With the damage the coronavirus shut-down has done to businesses, including health care practices, the government has stepped in to create an economic lifeline. However, with the uncertainty of the rapidly changing situation, it is important to stay up to date on the available resources and requirements.
While the CARES Act provided some needed relief to healthcare providers, once receivables began to dry up, many practices were in a bind regarding payroll, which is where the Paycheck Protection Program (PPP) came in. The time frame to use these funds, which were available to all businesses, has been expanded from eight weeks to 24 weeks. PPP money, which is considered a low-interest loan, can qualify for loan forgiveness if employees are paid at no less than a 25 percent reduction in salary. "If the loan doesn't qualify for forgiveness, the repayment period has been extended to five years at one percent interest,"said Sae Evans, CPA with Warren Averett.
Unemployment has skyrocketed with the pandemic, leaving many medical practices with questions about unemployment benefits and the extra benefits provided by congress for furloughed workers. Some practices have encountered a touchy situation when essential workers who are working with reduced hours are earning less than furloughed employees who stay home and receive expanded unemployment benefits. It is important to find a way to let essential employees know they are appreciated.
In response to the pandemic, Congress has passed the Emergency Paid Sick Leave Act which established 80 hours of paid sick leave for employees who are quarantined, showing symptoms or who are ill from the virus or who are caring for family in a similar situation.
"To recoup the cost of paid leave, the IRS allows the employer to retain a portion of payroll taxes equal to the amount paid," Evans said. "If taxes are insufficient to cover the amount, accelerated payments can be applied.
"The financial impact of the virus on providers has varied by specialty. Although elective procedures were postponed during lockdowns, some care such as trauma, heart attacks, cancer treatment and other urgent conditions was essential and had to continue. Other specialties, such as mental health, managed to adapt with the help of broader guidelines for telemedicine and telephone visits."
Tammie Lunceford, CMPE, CPA
"We've been advising providers to think more about services they may not have offered in the past that they could offer through portal visits, telemedicine, telephone or other methods to continue generating income and taking care of their patients," said Tammie Lunceford, CMPE, CPA, also with Warren Averett. "Chronic care management and wellness are areas that might fit in well with alternative modes of access."
With many patients losing jobs and insurance coverage, it's likely that providers will be working more closely with them on the financial aspects of their visits as the economic impact of the pandemic evolves.
"Right now, providers are tending to take a less active approach to collections," Lunceford said. "Kindness is good, but it's important to not let collections slide too far. Communicate with your patients. Let them know that you will work with them so they can pay what they can afford in smaller installments. As long as they talk with you and keep paying a little regularly, the relationship can continue. You don't have to lose patients because they are embarrassed that they owe money and don't know they can arrange payments."
"We don't know what is coming next, or how much help we can expect from Washington in the future," Evans said. "We don't know how long the pandemic will last, or when things will get back to normal.
"What we can do is be proactive. We can use the lessons we've learned. We can work to keep our providers and team healthy, safe and able to continue caring for patients. We can optimize opportunities and day by day, we can get through this."