April 2020
Resources for Financially Struggling Practices
Several State and Federal resources are available to help small and medium sized practices (less than 500 employees) cope with the negative financial effect of the COVID pandemic.
Paycheck Protection Program
Under the Paycheck Protection Program:
- Awardees can receive up to $10 million on a first-come-first-served basis.
- Loan payments will be deferred for six months.
- The loan will be forgiven if you maintain your workforce (and quickly rehire employees cut after Feb. 15) and the borrowed funds are used within first eight weeks exclusively for payroll expenses, existing interest, rent, lease, and/or utility payments.
- You can call your bank or credit union or find SBA-approved lenders in your area through SBA’s online Lender Match tool, and complete and download the application.
Economic Injury Disaster Loans
Small business owners are eligible to apply for an Economic Injury Disaster Loan and an advance of up to $10,000. Funds will be made available within three days of a successful application, and the loan advance will not have to be repaid. If a small business has an urgent need for cash while waiting for decision and disbursement on an Economic Injury Disaster Loan, they may qualify for an SBA Express Disaster Bridge Loan. Find an Express Bridge Loan Lender by connecting with your local SBA District Office.
State Resources
- Apply for the Unemployment Insurance (UI) Work Sharing Program to avoid laying off employees.
- All state taxpayers (individuals and businesses) can file and pay by July 15, 2020, matching the extended federal tax deadline.
- The state has compiled a list of assistance programs and regularly updated resource database.
Executive Order Changes Licensing, Scope Rules
Governor Gavin Newsom issued a wide-ranging executive order this week, giving the California Department of Consumer Affairs (DCA) the authority to temporarily loosen restrictions on staff-to-patient ratios at medical facilities and scope of practice rules for nurse practitioners (NP) and physician assistants (PA). The Director of DCA, Kimberly Kirchmeyer, said the state would give hospitals the authority to lift the cap on the number of PAs and NPs who can work under a supervising physician (currently limited to four each). As of today, there has been no indication that independent practice of medicine will be granted to non-physicians. The Director indicated that four other waivers have been initiated:
- Waiver of any CME or examination requirements for the renewal of licenses that occur between now and June 30, 2020, as well as a grace period up to six months after the state of emergency ends.
- Reinstatement of inactive/retired licenses of five years or less.
- Allow nursing students to use their time working during this crisis to count toward their clinical hours.
- Allow residents who complete their first year by June 2020 to become fully licensed without meeting the new 36-month residency requirement.
CAFP is in touch with the administration and organized medicine regarding these changes and will monitor DCA closely for any future action.
Telehealth Payment Update
During the COVID state of emergency, all California PPOs and HMOs, as well as Medicaid and Medicare (though excluding self-funded ERISA plans), are required to pay clinicians for telehealth services (including telephone visits) as they would in-person care. Plans may not subject enrollees to cost-sharing greater than if the service were provided in person. PLEASE NOTE: practices must ensure that their documentation matches the requirements of the CPT code they are billing, as well as appropriate use of the place of service (POS) code. Noridian has indicated that you should bill with the POS equal to where the services would have taken place (i.e., in office) if not for a public health emergency, along with a modifier 95, indicating that the service rendered was actually performed via telehealth.
In addition, Health Net will provide one-time funding (47 grants with a maximum of $125,000 per award) to California safety net clinics, Federally Qualified Health Centers, and independent provider practices to help build telehealth capacity and capability. Go to: http://healthnet.smartsimple.com to learn more.
New COVID-19 Initiative Seeks to Expand Workforce
The Governor announced a new website this week, https://covid19.ca.gov/healthcorps/, to encourage clinicians not currently in the workforce to help the State address an anticipated COVID-19 surge. Those who register will be paid and given malpractice insurance coverage. Locations will vary, but the State will try to match your geographical preferences. The state is specifically looking for:
- Physicians (MD, DO), and medical students
- Pharmacists
- Dentists
- Nurse practitioners
- Physician assistants
- Nurses (RN, LVN, CNA), and nursing students
- Behavioral health professionals
- Respiratory therapists
- Paramedics
- Medical assistants
- Emergency medical technicians
To be eligible for COVID-19 emergency medical staffing roles, you must:
- Be 18 years of age or over
- Be eligible to work in the United States
- Have a valid driver’s license or passport, and a social security card
- Have a valid California License for clinical practice
- Or are a medical student or nursing student
- Have no negative licensure/certification actions
