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COVID-19 Financial Relief: CARES Act

URGENT MESSAGE FROM JAMES C. DENNENY III, MD - March 27, 2020

Congress has passed, and the President signed, the $2.2 Trillion CARES Act that offers economic stimulus and relief broadly across our economy. There are several provisions that will benefit physicians and their practices that are important to each of you.

We are acutely aware of the dire situations that many otolaryngologists are operating under, both health and business wise. The need for small business survival strategies and financial support is critical to maintaining the physician workforce that protects our country during this crisis. It is also needed to support the existing medical care necessary for the ongoing health needs that will continue after the pandemic ends.

I attended a telebriefing, conducted by the U.S. House of Representatives Committee on Small Business this afternoon, following House passage of the CARES Act. It is apparent that both Congress and the Administration are fully aware of the acute problems the physician community is experiencing. The CARES Act contains a number of provisions that will be applicable to your practices including fully guaranteed loans, payroll protection loans with a forgiveness clause, and expedited access to federal funds. There is also the expectation that further Congressional action will be necessary to respond to the COVID-19 crisis moving forward. Below are general descriptions of the major portions of the Act affecting medicine. As the full language of the new law is analyzed, we will continue to update you.

I recommend that you contact your local SBA approved bank and begin applications for these loans immediately. They are funded on a first come first served basis and once the $350 Billion is expended, additional funds will need to be appropriated. For those who have already dismissed or furloughed staff, you are eligible for the Payroll Protection Act if the staff is rehired by June 1, 2020.

Thank you for your continued service to your communities and stay safe!

Jim Denneny
AAO-HNS/F EVP and CEO

FINANCIAL RELIEF: CARES ACT [March 27, 2020]

Today, President Trump signed into law, “The Coronavirus Aid, Relief, and Economic Security (CARES) Act.” The CARES Act (the “Act”) is the third aid package from Congress aimed to provide emergency relief to individuals and businesses during the COVID-19 crisis. AAO-HNS has worked to negotiate on behalf of the specialty throughout this process and ensure that our members are represented and protected in this legislation. The CARES Act includes the following provisions that impact otolaryngologist-head and neck surgeons practicing in a range of practice settings.

Public Health and Social Services Emergency Fund
The Act appropriates an additional $100 billion to remain available until expended, to reimburse eligible healthcare providers (public entities, Medicare or Medicaid enrolled suppliers and providers, and for-profit/nonprofit entities specified by the Secretary of Health and Human Services) who provide diagnoses, testing, or care for coronavirus, for healthcare related expenses or lost revenues directly attributable to coronavirus. Exact eligibility criteria and application process is not yet defined pending implementation.

Medical Supplies
The Act takes steps to address the medical supply shortages resultant from our response to COVID-19. The bill provides $16 billion for the Strategic National Stockpile in order to procure personal protective equipment, ventilators, and other medical supplies for federal and state response efforts.

Small Business Loans via the “Paycheck Protection Program”
The Act includes roughly $350 billion in funding to support small businesses experiencing economic strains caused by COVID-19. The “Paycheck Protection Program” will create Small Business Administration loans of up to $10 million to help cover salaries, leave and health benefits, rent, and/or retirement obligations, among other uses. Physician practices with no more than 500 employees may qualify. The program includes expanded loan forgiveness criteria.

Temporary Medicare Payment Update
The Act temporarily lifts the 2% sequestration on Medicare payments from May 1, 2020, until December 31, 2020. This provision will provide a 2% increase in Medicare physician payment.

Liability Protections
The Act includes critical liability limits for physicians and healthcare professionals who volunteer to provide healthcare services in response to the coronavirus pandemic. The Act makes clear that physicians who provide volunteer medical services during the COVID-19 outbreak have liability protections for the extent of the public health crisis.

Medicare Telehealth Flexibilities
The Act grants the Secretary of HHS the authority to waive telehealth coverage requirements for new Medicare patients. Previous legislation provided flexibility only for established patients seen within the past three years. This provision would only remain in effect for the duration of the current COVID-19 emergency. Another provision allows for enhanced use of telehealth under Medicare for federally qualified health centers (FQHCs) and rural health clinics (RHCs). FQHCs and RHCs will be able to serve as distant sites to provide telehealth services to patients in their homes and other eligible locations. Services at these sites would be reimbursed at the national average under the Medicare Physician Fee Schedule.