Payroll Tax Deferral

On August 8, 2020, President Donald Trump signed an executive memo directing the U.S. Department of the Treasury to defer certain payroll tax obligations amid the ongoing COVID-19 pandemic. On August 28, the Treasury & IRS issued Notice 2020-65 with further guidance to employers on how to implement this payroll tax deferral. Any employer required to withhold and pay the employee share of Social Security tax is deemed to be affected by the COVID-19 pandemic and may take advantage of this executive order. It appears employers have discretion (even on an employee-by-employee basis) on whether to stop withholding starting September 1, 2020.

Please click here to see pros and cons of tax deferral from QuarterMaster Tax Management.

COVID-19 Compliance Manual Template

This document in no way should be considered legal or malpractice advice. This was shared by another doctor and ChiroFutures to use as a template. This manual very well may be incomplete and is only a part of what needs to be done to keep your office safe and compliant with CDC and health department standards. Modify and personalize this manual as needed to suit your individual practice as well as state and local laws. Please read the first page of this manual before usage.

Microsoft Word Template. You will need to copy/paste it to personalize.

Checklist for DCs on COVID-19

It seems like there is constantly something doctors are supposed to be doing when it comes to COVID-19. ChiroCongress heard the request from multiple states and developed a checklist for doctors to utilize as a resource.

Click here to view the document.

Families First Coronavirus Response Act

The “Families First” law is federal and applies to all employers of 500 or fewer, so the information pertaining to employee leave under Families First will apply to most, if not all, of our doctors. Here is a summary from the Scott Benefit Services regarding Families First.

Congress extended the Family First Coronavirus Response Act tax credit into 2021 but not the employer requirement for paid leave. Beginning on January 1, 2021, employers are no longer required to provide FFCRA leave; however, covered employers who voluntarily offer such leave may utilize payroll tax credits to cover the cost of benefits paid to employees through the end of March.Click here to read more.

Click To Read the Summary

The Department of Labor has released a new poster outlining employees rights under the new Families First Coronavirus Response Act. Employers are required to post this notice in a conspicuous place where it can be viewed by all employees and applicants.

HIPAA & COVID-19 Impact

The Office for Civil Rights (OCR) has been very active this past month, going above and beyond to help mitigate the risk COVID-19 poses to public health privacy. Certain HIPAA regulations were updated in March to allow for health care practices to better work with patients in need of healthcare services as well as providing guidance on how to best disclose PHI without risk of a data breach. View these resources for the HIPAA related updates.

• HIPAA and COVID-19 FAQ
• “May I Disclose Personal Health Information”
• How to Handle HIPAA in Public Health Emergencies ( February 6, 2020)

Screening Documentation

Patient Screening Template

Employee Screening Template

Advertising & Marketing

Use care in advertising at this time and refrain from making claims that are not substantiated by peer-reviewed, empirical evidence about COVID-19.

Helpful Webinar Recordings

• Seeing Patients in the Time of COVID-19 by NCMIC
• Business Survival Kit: How to Stay Proactive During a Crisis by ChiroHealhUSA and SideCar

In response to the crisis, Congress enacted the CARES ACT (Coronavirus Aid, Relief and Economic and Security) which includes several provisions offering relief to small businesses. Click here to read a summary of the ACT. Unlike the disaster loans that are typically available through the Small Business Association (SBA), these loans are potentially forgivable up to 100% of the principal amount borrowed. They are also not tied directly to establishing losses suffered during a disaster – there is a presumption of negative impact from COVID-19.

• Click here for Coronavirus Relief Efforts Through the SBA
• WealthAbility Town Hall Webinar What the Cares Act Means to You and Your Business (April 1, 2020)

Information on Coronavirus Relief & Omnibus Agreement (CORONABUS)

In a COVID-19 relief and federal spending package passed at the end of December by a bipartisan group of U.S. House and Senate lawmakers, several essential items that the American Chiropractic Association lobby team has been pushing for have been included in the measure. Click here to read an update from ACA.

SBA Paycheck Protection Program

The Paycheck Protection Program is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. SBA will forgive loans if all employees are kept on the payroll for eight weeks and the money is used for payroll, rent, mortgage interest or utilities. 75% must be used for payroll in order to be forgiven. Loan payments will be deferred for six months. No collateral or personal guarantees are required. Neither the government nor lenders will charge small businesses any fees.

Congress Reopens the SBA’s PPP Program

On December 27, 2020 President Trump signed the Consolidated Appropriations Act, 2021 (“the Act”). The Act reopens the Small Business Administration’s (SBA) Paycheck Protection Program (PPP) that allows businesses to apply for a loan for the first time or allows existing PPP borrowers to apply for a second loan. First-time PPP borrowers will be subject to the PPP’s original eligibility rules, and second-time PPP borrowers will be subject to the following requirements…click here to read.

Guidance for PPP and Forgiveness

The Small Business Administration (SBA) and U.S. Department of the Treasury released long-awaited guidance on how loans obtained through the Paycheck Protection Program (PPP) can be forgiven. Two new interim final rules – one addressing requirements for loan forgiveness, the second outlining loan review procedures and borrower and lender responsibilities.

• The U.S. Small Business Administration (SBA) released an application form on May 15, 2020, for Paycheck Protection Program (PPP) loan forgiveness along with instructions for borrowers to complete the form.The PPP Loan Forgiveness Application and instructions expand on FAQs and interim final rules issued by the SBA over the past few weeks in conjunction with the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
• SBA Releases PPP Loan Forgiveness Application:A Deep Dive by Forbes ( May 16, 2020)
• PPP forgivness changes as of 6/4/2020. For more detailed information check out this article and this Baker Donelson web-post.

SBA Economic Injury Disaster Loan Program

This program includes an emergency advance of up to $10,000 to small businesses affected by COVID-19. To access the advance, you must first apply for an EIDL and then request the advance. The advance does not need to be repaid under any circumstance. The funds may be used to keep employees on the payroll, to pay for sick leave, meet increased production costs due to supply chain disruptions, or pay business obligations, including debts, rent, and mortgage payments. You may also qualify for funds above the emergency advance to help your practice.On June 15,2020, SBA resumed accepting new Economic Injury Disaster Loan (EIDL) applications from all qualified small businesses, including agricultural businesses, and non-profit organizations.

• EIDL Summary
• COVID-19 Economic Injury Disaster Loan Application

CARES Act Provider Relief Fund

Recognizing the importance of delivering funds in a fast and transparent manner, $30 billion is being distributed immediately – with payments arriving via direct deposit beginning April 10, 2020 – to eligible providers throughout the American healthcare system. These are payments, not loans, to healthcare providers, and will not need to be repaid.

Click here to view the details of CARES Act Provider Relief Fund.

General Distribution Portal FAQ Full Provider Relief Page

CMS Accelerated and Advance Payment Program

The CMS has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the COVID-19.The payments are available to Part A providers, including hospitals, and Part B suppliers, including doctors, non-physician practitioners and durable medical equipment (DME) suppliers. While most of these providers and suppliers can receive three months of their Medicare reimbursements, certain providers can receive up to six months. The advance and accelerated payments are a loan that providers must pay back. All other Part A providers and Part B suppliers will have up to 210 days to complete repayment of accelerated and advance payments, respectively. It is important to note, this funding is separate from the $100 billion provided in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Click here to continue reading.

Coronavirus and Forbearance Info for Students, Borrowers & Parents

On March 27, 2020, the president signed the CARES Act into law, which, among other things, provides broad relief for federal student loan borrowers. Click here to view the answered questions about several provisions of the Act. Questions that have been added or updated are identified with “NEW” or “UPDATED” before each question.

Payroll Tax Deferral

On August 8, 2020, President Donald Trump signed an executive memo directing the U.S. Department of the Treasury to defer certain payroll tax obligations amid the ongoing COVID-19 pandemic. On August 28, the Treasury & IRS issued Notice 2020-65 with further guidance to employers on how to implement this payroll tax deferral. Any employer required to withhold and pay the employee share of Social Security tax is deemed to be affected by the COVID-19 pandemic and may take advantage of this executive order. It appears employers have discretion (even on an employee-by-employee basis) on whether to stop withholding starting September 1, 2020.

Please click here to see pros and cons of tax deferral from QuarterMaster Tax Management.

• Q: If a doctor of chiropractic has been exposed to the virus (via a person who tested positive) do they need to notify all patients the doctor has seen in recent weeks?

  A: Answer from the NC DHHS: The CDC’s guidance regarding the assessment and need for work exclusion for healthcare provided (HCP) with exposures to COVID-19 patients can be found here. If work exclusion is recommended based on the identified risk exposure category for the HCP, there is no need to notify all the providers patients from recent weeks if the HCP is asymptomatic per current CDC guidance. Testing of an exposed but asymptomatic HCP is not recommended, but if the exposure risk is considered medium or high, self-quarantine and monitoring for signs of infection (i.e. fever, cough, SOB or sore throat) is recommended for 14 days post the last exposure to the confirmed COVID-19 case.

  Q: How can I help my community and volunteer?

  A: DHHS: The State Medical Response System is Seeking Volunteers. The are recruiting volunteers to supplement NC’s health care workforce during this pandemic. Clinical, clinical support & non-clinical support (facility maintenance, safety & administrative) volunteers are needed. You can register by clicking here.

  Q: What do I do if I think someone presents at my office with COVID-19?

  A: Contact your local health department or state health department at 919-733-3419 immediately.

  Q: How do I keep my office safe? What do I clean with?

  A: Specific Lysol products have demonstrated effectiveness against viruses similar to 2019 Novel Coronavirus (SARS-CoV-2) on hard, non-porous surfaces. In accordance with the EPA Viral Emerging Pathogen Policy. Some Lysol products can be used against 2019 Novel Coronavirus (SARS-CoV-2) when used in accordance with the directions for use.

  Does a Doctor of Chiropractic or Chiropractic Staff Need to Quarantine Due to Notice That a Patient Has Tested Positive for COVID-19 ?

  Whether a quarantine is necessary depends on factors such as length of exposure, proximity, and presence of face covering. If the patient diagnosed with covid and the health care provider were both wearing face masks then there are no work restrictions. Click here for more details from CDC.