Bill Finerfrock, HBMA Director of Government Affairs, will break down the CARES Act and its associated programs to provide you with key takeaways to help ease financial burdens and maintain current staff levels. In this webinar, Bill will discuss: -New Paycheck Protection Program -Other SBA (Small Business Association) programs -Medicare Advanced Payment Options -Provider Lost Revenue Program

1. Bill Finerfrock
Director of Government Affairs
Healthcare Business Management Association (HBMA)
Leveraging Federal Financial
Assistance Programs During
COVID-19

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3. • New Paycheck Protection Program
• Other SBA Options
• IRS – Employee Retention Credit
• Medicare Advanced Payment Options
• Provider Lost Revenue Program

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5. Bill Finerfrock
Director of Government Affairs
Bill Finerfrock has worked in and with the U.S. Congress and Federal agencies for
more than 40 years. Mr. Finerfrock began his political career in Washington in 1976
as a Lyndon Baines Johnson Congressional Intern for Congressman Bob Edgar (D-PA).
Between 1977 and 1984 he worked for Senator Edward W. Brooke (R-MA) and
Senator Roger Jepsen (R-IA). From 1985–1993, he was Director of Federal Affairs for
the American Academy of Physician Assistants.
Since 2014, he has been the President and owner of Capitol Associates, a health
policy consulting and advocacy firm. Prior to becoming the owner, Finerfrock had
been a Senior Vice President at the firm since 1993.
He has been working with the Healthcare Business Management Association for
more than 15 years. Bill specializes in healthcare finance, health system reform,
health workforce and rural health issues.
Disclaimer: I am neither a lawyer nor a certified business/financial consultant. This
presentation is intended to provide you with information about programs you or your
clients might find of interest as you navigate through the COVID-19 Pandemic.

6. HBMA During the Pandemic
Coronavirus/COVID-19 Resources Page
Federal Updates by Email
Timely Webinars
• Moving to Remote Operations
• Telehealth Updates
• COVID-19 Impact on Our Business (Member Panel)
• Leveraging Federal COVID-19 Programs for Your Business
Virtual Coffee Shops – informal way to connect

7. Paycheck Protection Program

8. Paycheck Protection Program: What Is It?
The Paycheck Protection Program is a
newly created loan/grant program.
Eligible businesses can receive a
forgivable loan in an amount equal to 2.5
times the company’s qualified monthly
payroll.
For purposes of this program, an eligible
business is a business with up to 500
employees (full-time or part-time).

9. Calculating Your Eligible Monthly Payroll Amount
Most eligible businesses will use their average
monthly payroll for 2019, excluding
compensation over $100,000 on an annualized
basis for each employee making more than
$100,000 annually.
If you are a NEW business, average monthly
payroll should be calculated using the time
period from January 1, 2020 to February 29,
2020, excluding compensation over $100,000
on an annualized basis for each employee.

10. How Much Can You Borrow?
To calculate the total amount you can
borrow, multiply your eligible
monthly payroll amount by 2.5 and
this is the amount you can borrow
under this program.
Here is an Example –
Monthly Payroll Amount:
$17,500 x 2.5 = $43,750 loan amount.

11. How Much Can Be Forgiven?
The entire loan can be forgiven if the
business meets certain
requirements.
If the business fails to meet the
requirements, then the amount
forgiven will be reduced or you may
have to pay the entire amount back.

12. What Must A Business Do For
The Loan To Be Forgiven?
In order for the loan to be forgiven, the small business must demonstrate that the loan monies were
used to pay employee salaries, health insurance premiums, rent or mortgage interest and utilities.
The business owner(s) must attest that you have the same number of employees (full-time and part-
time) at the end of the loan period (8 weeks) as you did at the beginning.
If you terminated employees during this period OR you reduced their salaries by more than 25%,
then you may have to pay a portion or the entire loan back – 2 years @ 1%.

13. For More Information
https://www.sba.gov/funding-programs/loans/coronavirus-
relief-options/paycheck-protection-program-ppp

14. Paycheck Protection Program
Here is the application:
https://home.treasury.gov/system/files/136/Paycheck-Protection-
Program-Application-3-30-2020-v3.pdf
For more info, go here:
https://www.sba.gov/funding-programs/loans/coronavirus-relief-
options/paycheck-protection-program-ppp

15. Participating Banks?
You can apply through any existing SBA 7(a)
lender or through any federally insured
depository institution, federally insured
credit union, Farm Credit System institution
that is participating.
Other regulated lenders will be available to
make these loans once they are approved
and enrolled in the program. You should
consult with your local lender as to
whether it is participating in the program.

16. Other SBA Options
Disaster Relief Programs

17. SBA Debt Relief
The SBA Enhanced Debt Relief program
will provide a reprieve to small businesses
as they overcome the challenges created
by the COVID-19 crisis.
The SBA will pay the principal and interest
on existing SBA 7(a) loans for a period of
six months.
Contact your local SBA loan office for
details.

18. Small Business Economic Injury Disaster Loan (EIDL)
Small Business Administration (SBA) loan
for up to $2 million*, including a $10,000
grant up front. May be used to pay fixed
debts, payroll, accounts payable and other
bills that can’t be paid because of the
disaster’s impact.
Interest rate of 2.75%, payable over up to
30 years. Can defer initial payments for up
to a year.
Apply directly at the SBA. Applicants may
apply online or call 1-800-659-2955.

19. NOTICE: You Cannot Use Loans
to Pay for the Same Expenses
You can have simultaneous loans as
long as the funds are being used for
different purposes.
Your SBA representative should work
with you to determine the best
combination/mix or sequencing of
these loan options.

20. IRS – Employee Retention Credit

21. IRS – Employee Retention Credit
The Treasury Department has launched 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.
The IRS/Treasury Department encourage businesses to take full
advantage of the Employee Retention Credit to keep employees
on their payroll.
This new credit is available to all employers, regardless of size of
business, and covers up to 50 percent of up to $10,000 in wages.

22. Qualifying Employers Must Fall Into One
of Two Categories:
1. The employer’s business is fully or partially
suspended by government order due to
COVID-19 during the calendar quarter.
2. The employer’s gross receipts are below 50
percent of the comparable quarter in 2019.
Once the employer’s gross receipts go above
80 percent of a comparable quarter in 2019 they
no longer qualify after the end of that quarter.
These measures are calculated each calendar quarter.

23. IRS – Employee Retention Credit
The amount of the credit is 50 percent of qualifying wages paid up to
$10,000 in total. Wages paid after March 12, 2020, and before January 1,
2021 are eligible for the credit. Wages taken into account are not limited
to cash payments, but also include a portion of the cost of employer
provided health care.

24. For More Information Please Visit:
Updates on the implementation of this credit:
https://www.irs.gov/coronavirus
And for more info on this program, go to:
https://home.treasury.gov/system/files/136/
Employee-Retention-Tax-Credit.pdf
You are encouraged to talk with your tax
business advisor about this tax credit.

25. Medicare Advanced Payments

26. Medicare Advanced Payment Option
CMS has relaxed the requirements for
providers wishing to obtain an advance
payment on future Medicare claims.
CMS is authorized to make advanced
payment through the duration of the
COVID-19 national public health emergency.
Application is through the provider’s
Medicare Administrative Contractor (MAC).

27. Who is Eligible for Advanced Payments?
Any provider…
1. Who has billed Medicare within
the past 180 days.
2. Who is not in bankruptcy.
3. Not under active medical review
or program integrity investigation.
4. Does not have any outstanding
delinquent Medicare overpayments.

28. Amount of Advanced Payment
The provider is limited how much can be requested – an
amount equal to the average monthly Medicare payments
for up to three months. Provider should consider that this
advanced payment will have to be paid back out of future
Medicare receipts. Repayment will begin – automatically –
120 days after the advance and must be fully repaid within
210 days of receiving the advance.
If Advanced Payment is NOT repaid within 210 days, CMS
begins charging INTEREST on this “loan”.

29. Can The Provider Continue To Submit Claims
During The 3-Month Advance?
Yes, the provider is not precluded
from submitting claims during the
3-month period covered by the
advance. Recoupment will still not
occur until 120 after receipt of the
advance.

30. Provider Lost Revenue Program

31. Provider Lost Revenue Program
Due to the COVID-19 pandemic, many physicians
have seen a precipitous drop in patient visits,
cancelation of “elective” non-essential surgeries, etc.
The purpose of this fund is to provide grants to
practices that have experienced a reduction in
revenue or an unexpected increase in costs due to
the COVID-19 pandemic. The money will be available
during the period of the national emergency.

32. Provider Relief Program
Submitted claims to Medicare in 2019 is eligible for a payment from this fund.
The Operation of this program is being done under contract with United Health
Group/Optum.
MOST providers began seeing money deposited in their accounts last Friday (4/10).

33. What Is The Provider Relief Program?
This is a brand-new program, authorized by
Congress and signed into law by the President as
part of the CARES Act – legislation signed into law
on March 27th.
Congress authorized $100 Billion for this program
to be administered by the Department of Health
and Human Services (HHS).

34. Provider Relief Program
On Friday, April 10th, CMS released the first
$30 Billion from this fund.
ANY “Provider” or “Supplier” who is
enrolled in Medicare or Medicaid.

35. Provider Relief Fund
Here is the formula CMS is using to determine the individual amount. Payment is
based on TIN and the Medicare enrolled provider to whom that TIN is linked.
Provider Medicare Payments for 2019 divided by $484,000,000,000. You then
multiply this number by $30,000,000,000.
OR
You multiply your 2019 Medicare payments by 6.1%

36. What MIGHT This Look Like?
1. Provider’s average monthly for 3/1 2019 – 12/28 2019 was $100,000.
2. Provider’s revenue in March 2020 was $20,000.
3. Providers estimated lost revenue $80,000.
4. HHS sends provider a check for $80,000.

37. Terms and Conditions: Relief Fund $$$
The Recipient certifies that it billed Medicare in 2019; currently provides diagnoses,
testing, or care for individuals with possible or actual cases of COVID-19; is not
currently terminated from participation in Medicare; is not currently excluded from
participation in Medicare, Medicaid, and other Federal health care programs; and
does not currently have Medicare billing privileges revoked.

38. Terms and Conditions: Relief Fund $$$
The Recipient certifies that it will not use the Payment to reimburse expenses or
losses that have been reimbursed from other sources or that other sources are
obligated to reimburse.
The Recipient certifies that the Payment will only be used to prevent, prepare for,
and respond to coronavirus, and shall reimburse the Recipient only for health care
related expenses or lost revenues that are attributable to coronavirus.

39. Provider Relief Fund
As a condition, providers are obligated to abstain from
"balance billing" any patient for COVID-related
treatment.

40. Awards and Rankings

43. Questions
Answers
For more COVID-19 resources and information, click here. To contact Bill Finerfrock

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