U.S. House of Representatives Approves Continuing Resolution

On September 22, 2020, the U.S. House of Representatives approved a continuing resolution to keep the government funded through December 11, 2020.  Under current law, government funding is set to expire at midnight on September 30, 2020.

The House resolution is a stopgap measure that would maintain funding for most government programs at their current Fiscal Year 2020 levels.  However, the Continuing Resolution omits $30 billion in agricultural aid sought by the Trump Administration and Senate Republicans.  As of last week, it appeared that a compromise had been struck between the Administration and Speaker Pelosi under which the agricultural aid would be tied to the extension of special food benefits to recipients of free or reduced-price school lunches authorized by the Families First Coronavirus Response Act.  The Continuing Resolution also does not include new spending on economic aid for those impacted by the coronavirus.

The Continuing Resolution will now go to the U.S. Senate for consideration.

Impact on Repayment of Medicare Accelerated and Advance Payments

In response to the COVID-19 pandemic, CMS announced that it would be opening the Medicare Accelerated and Advance Payment Program (AAPP) to all health care providers and suppliers that were impacted financially by the pandemic.  Under the AAPP, Medicare-enrolled providers and suppliers were eligible to receive an advance of up to three months of their historic Medicare payments.  These advances were structured as “loans,” and were required to be repaid through the offset of future Medicare payments.  CMS began accepting applications for Medicare advances in mid-March 2020, before ending the program in late April following the passage of the CARES Act.  CMS ultimately approved more than 45,000 applications for advances totaling approximately $100 billion, before it suspended the program in late April 2020.

Under the existing terms of the AAPP, repayment through offset was required to commence on the 121st day following the provider or supplier’s receipt of the advance funds.  The program also called for a 100% offset until all advanced funds had been repaid.

The American Ambulance Association, the American Hospital Association, the Association of American Medical Colleges, and numerous other advocacy groups have advocated that the AAPP be revised to give health care providers and suppliers greater flexibility to repay the advanced funds.  The AAA and others argued that these changes were necessary to avoid a financial crisis when CMS began offsetting Medicare payments to repay the advanced funds.  A copy of the AAA’s letter to CMS Administrator Seema Verma can be viewed by clicking here.

In the Continuing Resolution, the House addressed this issue by making the following changes to the AAPP:

  • Hospitals and Other Part A Providers: Upon request of the hospital or other Part A provider: (1) provide for 1 year before claims are offset to recoup the advanced funds, (2) limit the offset to not more than 25% of the payment on a future claim for the first 11 months during which offsets are required, (3) limit the offset to not more than 50% during the next 6 months, (4) provide for up to 29 months (from the date the advanced payments were first received) before requiring that the outstanding balance be paid-in-full, and (5) limit the interest charged on the unpaid principal balance of any advanced funds to 4%.
  • Part B Suppliers: Upon request of the supplier: (1) provide for 1 year before claims are offset to recoup the advanced funds, (2) limit the offset to not more than 25% of the payment on a future claim for the first 11 months during which offsets are required, (3) limit the offset to not more than 50% during the next 6 months, (4) provide for up to 29 months (from the date the advanced payments were first received) before requiring that the outstanding balance be paid-in-full, and (5) limit the interest charged on the unpaid principal balance of any advanced funds to 4%.

The Continuing Resolution would require the HHS Secretary to post within 2 weeks of enactment (and updated every 2 weeks thereafter) the following information related to the AAPP on the CMS website:

  • The total amount of such payments under each part of the program, including the specific percentage of such payments made out of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Insurance Trust Fund;
  • The total amount of payments under each part of the program, by industry type;
  • The CMS identifier and the amounts received by each health care provider or supplier.

HHS would also be required to post periodic reports, starting in July 2021 and every six months thereafter until all AAPP amounts have been repaid, that contain the following:

  • The total amounts yet to be repaid;
  • The total amounts yet to be repaid, by industry type;
  • The total amounts repaid under each program, including the specific percentage of such repayments deposited back to the Federal Hospital Insurance Trust Fund or the Federal Supplementary Insurance Trust Fund; and
  • The total interest collected on all repayments

The Senate will most likely approve the House CR before the September 30, 2020 deadline.

 

Contact the White House About Ambulance Funding

Congressional leaders and White House senior officials remain deeply divided in negotiating an additional stimulus package in response to the COVID-19 pandemic. Last week, Senate Republicans unveiled a smaller, limited package of COVID-19 relief. This “skinny” bill failed in the Senate in a 52-47 vote, with all Republicans except Sen. Rand Paul of Kentucky supporting it, falling short of the 60 votes needed to advance.

Unfortunately, Democrats and Republicans in Congress remain far from a passable stimulus package, and little progress is expected until after the 2020 election. Until then, the American Ambulance Association remains focused on ensuring ambulance service providers and suppliers have the resources they need to continue combating the coronavirus. The AAA is keeping in contact with Congressional and Administration officials as we push for expanded federal relief for the EMS industry.

Not over yet

While negotiations between Congress and the White House have stalled, there are still opportunities to advance the needs of EMS. The federal Department of Health and Human Services holds $50 billion in unappropriated stimulus dollars in its Provider Relief Fund. The AAA and our members have been doing a full-court press on the White House to allocate part of the $50 billion for ground ambulance services. We at the AAA strongly encourage you to use our platform to contact your federal elected officials and urge them to appropriate an additional $2.62 billion from the Provider Relief Fund directly to ambulance service providers and suppliers

We would like to thank the hundreds of AAA members who have already written their elected officials about the need for increased funding for EMS using our new platform which makes contacting your federal elected officials as easy as a few clicks.

Help us help you

If you have not already done so, please use our platform to contact your Members of Congress and the White House to ensure EMS voices are heard during these unprecedented times.

Contact your Elected Officials

 

Amid Stimulus Impasse, Bipartisan Group Offers $1.5 Trillion Compromise

From the New York Times

Members of the House Problem Solvers Caucus plan to map out a recovery package they hope can push top Democrats and White House officials back to the negotiating table…

A bipartisan group of 50 centrist lawmakers plans on Tuesday to present a $1.5 trillion plan to prop up the coronavirus-ravaged economy, making a last-ditch attempt to broach a compromise in hopes of breaking a stalemate in stimulus talks before November’s elections.

The proposal faces long odds amid partisan divisions over what should be included in such a package, and members of the group — which calls itself the House Problem Solvers Caucus — concede privately that their framework stands little chance of becoming law. But the decision to offer it up publicly reflects frustration among rank-and-file lawmakers in both parties at the failure by their leaders to agree to another round of pandemic aid, and a reluctance to return home weeks before Election Day without cementing such help.

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Use AAA’s New Online System to Contact Your Members of Congress on EMS Funding

The American Ambulance Association is pleased to announce our new advocacy software to make contacting your Members of Congress even easier. With just a few clicks, you can contact your Senators and Representative without hassle.

Follow the button below to send messages to Congress within minutes:

Contact Congress Today

As we reach the end of Congressional negotiations, it is critical now more than ever that you contact your Senators and Representative and ask them to support increased funding for ambulance service providers under the Public Health and Social Services Emergency Fund specifically for the increased costs, loss of revenue and uncompensated care facing ground ambulance service organizations due to COVID-19.

In addition to advocating for Congress to include funding specifically for ground ambulance services in the next COVID-19 economic relief package, the AAA is pressing for the Department of Health and Human Services to allocate more funding to EMS under the $75 billion already appropriated to the PHSSEF through the Paycheck Protection Program and Health Care Assistance Act.

The AAA will continue to fight for our members as your paramedics and EMTs are on the front lines of combating the Coronavirus.

 

HHS Report Calls for Congressional Action to Combat Surprise Billing

From HHS.gov on July 29, 2020

HHS Secretary’s Report Calls for Congressional Action to Combat Surprise Billing and Promote Price Transparency

Today, the U.S. Department of Health and Human Services released the HHS Secretary’s Report on Addressing Surprise Billing. The report, called for in Section 7 of President Trump’s Executive Order 13877, Improving Price and Quality Transparency in American Healthcare to Put Patients First, outlines critical steps, including Congressional action, to implement the Administration’s principles on surprise billing. Sound surprise billing legislation will not only protect patients but will encourage a fairer, more transparent, patient-centered healthcare system that benefits all Americans.

“Americans have the right to know what a healthcare service is going to cost before they receive it,” said HHS Secretary Alex Azar. “President Trump and his administration have done their part to deliver historic transparency around the prices of many procedures. Now it’s time for Congress to do what we all agree is necessary: combat surprise billing with an approach that puts patients in control and benefits all Americans.”

Surprise medical billing is a widespread and costly problem in the United States, and the need to address it has been highlighted during the Public Health Emergency (PHE) presented by COVID-19. Research shows that 41 percent of insured adults nationwide were surprised by a medical bill in the past two years alone, and that two thirds of adults worry about their ability to afford an unexpected medical bill.  At a time when Americans are increasingly seeking medical care, practices such as surprise billing leave many patients vulnerable to the financial burdens presented by a nationwide pandemic.

HHS has taken regulatory and administrative action to increase price transparency permanently. On June 24, 2019, President Trump signed Executive Order 13877. Following direction from this Executive Order, HHS published two rules supporting the Administration’s mission to improve accessibility of healthcare price information to help patients make informed decisions about their use of healthcare services. The first, poised to go into effect January 1, 2021, requires hospitals operating in the United States to establish, update, and make public, at least annually, a list of their standard charges for the items and services that they provide. The second companion proposed rule would demand similar transparency from most group health plans and issuers of health insurance coverage within both the individual and group markets.

To supplement this progress, Congress must take additional action to build on the achievements of the Administration to eliminate the threat of surprise billing once and for all. This should be accomplished with the following principles in mind, as laid out by the Trump Administration on May 9th, 2019:

  • Patients receiving emergency care should not be forced to shoulder extra costs billed by a care provider but not covered by their insurer;
  • Patients receiving scheduled care should have information about whether providers are in or out of their network and what costs they may face;
  • Patients should not receive surprise bills from out-of-network providers they did not choose; and
  • Federal healthcare expenditures should not increase.

If done swiftly, a remarkable burden will be lifted from the shoulders of millions of Americans. By building on the foundation placed by Executive Order 13877, there is an opportunity to fill the remaining gaps and solve comprehensively a longstanding flaw, equivalent to price-gouging, within our healthcare industry.

URGENT: Ask Congress to Support EMS-Specific Relief

Ambulance services, please follow the instructions below. Members of the community, please click here to send an email!

Contact Your Members of Congress Today on Ambulance Specific Funding!

Congress returned this week from recess and has three weeks in which to get another COVID relief package passed before their August recess.

Please contact your Senators and Representative today and ask that they advocate for a funding program under the Public Health and Social Services Emergency Fund specifically for the increased costs, loss of revenue and uncompensated care facing ground ambulance service organizations due to COVID-19.

Please e-mail your Senators and Representative today!

 It will take you only a few minutes per Congressional office to email a letter. Just follow these steps.

 1. USE LETTER TEMPLATE: CLICK HERE to access a draft letter. Please customize your letter including the cities and towns you serve, and any additional details as to services you are providing during the COVID-19 outbreak and the financial impact on your operation.

2. LOOK UP YOUR SENATORS AND THEIR WEBFORM ADDRESS: CLICK HERE to access a list of the webform addresses of your Senators.

3. LOOK UP YOUR REPRESENTATIVE AND THEIR WEBFORM ADDRESS: CLICK HERE and enter your zip code to find the online contact form of your Representative.

4. SEND LETTERS TO MEMBERS: Follow the webform link into your Internet browser and you will be directed to the webpage for contacting your member of Congress. Fill in your contact information, cut and paste your letter into the comments box and hit submit.

In addition to advocating for Congress to include funding specifically for ground ambulance services in the next COVID-19 economic relief package, the AAA is pressing for the Department of Health and Human Services to allocate more funding to EMS under the $75 billion already appropriated to the PHSSEF through the Paycheck Protection Program and Health Care Assistance Act.

The AAA will continue to fight for our members as your operation and paramedic and EMTs are on the front lines of combating the Coronavirus.

Always In Our Hearts

Please join the American Ambulance Association in honoring those who have fallen serving their communities in the COVID-19 pandemic.

What does it mean to be a hero? Paramedics, EMTs, nurses, and firefighters risk their lives every day to serve on the…

Posted by American Ambulance Association on Tuesday, June 30, 2020

Senate Passes PPP Flexibility Act

On June 3, the U.S. Senate passed on voice vote the Paycheck Protection Program Flexibility Act of 2020. The legislation was passed by the House on May 28. The President is expected shortly to sign the bill into law.

The Paycheck Protection Program Flexibility Act (H.R. 7010) provides small businesses with more flexibility in how the Paycheck Protection Program (PPP) funds established under the CARES Act can be spent.

Under this new bill, borrowers who furloughed or laid-off workers will not be subject to a loan forgiveness reduction due to reduced employee count as long as they restore their pre-COVID employment by the new deadline of December 31, 2020. Businesses will also have 24 weeks instead of just 8 weeks to spend the funds.

This legislation lowers the minimum percentage of PPP loans that must be allocated towards payroll from 75% to 60% and clarifies a borrower does not have to begin repaying a loan until the SBA determines whether or not the business is eligible for loan forgiveness.

The PPP Flexibility Act also lifts the ban on borrowers whose loans were partially or completely forgiven from deferring payment of payroll taxes. The payroll tax deferral is now open to all PPP borrowers.

The PPP provides businesses with fewer than 500 employees, including ground ambulance service organizations, with access to loans at favorable terms to cover employee payroll for an original timeframe of eight weeks. Under the CARES Act, a borrower can have all or a portion of the loan forgiven depending on the percentage of retained employees.

The AAA will continue to press the Congress and federal agencies for help to ensure ambulance service organizations and our paramedics and EMTs serving on the front lines of the COVID-19 pandemic have the necessary resources and financial assistance to serve their communities.

URGENT – CALL TO ACTION

Contact Your Senators Today on Ambulance Specific Funding!

The U.S. Senate is currently developing its next economic relief package to address the impact of COVID-19. The House had passed its version, the HEROES Act, which includes $100 billion for health care providers. While our members would likely be eligible for a portion of those funds, it is vital that the final package passed by Congress allocate funds specifically for ground ambulance services.

Please contact your Senators today and ask that they advocate for a funding program under the Public Health and Social Services Emergency Fund specifically for the increased costs, loss of revenue, and uncompensated care facing ground ambulance service organizations due to COVID-19.

Please e-mail your Senators today!

 It will take you only a few minutes per Senate office to email a letter. Just follow these steps. 

  1. USE LETTER TEMPLATE: CLICK HERE to access a draft letter. Please customize your letter including the cities and towns you serve, if you are sending to the office of a Senator or Representative and any additional details as to services you are providing during the COVID-19 outbreak and the financial impact on your operation.
  1. LOOK UP YOUR MEMBERS OF CONGRESS AND THEIR WEBFORM ADDRESS: CLICK HERE to access a list of the webform addresses of your Members of Congress.
  1. SEND LETTERS TO MEMBERS: Cut and paste the webform link into your Internet browser and you will be directed to the webpage for contacting your member of Congress. Fill in your contact information, cut and paste your letter into the comments box and hit submit.

In addition to advocating for the Senate, as well as the House, to include funding specifically for ground ambulance services in the next COVID-19 economic relief package, the AAA is pressing for the Department of Health and Human Services to allocate more funding to EMS under the $75 billion already appropriated to the PHSSEF through the Paycheck Protection Program and Health Care Assistance Act.

The AAA will continue to fight for our members as your operation and paramedic and EMTs are on the front lines of combating the Coronavirus.

House Passes Paycheck Protection Program Flexibility Act

On May 28, the U.S. House of Representatives passed by a vote of 417 to 1 the Paycheck Protection Program Flexibility Act of 2020.

The Paycheck Protection Program Flexibility Act of 2020 provides small businesses with more flexibility in how the Paycheck Protection Program (PPP) funds established under the CARES Act are spent and still qualify for loan forgiveness.

The PPP provides businesses with fewer than 500 employees, including ambulance service organizations, with access to loans at favorable terms to cover employee payroll for an original timeframe of eight weeks. Under the CARES Act, a borrower can have all or a portion of the loan forgiven depending on the percentage of retained employees.

The Paycheck Protection Program Flexibility Act extends the timeframe in which to spend PPP funds from the current 8 weeks to 24 weeks and extends the original deadline from June 30, 2020 to December 31, 2020 for businesses to rehire furloughed employees to qualify for loan forgiveness. The legislation also lowers the minimum percentage of loans that must be allocated towards payroll from 75% to 60% and clarifies a borrower does not have to start repaying a loan until the SBA determines whether or not the business is eligible for loan forgiveness.

Further, the bill amends the program so loan forgiveness will not be affected by an inability to rehire all employees if an employer is unable to rehire a former employee, can demonstrate an inability to hire similarly qualified employees before the deadline, or can demonstrate an inability to return to their pre-COVID level of business activity.

The final provision of the Paycheck Protection Program Flexibility Act removes restrictions on deferment of payroll taxes and PPP loan forgiveness, allowing small businesses to both qualify for loan forgiveness under the PPP and delay their 2020 payroll taxes.

The AAA leadership and staff will continue to tirelessly advocate for the much-needed relief to ensure that our members can keep their doors open, receive the equipment necessary to protect their staff, and the resources to provide excellence in mobile healthcare. We will keep you abreast of our advocacy efforts as well as changes to the Paycheck Protection Program as soon as the details become available.

Justice Department Responds on PSOB

On April 9, the AAA and the National Association of Emergency Medical Technicians (NAEMT) sent a letter to U.S. Attorney General William Barr requesting the Department of Justice extend coverage under the Public Safety Officers’ Benefits (PSOB) program to all paramedics and EMTs during the COVID-19 national health emergency. While paramedics and EMTs employed by governmental and non-profit EMS agencies are currently eligible for the program, those employed by private for-profit organizations and on the front lines of responding to COVID-19 pandemic are not covered. Read our letter HERE.

On May 22, the AAA received a written response from the DOJ denying any expansion of the PSOB program. They state paramedics and emergency medical technicians employed by private for-profit EMS agencies do not meet the definition of “public safety officers” for purposes of PSOB eligibility as defined under the 1976 PSOB Act despite the waiver of said eligibility requirements by former Attorney General Ashcroft in the aftermath of September 11, 2001. Read their Response HERE.

The AAA continues to pursue an expansion of the PSOB program to include all paramedics and EMTs and will push for a legislative solution on Capitol Hill.

Legislative hurdles check hazard pay, PSOB benefits

Frustration mounts as small print delays the HEROES Act, and presents a dual standard for provider benefits for the fallen

May 22 at 2:20 PM | EMS1 | By AAA Communications Chair Rob Lawrence

In  my last EMS One-stop column, I commented on the legislative to-do list to ensure that EMS receives the federal support it deserves right now as we staff the front lines and perhaps brace ourselves for COVID-19 round two as the nation craves a return to the normality and liberty enjoyed before the lockdown.

On May 15, 2020, the much talked about HEROES Act narrowly passed from the U.S. House of Representatives by a 208 to 199 vote to the Republican-controlled Senate.  The HEROES Act proposed $3 trillion in tax cuts and spending to address the negative health and financial impacts of the COVID-19 pandemic. This included benefits for the public safety community, extensions to enhanced unemployment benefits, debt collection relief, direct cash payments to households and possibly even hazard pay.

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HHS Posts FAQ on Healthcare COVID-19 Relief Fund

Earlier today, the Department of Health and Human Services (HHS) posted a revised set of frequently asked questions (FAQs) regarding the terms and details of payments distributed under the Public Health and Social Services Emergency Fund to Medicare providers including ground ambulance service providers and suppliers. The updated FAQs cover a range of topics regarding the acceptance of funds, revenue data submission and eligibility criteria.

Download FAQ

CMS Modifies the Cost Data Collection System Year 1 Data Collection

CMS has issued a blanket waiver modifying the data collection period for the ground ambulance services that were selected to report in Year 1.  Under the current law, these organizations would have been required to collect data beginning January 1, 2020, and through December 31, 2020.  The waiver allows these organizations to select a new continuous 12-month data collection period that begins between January 1, 2021 and ends December 31, 2021.  This modification means that such organizations will collect and report data during the same time period as the ground organizations that CMS will select for Year 2 of the cost collection program.

From the summary of the waiver, it appears that organizations will have the choice of submitting data in Year 1 or Year 2.  CMS has not moved the timeline for any other data collection year, so there is the potential for a substantial number of organizations to report in Year 2, which would increase the amount of data available.

The AAA has supported the data collection system to make sure that CMS and the Congress have valid and reliable data to support maintaining the geographic add-ons to the Medicare Ambulance Fee Schedule and to support efforts to address the chronic underfunding of the Medicare Ambulance Fee Schedule.

The complete FAQ is below and also available at: https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf (on page 29).

“CMS is modifying the data collection period and data reporting period, as defined at 42 CFR § 414.626(a), for ground ambulance organizations (as defined at 42 CFR § 414.605) that were selected by CMS under 42 CFR § 414.626(c) to collect data beginning between January 1, 2020 and December 31, 2020 (year 1) for purposes of complying with the data reporting requirements described at 42 CFR § 414.626. Under this modification, these ground ambulance organizations can select a new continuous 12-month data collection period that begins between January 1, 2021 and December 31, 2021, collect data necessary to complete the Medicare Ground Ambulance Data Collection Instrument during their selected data collection period, and submit a completed Medicare Ground Ambulance Data Collection Instrument during the data reporting period that corresponds to their selected data collection period. CMS is modifying this data collection and reporting period to increase flexibilities for ground ambulance organizations that would otherwise be required to collect data in 2020- 2021 so that they can focus on their operations and patient care.”

“As a result of this modification, ground ambulance organizations selected for year 1 data collection and reporting will collect and report data during the same period of time that will apply to ground ambulance organizations selected by CMS under 42 CFR § 414.626(c) to collect data beginning between January 1, 2021 and December 31, 2021 (year 2) for purposes of complying with the data reporting requirements described at 42 CFR § 414.626.”

House Vote Scheduled today on HEROES Act

The U.S. House of Representatives is scheduled to vote later today on the Health and Economic Recovery Omnibus Emergency Solutions Act “HEROES Act” (H.R. 6800). The HEROES Act is the House Democratic proposal for the latest legislative effort on economic relief related to COVID-19. The House is expected to pass the HEROES Act along party lines with the Senate developing its own legislative proposal with consideration in the coming weeks.

The HEROES Act contains numerous provisions of interest to ground ambulance service providers and suppliers. For a comprehensive summary of those provisions, please click HERE.

Here are a few of the highlights:

$100 Billion for Health Care Fund

  • $100 billion in additional funding for the Public Health and Social Services Emergency Fund. This is the Fund under which ground ambulance service providers and suppliers have received direct payments to partially offset lost revenue as well as eligibility for grant funds to cover the cost of treating uninsured presumptive and actual COVID-19 patients. The bill would also set forth a methodology for the distribution of the new funds and all previously unallocated funds, based on the lost revenue and expenses of a provider or supplier. The AAA continues to advocate for a program under the Fund specifically for ground ambulance services.

Employee Retention Tax Credit Improvements

  • Increases the retention credit from 50% to 80% and the wage cap from $10,000 to $15,000 per quarter. The bill would also change the definition of a large employer from organizations with over 100 employees to those with over 1,500 employees. The Employee Retention Tax Credit is intended for companies not eligible for the Paycheck Protection Program and allows employers to offset employment taxes, with any excess treated as refundable tax credits.

Payroll Protection Program

  • Eliminates the limitation for employers to take advantage of the payroll tax deferral period to the extent they qualified for loan forgiveness under the Paycheck Protection Program or the U.S. Treasury Program Management Authority.

$500 Tax Credit for First Responders and Frontline Employees

  • Provides a $500 above the line deduction for 2020 for the uniforms, supplies, and equipment of governmental and non-governmental first responders and COVID19 frontline employees.

The AAA has already turned its sights on the Senate as we continue to advocate for ground ambulance service providers and suppliers in our vital role as frontline medical responders in combating COVID-19.

 

AAA Sends Letter Requesting Priority Testing for EMS

AAA Sends Letter to Requesting Priority Testing for First Responders

Earlier today, the AAA sent a letter to the U.S. Public Health Service (USPHS) requesting that first responders with COVID-19 symptoms be given priority one status in the order of groups to be tested for COVID-19. The USPHS had issued guidance that assigned first responders a level two status. The AAA stated paramedics and EMTs should be included in the top level with other health care professionals who are on the front lines of caring for patients with COVID-19.  Read the Letter HERE.

 

Read the Letter

Congress Provides More PPP and Health Care Funds

Congress Provides More PPP and Health Care Funds

Moments ago, the U.S. House of Representatives passed by a vote of 388 to 5 the Paycheck Protection Program and Health Care Enhancement Act. The United States Senate had passed the legislation by unanimous consent on Tuesday evening. The legislation is a bridge package between the CARES Act and Stimulus Package 4 which is still under development.

The Paycheck Protection Program and Health Care Enhancement Act provides an additional $310 billion for the Paycheck Protection Program (PPP) established under the CARES Act. The PPP had run out of its initial funding on April 9 and the program has been closed to new applications. The PPP provides businesses with fewer than 500 employees, including ambulance service organizations, with access to loans at favorable terms to cover employee payroll for eight weeks. A borrower can have all or a portion of the loan forgiven depending on the percentage of retained employees.

The legislation also allocates an additional $75 billion in funds for the Public Health and Social Services Emergency Fund (PHSSEF). Like the initial $100 billion funding from the CARES Act, these funds are intended to provide economic relief to health care providers during the COVID-19 public health emergency. AAA members received direct grant money a few weeks ago under the PHSSEF in the form of an additional Medicare payment. The Department of Health and Human Services (HHS) will have the discretion to determine how the additional $75 billion is made available to health care providers. The AAA continues to advocate directly with senior HHS officials for ground ambulance service suppliers and providers to receive a share of funds proportional to our role health care providers on the front line of the pandemic.

The final provision of the Paycheck Protection Program and Health Care Enhancement Act provides additional funding for testing and research related to COVID-19 through the remainder of 2020.

The AAA with the help of our members had pushed for additional funding under the PHSSEF and were successful. We now need to ensure that the actual funds make their way to our members.

The AAA leadership and staff will continue to tirelessly advocate for the much-needed relief to ensure that our members can keep their doors open, receive the equipment necessary to protect their staff, and the resources to provide excellence in mobile healthcare. We will keep you abreast of our advocacy efforts as well as how to access funding under the PHSSEF as soon as the details become available.

Grants and Tax Credits Toolkit

Grants and Tax Credits Toolkit

Download materials from Akin Gump including aid summaries and how-to guides on qualifying for tax credits and deferments and applying for financial assistance.

 

 

Paycheck Protection Program Funding Update

The Department of Treasury has announced that the $350 billion appropriated under the CARES Act for the Paycheck Protection Program has been exhausted. However, Congressional leaders are currently negotiating an economic stimulus package to act as a bridge between the CARES Act and the next comprehensive package stimulus package. A core provision of the bridge package is an allocation of an additional $250 billion for the Paycheck Protection Program. If your operation is in the process or plans to apply for a loan under the Paycheck Protection Program, you should move forward with your efforts. The AAA is advocating that the bridge package or next comprehensive package include more funding for ambulance services.