By John Falardeau
In a COVID-19 relief and federal spending package passed earlier this week by a bipartisan group of U.S. House and Senate lawmakers, several important items that the American Chiropractic Association (ACA) lobby team has been pushing for have been included in the measure.
First, included in the legislation is ACA supported language specifying that forgiven Paycheck Protection Program (PPP) loans will not be included in taxable income and clarification that deductions are allowed for expenses paid with proceeds of a forgiven PPP loan, effective as of the date of enactment of the CARES Act and applicable to subsequent PPP loans.
Staying with PPP, ACA supports further expansion of the package included in the bill, an expansion that includes more than $280 billion in new loans to the hardest hit small businesses. Forgivable expenses are expanded to include supplier costs and investments in facility modifications and personal protective equipment to operate safely. In addition, the loan forgiveness process is simplified for borrowers with PPP loans of $150,000 or less. The bill also makes a handful of special set-asides for specific kinds of businesses, such as those with less than 10 employees, and first-time borrowers.
ACA is encouraged that Congress will provide an additional $3 billion in grants to healthcare providers to be reimbursed for healthcare related expenses or lost revenue directly attributable to the public health emergency, along with direction to allocate not less than 85 percent of unobligated funds in the Provider Relief Fund through an application-based portal to reimburse healthcare providers for financial losses incurred in 2020.
Provider Anti-Discrimination Language Included
ACA also supports language in the bill requiring the departments of Health and Human Services, Labor, and Treasury to promulgate a rule within six months of enactment, implementing protections against provider discrimination. The non-MD/DO coalition that ACA belongs to, the Patient Access to Responsible Care Alliance (PARCA), worked to advance this language and we believe that the federal government must help ensure the appropriate implementation of provider nondiscrimination protections under section 2706(a) of the Public Health Service Act (42 U.S.C. 300gg-5(a)). By prohibiting the exclusion of non-MD/DO providers from insurance networks based solely on the provider’s licensure, this consumer-friendly provision promotes competition, consumer choice and high-quality healthcare.
Medicare Fee Schedule Cuts Lessened
Finally, regarding the reimbursement cut approved by the Centers for Medicare and Medicaid Services (CMS) earlier, Congress added an additional $3 billion to the Physician Fee Schedule (through new subsection (t) at SSA 1848), which would be applied in 2021 only and increase fee schedules by 3.75 percent. In essence, the 10 percent cut in the PFS that has been assigned to chiropractors is now a 6.25 percent decrease.
ACA has been active this past year in working to alleviate the cuts through a varied coalition of provider groups. Support for legislation in both the House of Representatives and the Senate for legislation addressing this issue remains high and we expect further collaborative work to continue next year.
Once the relief bill is signed, how to apply for these additional funds will be determined in the following days, so stay informed via ACA social media and our COVID-19 webpage.
John Falardeau is ACA senior vice president of public policy and advocacy.