved to July 15th. Second quarter estimates are currently still due on June 15th, but this may change. Corporate Income tax due for 2019 as well as 2020 first quarter estimates has also been deferred until July 15th. Underpayment of estimated tax may still apply.
North Carolina has also extended the filing and payment deadline to July 15th. However, under current state law, interest will be accruing on those payments until paid. Again, this may change pending action from the General Assembly. This extension applies to individual, corporate and franchise tax filings and payments.
Currently, there is no deferment on payroll taxes. Businesses need to keep paying payroll taxes as regularly scheduled. Legislation aimed at assisting large employers in under consideration.
Sales Tax- Payments due March 15- March 31 can be deferred until April 15th. Businesses would need to include form 5500 waiver with payment.