We want to bring you with the latest news. ASIPP’s hard work is helping during the pandemic.

1. As we covered in the ASIPP e-news last week, the third round of stimulus checks have already begun arriving; however, some physicians are having difficulty receiving these checks. This program is in addition to Phase 1, Phase 2, and Phase 3. Only the providers applying for this phase are eligible to receive the funds. Originally, HHS proposed to use $20 billion for this program; however, it was increased to $24.5 billion. Distribution started on December 16. https://www.hhs.gov/about/news/2020/12/16/hhs-increases-begins-distributing-over-24-billion-in-phase-3-covid-19-provider-relief-funding.html

Even if you applied, you may not receive funds. Essentially, there is a process to apply, unless you already have an established OPTUM pay processing. If you have not already done so, you must complete an OPTUM EPS EFT new enrollment authorization agreement.

The process is as follows:

You must fax your completed EPS EFT form to OPTUM Bank Pay at (844) 207-6458, Attn: Processing Manager. A completed W9 and bank letter and/or voided check copy are required, or the form will be rejected.  

After submission, you may call, 877-620-6194, Option 2, to check the status of your EPS EFT enrollment.

For assistance you may call HHS at (866) 569-3522.

2. COVID-19 stimulus brings essential support to patients and physicians. The emergency relief legislation enacted by Congress on December 21, 2020, advances critically important policies to support patients and physicians during the COVID-19 pandemic, including interventional pain physicians and chronic pain patients by:

• Raising payments for evaluation and management services, by reducing budget neutrality payment reductions.
• Funding COVID-19 testing and tracing and vaccination distribution.
• Funding key public health and workforce programs, providing a second Paycheck Protection Program.
• By providing low-interest loans to small businesses.

RAISING MEDICARE PAYMENTS

ASIPP is very pleased that the legislation provides across-the-board increases in Medicare payments to physicians in all specialties, substantially offset budget neutrality requirements. In addition, there is overwhelming support for the CMS decision to finalize higher payments for office visits and other related evaluation and management services.

• However, the new add-on code (G2211) for visit complexity will be delayed for 3 years.

Overall, this allows for increases in relative values and payments for E/M services to be implemented on January 1, as finalized by CMS in the 2021 Medicare Physician Schedule.

• It provides an additional $3 billion to increase reimbursement for all physician services by 3.5%, which will help to mitigate a substantial portion of the cuts that were expected from budget neutrality while further increasing payments to frontline primary and comprehensive care physicians.

• This means interventional pain physicians will see increases in E/M services. Interventional pain management physicians will see increases of 3.75% for E/M services, and it appears to be for all interventional procedures and surgical services. https://asipp.org/wp-content/uploads/2020/12/2021PhysicianF.pdf

• In addition, this bill delays forthcoming Medicare sequestration payment reductions through March 31, 2021.

PAYCHECK PROTECTION PROGRAM

As we have informed you last week, the legislation will expand the Paycheck Protection Program (PPP) that was established earlier this year, providing more money and more flexibility for recipients. This program has been vital for many of our interventional pain management physicians and small practices, helping them to run the practice, and continue to provide crucial care to the patients in their communities, while absorbing extensive and exuberant costs with decreased revenues. The bill addresses multiple PPP questions. Consequently, the return of PPP is of particular interest to those who are worried about the tax consequences and their accountants who played a significant role in helping millions of small businesses acquire $525 billion in forgivable loans during the 5 months the program was accepting applications, according to SBA reporting. The new round of PPP, or PPP2 as some call it, contains many similarities to the first round of the PPP, but also has several important differences.

WHO IS ELIGIBLE TO APPLY?

PPP2 loans will be available for first-time qualified borrowers, and for the first time, to businesses that previously received a PPP loan. Specifically, previous PPP recipients may apply for another loan of up to $2 million, provided they:

• Have 300 or fewer employees.
• Have used or will use the full amount of their first PPP loan.
• Can show a 25% gross revenue decline in any 2020 quarter compared with the same quarter in 2019.

PPP2 will also permit first-time borrowers from the following groups:

• Businesses with 500 or fewer employees that are eligible for other SBA 7(a) loans.
• Sole proprietors, independent contractors, and eligible self-employed individuals.
• Not-for-profits, including churches.
• Accommodation and food services operations (those with North American Industry Classification System (NAICS) codes starting with 72) with fewer than 300 employees per physical location.

PPP LOAN TERMS

As with PPP1, the costs eligible for loan forgiveness in PPP2 include payroll, rent, covered mortgage interest, and utilities. PPP2 also makes the following potentially forgivable:

• Covered worker protection and facility modification expenditures, including personal protective equipment, to comply with COVID-19 federal health and safety guidelines.
• Expenditures to suppliers that are essential at the time of purchase to the recipient’s current operations.
• Covered operating costs such as software and cloud computing services and accounting needs.

ELIGIBILITY FOR FULL LOAN FORGIVENESS

PPP borrowers will have to spend no less than 60% of the funds on payroll over a covered period of either 8 or 24 weeks.

TAX DEDUCTIBILITY FOR PPP EXPENSES

The bill also specifies that business expenses paid with forgiven PPP loans are tax deductible.

The bill clarifies that “no deduction shall be denied, no tax attribute shall be reduced, and no basis increase shall be denied, by reason of the exclusion from gross income provided” by the CARES Act. This provision applies to loans under both PPP1 and PPP2.

PPP loans are not taxable.

SMALL BUSINESS LOANS

Stimulus package clears path for increased SBA lending by enhancing key elements for the Small Business Administration’s traditional lending efforts. The package authorizes $2 billion for SBA’s programs, and allows the agency to waive borrower and lender fees.

The SBA will be able to raise the standard guarantee on loans to 90% from 75%, retain the size threshold for SBA express loans at $1 million, and authorize express program to expedite approval of loans under $500,000. Further, in all cases, monthly payments are capped at $9,000.

CHANGES TO THE EMPLOYEE RETENTION TAX CREDIT

A massive change for companies in the new stimulus bill is that companies will be able to take advantage of both PPP loans and the Employee Retention Tax Credit (ERTC). It also greatly expands the ERTC in 2021 with the new ERTC credit offering maximum of $14,000 for employee through June 30, 2021. It appears that if a business used and exhausted a PPP loan in 2020, they could then use ERTC to help with their 2020 taxes.

We will bring more news and details as we move on. Some of the elements of the nearly 5,600-page bill are not quite interpreted yet. We will continue to update member as additional information is released.  

This is good news during the pandemic for all physicians and patients, specifically members of the American Society of Interventional Pain Physicians. We have been working on these a multitude of issues tirelessly over the years, but none as complex and challenging as the issues related the COVID-19 pandemic. We have been fighting for your survival from the onset and will continue to do so.

If you have any questions, please feel free to contact us.