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As resources are released to help not-for-profit organizations navigate the rapidly changing landscape, we will add important links and information to this blog post:

We are here to help
Please contact the BerryDunn not-for-profit team if you have any questions, or would like to discuss your specific situation.

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Resources for not-for-profits affected by COVID-19

Read this if you are a leader at a state Medicaid agency.

Here is a summary of information we have gleaned from CMS Administrator Verma’s recent call.

CMS is implementing new rules and waivers that increase provider flexibility and free up resources to deal with a surge in COVID-19 patients. CMS is working with the provider community to provide clarity around specific changes that impact their operations.

  • The rulemaking process has been dramatically expedited to accommodate recent and forthcoming regulatory changes
  • CMS is in the process of working out details to administer CARES act provisions, including further regulatory flexibilities, expansion of accelerated payment program, and $100 billion appropriated to reimburse eligible health care providers
  • CMS clarifies 3-Day Rule Waiver for skilled nursing facilities applies throughout the country and to all patients, regardless of their COVID-19 status

Medicaid Substance Use Disorder Treatment via Telehealth, and Rural Health Care and Medicaid Telehealth Flexibilities Guidance

This informational bulletin is composed of two parts: Rural Health Care and Medicaid Telehealth Flexibilities and Medicaid Substance Use Disorder Treatment via Telehealth.

  • The informational bulletin identifies opportunities for telehealth delivery for services to increase access to Medicaid services. It is composed of two parts, Rural Health Care and Medicaid Telehealth Flexibilities and Medicaid Substance Use Disorder Treatment Services Furnished via Telehealth
  • The bulletin provides SUD guidance around Medication Assisted Treatment (MAT), counseling, high risk populations, and other areas critical to providing SUD services.

Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit

CMS is issuing an electronic toolkit regarding telehealth and telemedicine for Long Term Care Nursing Home Facilities.

  • The toolkit includes electronic links to sources of information regarding telehealth and telemedicine, including the changes made by CMS over the last week in response to the National Health Emergency.
  • Much of the toolkit’s information is intended for providers who may wish to establish a permanent telemedicine program, but there is information here that will help in the temporary deployment of a telemedicine program as well.
  • There are specific documents identified that may be useful in choosing telemedicine vendors, equipment, and software, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools. 


CMS makes regulatory changes to help US healthcare system address COVID-19 patient surge

CMS has issued a number of temporary regulatory waivers and new rules to assist the nation’s healthcare system with improved flexibility.

  • Increased hospital capacity. CMS will allow communities to take advantage of local ambulatory surgery centers that have canceled elective surgeries, per federal recommendations.
  • Healthcare workforce expansion. CMS’s temporary requirements allow hospitals and healthcare systems to increase their workforce capacity by removing barriers for physicians, nurses, and other clinicians to be readily hired from the local community as well as those licensed from other states without violating Medicare rules.
  • Paperwork requirements. CMS is temporarily eliminating paperwork requirements.
  • Telehealth in Medicare. CMS will now allow for more than 80 additional services to be furnished via telehealth.

Additional COVID-19 FAQs for state Medicaid and Children's Health Insurance Program (CHIP) agencies

CMS released an update to the COVID-19 FAQs posted on March 18, 2020 related to emergency preparedness and response, eligibility and enrollment flexibilities, benefit flexibilities, cost sharing flexibilities, financial flexibilities, managed care flexibilities, fair hearing flexibilities, health information exchange flexibilities, and COVID-19 T-MSIS coding guidance. Notably:

  • States that have CHIP disaster provisions in their state plans can activate these provisions. CMS considers a significant outbreak of an infectious disease to be a disaster. CMS also recommends that states that do not have disaster relief provisions into their CHIP state plans include language that a federal- or governor-declared emergency is considered an event that can trigger the disaster provisions.

States may not suspend use of their AVS, however CMS reminds states that they can rely on self-attestation of assets and verify financial assets using their AVS post-enrollment in Medicaid.

  • CMS can help provide technical assistance regarding approaches states can use to rapidly scale telehealth technologies.
  • CMS clarified and provided COVID-19 T-MSIS coding guidance.

For more information

We’re here to help. If you have more questions or want to have an in-depth conversation about your specific situation, please contact the team

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Takeaways from CMS national stakeholder call

Read this if your company would like to request an advance payment of the tax credits.

In response to the paid sick and family medical leave credit provisions enacted by the Families First Coronavirus Response Act (FFCRA) and the employee retention credit enacted by the CARES Act, the IRS has issued Form 7200 to request an advance payment of the tax credits.

Who may file Form 7200?

Employers that file Form(s) 941, 943, 944, or CT-1 may file Form 7200 to request an advance payment of the tax credit for qualified sick and family leave wages and the employee retention credit.

Eligible employers who pay qualified sick and family leave wages or qualified wages eligible for the employee retention credit should retain the amounts qualified for either credit rather than depositing these amounts with the IRS.

With respect to the sick and family leave payments, the credit includes amounts paid for qualified sick and family leave wages, related health plan expenses, and the employer’s share of the Medicare taxes on the qualified wages.

With respect to the employee retention credit, the credit equals 50% of the qualified wages, including certain health plan expense allocable to the wages, and may not exceed $5,000 per qualifying employee. Of note:

  • Employment taxes available for the credits include withheld federal income tax, the employee's share of Social Security and Medicare taxes, and the employer's share of Social Security and Medicare taxes with respect to all employees.
  • If there aren’t sufficient employment taxes to cover the cost of qualified sick and family leave wages (plus the qualified health expenses and the employer share of Medicare tax on the qualified leave wages) and the employee retention credit, employers can file Form 7200 to request an advance payment from the IRS.
  • The IRS instructs employers not to reduce their deposits and request advance credit payments for the same expected credit. Rather, an employer will need to reconcile any advance credit payments and reduced deposits on its applicable employment tax return.

Examples

If an employer is entitled to a credit of $5,000 for qualified sick leave, certain related health plan expenses, and the employer’s share of Medicare tax on the leave wages and is otherwise required to deposit $8,000 in employment taxes, the employer could reduce its federal employment tax deposits by $5,000. The employer would only be required to deposit the remaining $3,000 on its next regular deposit date.

If an employer is entitled to an employee retention credit of $10,000 and was required to deposit $8,000 in employment taxes, the employer could retain the entire $8,000 of taxes as a portion of the refundable tax credit it is entitled to and file a request for an advance payment for the remaining $2,000 using Form 7200.

When to file

Form 7200 can be filed at any time before the end of the month following the quarter in which qualified wages were paid, and may be filed several times during each quarter, if needed. The form cannot be filed after an employer has filed its last employment tax return for 2020.

Please note that Form 7200 cannot be corrected. Any error made on Form 7200 will be corrected when the employer files its employment tax form.

How to file

Fax Form 7200, which you can access here, to 855-248-0552. Form 7200 instructions.

If you need more information, or have any questions, please contact a BerryDunn tax professional. We’re here to help.

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IRS releases Form 7200: Advance payment of employer credits due to COVID-19

Read this if your financial institution is providing funding under the PPP. This information is current as of March 31, 2020.

The Paycheck Protection Program provides small businesses with funds to pay up to 8 weeks of payroll costs including benefits. Funds can also be used to pay interest on mortgages, rent, and utilities. 

The Treasury Department is encouraging people to apply ASAP because there is a funding cap.

When to accept applications?

Starting April 3, 2020, small businesses and sole proprietorships can apply. Starting April 10, 2020, independent contractors and self-employed individuals can apply.

What underwriting is required?

In evaluating the eligibility of a borrower for a covered loan, a lender shall consider whether the borrower:
•    was in operation on February 15, 2020.
•    had employees for whom the borrower paid salaries and payroll taxes.
•    paid independent contractors, as reported on a Form 1099-MISC.

Lenders are also required to follow applicable Bank Secrecy Act requirements.
Refer to the SBA’s Paycheck Protection Program Information Sheet for Lenders.

Loan provisions

The Treasury Department issued guidance on March 31, 2020, that alters some of the assumptions around PPP:

  1. At least 75% of the forgiven amount should be used for payroll (changed due to anticipated high demand for program)
  2. Repayment of non-forgiven amounts are now repaid over 2 years at 0.5% interest (not 10 years and 4% as in the CARES Act)

Although the “covered period” is February 15, 2020 to June 30, 2020, forgiveness of the loan is based on expenses (primarily payroll) during the eight-week period after the loan is received.

Regulatory capital requirements

With respect to the appropriate Federal banking agencies or the National Credit Union Administration Board applying capital requirements under their respective risk-based capital requirements, a covered loan shall receive a risk weight of zero percent.

Borrower certification

An eligible recipient applying for a covered loan shall make a good faith certification: 

  1. that the uncertainty of current economic conditions makes necessary the loan request to support the ongoing operations of the eligible recipient; 
  2. acknowledging that funds will be used to retain workers and maintain payroll or make mortgage payments, lease payments, and utility payments;
  3. that the eligible recipient does not have an application pending for a PPP  loan for the same purpose and duplicative of amounts applied for or received under a covered loan; and
  4. during the period beginning on February 15, 2020 and ending on December 31, 2020, that the eligible recipient has not received amounts under the PPP for the same purpose and duplicative of amounts applied for or received under a covered loan.

What are considered payroll costs?

Payments of any compensation with respect to employees that is:

  • Salary, wage, commission, or similar compensation
  • Payment for vacation, parental, family, medical, or sick leave
  • Payment required for the provisions of group health care benefits, including insurance premiums
  • Payment of any retirement benefit
  • Other qualified payroll costs under Sec. 1102 of the CARES Act

Payroll costs are limited to $100,000 per employee, as prorated for the covered period, and exclude qualified sick leave wages and family leave wages for which a credit is allowed under sections 7001 and 7003 of the Families First Coronavirus Response Act.

Important to note:

  1. Questions around 500 employees
    We don’t know for certain how the 500 employees are counted. Other SBA programs use average headcount over the prior 12-month periods. Some companies are proceeding on that assumption. We are awaiting additional guidance from the SBA for confirmation. Certain industries have an expanded headcount. The list can be found on SBA websites and BerryDunn has a lookup tool to help. If you don’t know, please reach out to us. We’re here to help.
  2. The CARES Act states that loans taken from January 31, 2020, until “covered loans are made available may be refinanced as part of a covered loan.”
  3. Participation in PPP (Section 1102 and 1106 of the CARES Act) precludes participation in the Employee Retention Credit (Section 2301) Payment of Employer Payroll Taxes (Section 2302)

Fully forgiven

Funds are provided in the form of loans that will be fully forgiven when used for payroll costs, interest on mortgages, rent, and utilities (due to likely high subscription, at least 75% of the forgiven amount must have been used for payroll). Loan payments will also be deferred for six months. No collateral or personal guarantees are required. Neither the government nor lenders will charge small businesses any fees.

Must keep employees on the payroll—or rehire quickly

Forgiveness is based on the employer maintaining or quickly rehiring employees and maintaining salary levels. Forgiveness will be reduced if full-time headcount declines, or if salaries and wages decrease.

All small businesses eligible

Small businesses with 500 or fewer employees—including nonprofits, veterans organizations, tribal concerns, self-employed individuals, sole proprietorships, and independent contractors— are eligible. Businesses with more than 500 employees are eligible in certain industries.

The Paycheck Protection Program is implemented by the Small Business Administration with support from the Department of the Treasury. Lenders should also visit sba.gov or coronavirus.gov for more information.

Economic Injury Disaster Loans (EIDL)

EIDLs are available through the SBA and were expanded under section 1110 of the CARES Act. Eligible are businesses with 500 or fewer employees, including ESOPs, cooperatives, and others. Terms: Up to $2 million per loan. Up to 30 years to repay. Comes with an emergency advance (available within 3 days) of $10,000 that does not have to be repaid – even if the loan application is turned down. This $10,000 does not impact participation in other programs/sections of the CARES Act. Some portion of the EIDL may reduce loan forgiveness under PPP, but receiving an EIDL does not preclude the borrower from participating in the PPP.


BerryDunn COVID-19 resources

We’re here to help. If you have questions about the PPP, contact a BerryDunn professional.

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Paycheck Protection Program (PPP): Resource for lenders

Read this if your company is seeking assistance under the PPP. This information is current as of March 31, 2020.

The Treasury Department is encouraging people to apply ASAP because there is a funding cap.

The Treasury Department issued guidance on March 31, 2020, that alters some of the assumptions around PPP:

  1. At least 75% of the forgiven amount should be used for payroll (changed due to anticipated high demand for program)
  2. Repayment of non-forgiven amounts are now repaid over 2 years at 0.5% interest (not 10 years and 4% as in the CARES Act)

Although the “covered period” is February 15, 2020 to June 30, 2020, forgiveness of the loan is based on expenses (primarily payroll) during the eight-week period after the loan is received.

Important to note:

  1. Questions around 500 employees

    We don’t know for certain how the 500 employees are counted. Other SBA programs use average headcount over the prior 12-month periods. Some companies are proceeding on that assumption. We are awaiting additional guidance from the SBA for confirmation.

    Certain industries have an expanded headcount. The list can be found on SBA websites and BerryDunn has a lookup tool to help.

    If you don’t know, please reach out to us. We’re here to help.
  2. The CARES Act states that loans taken from January 31, 2020, until “covered loans are made available may be refinanced as part of a covered loan.”
  3. People may want to tap into available credit now. If they are granted a covered loan (PPP loan), they can refinance. Given anticipated demand, it may take time to get the PPP loan processed.
  4. Participation in PPP (Section 1102 and 1106 of the CARES Act) precludes participation in the Employee Retention Credit (Section 2301) Payment of Employer Payroll Taxes (Section 2302)

While we think it will generally be more favorable to participate in PPP (Section 1102 and 1106) than ERC (Section 2301), it would be wise to run some numbers and validate the assumption.

Economic Injury Disaster Loans (EIDL)

EIDLs are available through the SBA and were expanded under section 1110 of the CARES Act. Eligible are businesses with 500 or fewer employees, including ESOPs, cooperatives, and others. Up to $2 million per loan. Up to 30 years to repay. Comes with an emergency advance (available within 3 days) of $10,000 that does not have to be repaid – even if your loan application is turned down. This $10,000 does not impact participation in other programs/sections of the CARES Act. Some portion of the EIDL may reduce your loan forgiveness under PPP, but receiving an EIDL does not preclude you from participating in the PPP.

From Treasury.gov: Small business PPP 

The Paycheck Protection Program provides small businesses with funds to pay up to 8 weeks of payroll costs including benefits. Funds can also be used to pay interest on mortgages, rent, and utilities.

Fully forgiven

Funds are provided in the form of loans that will be fully forgiven when used for payroll costs, interest on mortgages, rent, and utilities (due to likely high subscription, at least 75% of the forgiven amount must have been used for payroll). Loan payments will also be deferred for six months. No collateral or personal guarantees are required. Neither the government nor lenders will charge small businesses any fees.

Must keep employees on the payroll—or rehire quickly

Forgiveness is based on the employer maintaining or quickly rehiring employees and maintaining salary levels. Forgiveness will be reduced if full-time headcount declines, or if salaries and wages decrease.

All small businesses eligible

Small businesses with 500 or fewer employees—including nonprofits, veterans organizations, tribal concerns, self-employed individuals, sole proprietorships, and independent contractors— are eligible. Businesses with more than 500 employees are eligible in certain industries.

When to apply

Starting April 3, 2020, small businesses and sole proprietorships can apply. Starting April 10, 2020, independent contractors and self-employed individuals can apply.

How to apply

You can apply through any existing SBA 7(a) lender or any federally insured depository institution, federally insured credit union, or 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. All loans will have the same terms regardless of lender or borrower. Find a list of participating lenders and additional information and full terms at sba.gov.

The Paycheck Protection Program is implemented by the Small Business Administration with support from the Department of the Treasury. Lenders should also visit sba.gov or coronavirus.gov for more information.

BerryDunn COVID-19 resources

We’re here to help. If you have questions about the PPP, contact a BerryDunn professional.

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Funding for the Paycheck Protection Program (PPP) starts Friday, April 3