A bill that would extend the period small businesses can use Paycheck Protection Program (PPP) loans from 8 weeks to 24 weeks (H.R. 7010) passed the U.S. House of Representatives by a vote of 417-1 Thursday. A similar bill is being considered in the U.S. Senate. Vermont Congressman Peter Welch co-sponsored H.R. 7010 and said, “The Payroll Protection Program has provided much-needed funds for thousands of Vermont businesses devastated by the pandemic, but the strict SBA loan forgiveness requirements make the program unworkable for many businesses. Vermont businesses need urgent relief, and these reforms help provide the necessary flexibility so that these loans work for them. This bill is critical to help small businesses survive during this unprecedented crisis.” ThePaycheck Protection Program Flexibility Act of 2020 (H.R. 7010)will:
- Allow forgiveness for expenses beyond the current 8-week covered period to 24 weeks and extend the rehiring deadline.
- Increase the limit for nonpayroll expenses from 25 percent to 40 percent to better match business expenditures.
- Extend loan terms from 2 years to 5 years for new loans.
- Ensure full access to payroll tax deferment for recipients of PPP loans.
Latest CARES Act Funding - All Practices Must Submit Revenue InfoThe Department of Health and Human Services (HHS) announced the second wave of provider relief funds will begin to be distributed. Starting on April 24, a portion of providers were automatically sent an advance payment based off the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to submit their revenue information to the General Distribution Portal . The customer service line confirmed anyone who has a Billing TIN (including a pediatric or obstetric practice) who lost revenue in March and/or can estimate lost revenue in April due to the COVID-19 crisis, should be filling out this portal. Please see further FAQ and guidance from the AMA and the following HHS FAQs.
HHS has extended the deadline for healthcare providers to attest to receipt of payments from the Provider Relief Fund and to accept the Terms and Conditions. Recipients now have 45 days from the date they receive a payment from any of the allocations to attest and accept HHS terms or to return the funds. With the extension, not returning the payment within 45 days of receipt of payment will be viewed as acceptance of the Terms and Conditions. The allocations include:
- HHS is distributing $50 billion across the healthcare system to providers and facilities that bill Medicare.
- HHS is using a portion of the Provider Relief Fund to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured.
Additional Funding Related to Treatment of the UninsuredA portion of the $100 billion Provider Relief Fund will be used to reimburse healthcare providers, at Medicare rates, for COVID-related treatment of the uninsured. Every health care provider who has provided treatment for uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through the program and will be reimbursed at Medicare rates, subject to available funding. Steps will involve: enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit. Providers can register for the program on April 27, 2020, and begin submitting claims in early May 2020. For more information, visit coviduninsuredclaim.hrsa.gov.
The Quality Payment Program (QPP) data submission window has been extended to April 30, 2020. CMS has moved the deadline.
Click here for OneCare practice relief initiatives.
Bi-State VT Telehealth Update
- Medicare will pay physicians for telehealth services at the same rate as in-person visits for all diagnoses, not just services related to COVID-19.
- Patients can receive telehealth services in all areas of the country and in all settings, including at their home.
- Increased reimbursement rates for audio-only telemedicine. The change, which is retroactive to March 1, boosts payments for telephonic evaluation and management services (CPT codes 99441-99443) to match those of regular, in-office E/M visits (99212-99214). Payments will increase from about $14-$41 to about $46-$110.
- CMS expanded the list of services eligible to be reported via telehealth (link here)
- CMS will permit reporting of telehealth E/M office or other outpatient visits based on time or Medical Decision Making (MDM).
- The Qualified Healthcare Professionals that are eligible for telehealth has been expanded. Additional codes for these services were also added to the CMS telehealth list.
- CMS has clarified that telehealth services are permitted with both new and established patients.
- Physicians can reduce or waive cost-sharing for telehealth visits. In addition, all cost-sharing for Medicare beneficiaries is waived for COVID19 testing and visits related to the testing. Modifier CS – Cost sharing must be appended to these claims to ensure cost-sharing.
- Physicians licensed in one state can provide services to Medicare beneficiaries in another state. State licensure laws still apply.
- Well-child care should occur in person whenever possible.
- Well-childcareshould be provided consistentwiththeBright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents(4thEdition)and the correspondingBright Futures/AAP Recommendations for Preventive Pediatric Health Care(Periodicity Schedule).
- Well-child care should occur within the child’s medical home where continuity of care may be established and maintained.
- Where community circumstances require pediatricians to limit in-person well visits:
- Clinicians are encouraged to prioritize in-personnewborn care, and well visits and immunization of infants and young children (through 24 months of age) wheneverpossible.
- Well visits for children may be conducted through telehealth, recognizing that some elements of the well exam should be completed in clinic once community circumstances allow.These elements include, at a minimum: the comprehensive physical exam; office testing, including laboratory testing; hearing, vision, and oral health screening; fluoride varnish; and immunizations.
Tuesday, April 7th, 12:15-12:45pm
Please join VMS, for a weekly COVID-19 update from 12:15-12:45 pm hosted by Vermont Department of Health (VDH) Commissioner Mark Levine.
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Vermont Physician License Renewal to Open in August; CME Requirement Reduced - June 9.2020
The license renewal process for physicians for the next biennium (Dec. 1, 2018 to Nov. 30, 2020) will begin August, 2020 and will close at the end of November, 2020. As an acknowledgement of the cancellation of many CME programs and conferences and the many hours of professional development performed by licensees to learn about COVID-19, the Board of Medical Practice has reduced the CME requirement from 30 hours to 15 hours of AMA PRA Category 1 Credit™, including 1 hour addressing palliative care, hospice care, OR pain management, and 2 hours addressing prescribing-controlled substances for physicians with DEA registrations. These three subject-specific activities count towards the 15-hour requirement (and cannot be waived by the Board as they are required by Vermont State statute). Licensees who have not completed the 15-hour CME requirement may file ‘make-up plans’ along with their license renewal application. For online, free or low cost CME options,click here.For more information about license renewal, see theBoard of Medical Practice webpage.
Vermont’s designated and specialized service agencies are still here to help with mental health, substance use disorder and developmental services needs via video and phone. Clinical assessment, individual therapy, and 24/7 mental health crisis response – among other services – are all just a phone call away and are generally covered by your insurance, Medicaid, or other public funding. Find your local agency. Intake phone numbers and crisis lines are here.