After making sure that physicians would get paid for the patients they were able to treat during the initial 1 COVID-19 pandemic, the LSMS focus shifted to making sure physicians and their offices were included 2 in any federal stimulus bills or packages so that they can keep their practices open and viable post COVID- 3 19. We also wanted to ensure that physicians knew how to access the available resources. To that end, 4 we have been highly active and involved in: ▪ CARES Act – this dedicated $100B to be paid directly to healthcare providers. To date, 30% 7 ($30B) has been dispersed in the form of Medicare grants. Grant amounts were based on each 8 providers 2019 actual Medicare billing. Funds were direct deposited into banks if that option was 9 readily available. If not, paper checks will be distributed. Unfortunately, Medicare Advantage 10 plans were not part of the provider calculation as they are considered ERISA plans and as such are 11 not under the purview or control of the federal government. How the remaining $70B will be 12 distributed remains to be seen but the LSMS is pushing that all the funds go directly to physicians 13 in the form of additional grants or zero interest loans with repayment not occurring until 2022 or 14 later. 5 6 ▪ Payroll Protection Program (PPP) - $450B for businesses with less than 500 employees. If used 17 to pay employee salaries and rent the loan will be converted to grant. Yes, there were outliers like 18 Ruth’s Chris and Shake Shack who received millions and probably should not have but the average 19 award was for $250,000 meaning the bulk of the funds went to small businesses. $28B (11.3%) 20 of the total funds went to physicians with the average award of $244,000. An additional $320B 21 could be appropriated for the PPP this week. If you have not already applied for a PPP loan you 22 should do so upon the adjournment of this call. ▪ There is also discussion of a 4th stimulus package, which would include additional PPP for 25 employers with more than 500 employees (hospitals) but details have not been made public or 26 share otherwise. 15 16 23 24 ▪ There have been numerous conversations with the State regarding Medicaid and advanced 29 payments and/or enhanced payments going forward. Also, looking to the federal government and 30 CMS to support raising Medicaid rates to parity Medicare for the foreseeable future. 31 32 In the most recent weeks of this pandemic we have been squarely focused on getting physicians back to 33 work. Specifically, this includes: ▪ Working directly with the Louisiana Department of Health (LDH) and Governor Edwards on the 36 new April 27, 2020 practice guidelines. 34 35 ▪ Continue having conversations with LDH in order to provide some clarity and answer questions 39 that have arose from the release of the guidelines. This may include the creation a frequently asked 40 questions document and/or a town hall style meeting to answer questions. Specifically, we have 41 concerns and seek clarity on the guidelines related to PPE, COVID-19 testing, and labs. 27 28 37 38
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• Working on a public relations campaign with LDH and the Governor to send the message to
patients statewide that it is safe to seek healthcare.
45 46 • Asking the Louisiana Department of Insurance to consider any and all restrictions relative to out- 47 of-network access to health care services be waived during the emergency, allowing patients to 48 seek care where they feel comfortable and safe.
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