Federal Programs for Pediatric Practices and Small Businesses

Many pediatric practices are facing significant challenges and economic strain due to the COVID-19 pandemic. This document provides an overview of new resources potentially available to pediatric practices through the Families First Coronavirus Response Act (FFRCA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Below is an overview of key programs that may be of interest to AAP members.

Disclaimer: This information is rapidly evolving. Details related to the following programs may become quickly outdated. Please consult your accountant, banker, financial advisor, or human resources consultant for additional guidance about the right business decisions for your practice.

Loans/Grants

Paycheck Protection Program

This new loan program provides federally guaranteed, forgivable loans of up to $10 million available to qualifying small businesses.

Economic Injury Disaster Loans and Loan Advance

The SBA’s Economic Injury Disaster Loan program provides economic relief to businesses that are currently experiencing a temporary loss of revenue.

Additional Member Resource

New Financing Program for AAP Members: The AAP has partnered with Bankers Healthcare Group, a direct lender who has been working with healthcare professionals for nearly twenty years. BHG is offering AAP members a no-payment incentive, for up to 60 days*, for access to the funds. Loan features include:

• No payment due for 60 days on new loans
• Flexible repayment terms
• Fast approval and funding

¹Subject to credit approval. Loan sizes and interest rates vary and are determined by applicant’s credit profile. Loans made or arranged pursuant to the California Financing Law, License No. 603-G493. Call for full program details. *Deferred loan program not available in Tennessee, Mississippi, Vermont, Rhode Island, North Dakota, and South Dakota.

The partnership also includes Fund-Ex Solutions Group, a wholly-owned subsidiary of BHG, who can assist members with SBA 7(a) loans  and other financial assistance programs. Businesses with fewer than 500 employees, sole proprietors, independent contractors, and self-employed individuals are eligible.

Employment Resources

Paid Family and Sick Leave

The Families First Coronavirus Response Act significantly expanded the Family and Medical Leave Act (FMLA) for needs related to COVID-19.

Employee Retention Credit for Employees Subject to Closure Due to COVID-19

Employers who are providing required paid sick or family leave wages to employees who are unable to work or telework due to certain circumstances related to COVID-19 may be entitled to a refundable tax credit.

Unemployment Insurance

Unemployment insurance programs exist in every U.S. state and territory to provide benefits to those who have become unemployed through no fault of their own. These programs are a federal-state partnership much like the Medicaid program: the federal government helps provide funding and sets certain national parameters, but each state has ultimate responsibility for running its own unemployment program.

Recently, Congress made several changes to the program in response to the COVID-19 pandemic. States can provide an extra $600 per week in benefits and extend the length of those benefits for an additional 13 weeks. In addition, states can now pay benefits in circumstances where:

• An employer temporarily ceases operations due to COVID-19, preventing employees from coming to work;
• An individual is quarantined with the expectation of returning to work after the quarantine is over; and
• An individual leaves employment due to a risk of exposure or infection or to care for a family member.

Depending on the rules in your state, part-time employees may receive unemployment benefits if their hours were recently reduced.

For information on how employees can apply for unemployment benefits, contact your state unemployment office. The U.S. Department of Labor supports an Unemployment Benefits Finder website that will connect you to resources in your state.

Payroll Tax Deferral

The CARES Act allows employers to defer paying their 6.2 percent Social Security payroll (FICA) tax on employee wages paid through the end of 2020. This deferred tax must ultimately be paid in two installments in 2021 and 2022. However, employers who receive loan forgiveness under the Paycheck Protection Program are not eligible for this payroll tax deferral.

Provider Relief Fund

The CARES Act and the Paycheck Protection Program and Health Care Enhancement Act provide $175 billion for grants though the Public Health and Social Services Emergency fund to provide immediate financial relief by covering non-reimbursable expenses and lost revenue attributable to COVID-19. Health care entities, such as physician practices, that provide health care, diagnoses, or testing will be eligible for grants to pay for PPE, testing supplies, increased workforce training, emergency operation centers, and more.

HHS is instructed to review applications and make payments on a rolling basis to get money into the health system as quickly as possible. $50 billion of the Provider Relief Fund has been allocated for general distribution to facilities and providers that bill Medicare and are impacted by COVID-19, based on eligible providers' 2018 net patient revenue.

If you billed Medicare in 2019, you may be eligible for additional funds available now. You can assess your eligibility through this portal (note: you must have received Medicare fee-for-service payments in 2019 to be eligible for this funding and to access the portal). More information about the currently available funds is here. The Academy is advocating for Provider Relief funding to be immediately available to pediatric providers who do not participate in Medicare.

COVID-19 Claims Reimbursement for Testing and Treatment to Health Care Providers and Facilities Serving the Uninsured

Both the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security (CARES) Act appropriated funding to reimburse providers for conducting coronavirus testing for the uninsured. Under the program, HHS will provide claims reimbursement to health care providers generally at Medicare rates for testing uninsured patients for COVID-19 and treating uninsured patients with a COVID-19 diagnosis.

More information: https://www.hrsa.gov/coviduninsuredclaim

If you have any questions, please contact us at [email protected]. Additionally, you can post questions to your peers at the AAP COVID-19 virtual community.