Gassmanlaw.com



“Florida Medical Practice Briefing”Wednesday, April 29, 2020Presented by:Alan Gassman, Jeff Howard and Brandon Ketron0:03Hi, this is Alan gassman.?And I'm very glad to be here today with two people who have a lot of information that I don't have yet.?And that's Jeff Howard the very talented and experienced Medical Practice consultant and Brandon ketron of our Law Firm.?We are certainly not going to be able to answer all of your questions today.?Send us emails.?You've got our email address is there will tell you what we know and what we can.0:33I don't think that this is going to last a full hour, but you never know Brandon.?I think you have control of the slides here.?You want to go to the next slide or so there is a webinar that is available free of charge on the line Berg system on Employment Practices.?And we do mention medical practices in the webinar.?That's free of charge.?Then the next slide.?There's one with David Finkel on the success of your professional practice.1:02It's highly recommended that is also free of charge.?If you want to copy of our grow your medical practice book, I guess maybe we should have called it regrow your medical practice.?Send us an email will send you a free copy and here is an April 27th regulatory alert.?So right after we reported to everybody that there were Medicare loans against accounts.1:32Eva Bowl we reported that Medicare was loaning 90 days to a hundred and twenty days of average receipts.?No questions asked all you had to do was apply then there was no payment due for a hundred and twenty days.?That's all gone.?They took that out on Sunday and apparently what they did was they took the additional hundred million dollars that was allocated to Medical business and medical provider release.2:02nice relief rather and they put at least 20 billion into a new second tranche program and what they're saying is First make sure you got your six point one nine percent of 2019 Medicare Billings that goes to your medical practice or your entity free of charge.?So to speak as extra money, as long as you follow the rules, we're going to talk about and the rules are not difficult to follow.2:35Once you've gotten that money now, you can apply for more money and it's not going to be based upon a fixed percentage of what you received last time.?This is going to be based apparently or to some extent upon your lost revenues and may be based upon what you tell them you're going to do with the funds.?You know, this is like taking the math sat.3:05Not knowing how they're going to score it or taking a test and not knowing exactly how they're going to score it and to be quite honest.?I don't think they know how they're going to score it.?One thing.?They do say that's very clear is that you go onto the portal you make your application and then they batch all of the applications and every Wednesday at noon all of the applications that they have received.3:35In the past seven days all get pushed together.?So no one of them is in line above the other.?So if you have the time and the information this morning, you can supposedly go on their website.?Although it may break down because there's going to be so many people doing this and get your application in by noon today.3:59If you don't get it in by noon today, you can take a couple of deep breaths and maybe even drink a bloody mary because your next due date will be in a week.?It'll be next Wednesday at noon.?So Brandon you want to turn the slide there and we have more information.4:19Let's go to page 7 even more information and you have the different portals here and this pretty much repeats what I just said, but the bottom of page 10, it says payments will go out weekly on a rolling basis as information is validated with the first wave being delivered the end of the week April 24th.?I don't think that's going to happen.4:46They are saying that they're going to be giving people the money 7 to 10 days after the Wednesday at noon time.?Let's see what what we have is the next slide.?So these are the actual terms and conditions that you sign up for Brandon.?Is there any way to give me control of the Year PowerPoint?5:15See if you can do it now.?Nope.?Oh there goes.?Okay good.5:23So there's all kinds of attestations almost the same terms and conditions as we saw for the original six point one nine percent.?So we don't think that anything has changed.?We think as long as the money is spent for legitimate expenses of the medical practice, which can include lost revenues and therefore compensation of the Physicians of up to a hundred and twenty three thousand dollars a year.5:52Everybody that I know should be able to get this money and keep this money, but it has to you have you must agree that this money is going into an account that is primarily or solely a medical practice or business account.?This can't be brought out to buy a boat or to buy a luxury car.?This needs to be spent on the medical practice and the same rule that if you receive more than a hundred and fifty thousand dollars.6:22You have greater attestation obligations.?I don't think that that would bother me at all because the rules are going to be the same.?Obviously you can't use the money for lobbying.?You can't use the money for abortion or embryo study.?You can't use the money for pornography.?I'm sure a lot of you otherwise would have used it for pornography.?You can't use it to promote controlled substances and you can't be in violation of federal law.6:50So if you have an active Marijuana party your practice.?I'm not sure exactly how this is going to work.?So you're going to want to check that out.?So Jeff, what do you have to say or add to my having just shared all the knowledge I have on this program, basically.7:08Well Alan, you know, one of the things that I've had a lot of questions over the past week or two as been game we use his stimulus money to improve the plant facility at the practice my initial thought on this is yes, you can because your position in the practice to better treat patients from the future, but I welcome your and Brandon salt on that because like I said, I think it can be and it's not a bonus.?It's doing something to improve the practice.7:39Right, right, and I have not to be quite honest.?I have not seen the application.?I don't think that the application is asking for what you're going to spend it on and how much you're going to spend but that's probably going to happen later as they first.?I think they're just pushing out money as fast as they can 20 out of that new hundred and then I think the cares act itself which we went over last week does say that the intent is to provide.8:08I'd loans and to provide infrastructure loans for facilities.?So right now I'm just going to read a couple things you're going to need for the application portal.?If you want to try to file your application today by noon, you're going to need your gross receipts or sales and your program service Revenue as submitted on your federal income tax return.?I'm not sure what that means.8:38They're going to collect that information.?Maybe they already have that information.8:43Number two, they want to know your estimated revenue losses in March and April 2020.?Now, I don't think I would base this on cash.?I was speaking with the very smart CPA yesterday about this.?I don't think I would base this on your actual cash in the door, March and April.?I think I would base it on your Billings and what you expect to collect for your work done in March and April of 2020.9:07If you can come up with a estimate of that then they're going to want to Copy of your most recently filed federal income tax return and then a listing of any tax ID numbers that your subsidiary organizations have received relief funds under so if you have more than one entity in most people watching this webinar do not have more than one entity, then you don't have to worry about that requirement.9:40Page 34.?Yes.?Go ahead.?I was going to say one of the concerns I've heard from providers is in this at this point.?You're also releasing information on your private business.?Not just Medicare and I've had some providers how to reluctant to let Medicare know what's coming in through their private business.?And this was something with the Panama AG that affected Clinical Laboratory several years ago and their payment they had to disclose what they were being paid by private.10:09Eight years and I was in general that really cost them laboratory industry money on The Clinical Laboratory fee schedule because Medicare utilize that discounted pricing in there and so providers are cautious about letting Medicare know why Private Industry is doing because it seems like every time the government finds out more about the Private Industry.?They try to match what Private Industry is doing and if it's lower than the government tries to go that way if it's higher they seem to ignore it.10:39So the only the only time they're printed with our tax dollars it seems like is when they're not paying our clients properly.?Right??Right.?Well, I'm sure that's a legitimate concern but I also think almost every medical practice and their brother will be providing this information.?So how do too so, you know, if a thousand people provide the information I don't think it helps for two or three people to withhold the information.?I don't think anyone's going to be singled out.11:09So Jeff, what what do you know or what should we say about the ability to be compensated for the uninsured covid-19 patients.?This is an absolute program.11:21I recommend that provider sign up you can go to the health and human Human Health Resources and services Administration website, and there's links this program providers can sign up and I believe it's through February for yes, very, Very for 2020 retroactive provider can be paid Medicare rates for services rendered to any patients at our potential covid patients or covid patients.?No one has really been able to Define.?What a potential patient is other than the fact that every patient that scene now they appears to be a potential covid patient.12:00So that basically means any uninsured patients that scene for any any covid related purpose can be Hey, the Medicare allowed amount to the provider that provider must sign up for this program.?However, if the provider signs up this program receives a government rates, they must agree not the balance bill this patient and accept the Government rate says paying in full.?Now this is different in that.?I'm the original six point one nine percent payment on the cares act providers agreed to accept.12:39The Medicare allowable as payment in full and on that if you don't use a modifier Medicare would still pay 80% and your wave 20% but on this they would automatically pay 100% of the Medicare allowed amount.?So this is a plan.?I'm recommending provider sign up for they will need to build certain Manner and then they will be paid.13:07This is a lot of good collectible Revenue that Been messed in the past.13:12Okay.13:14All right, very good.?Well that's good news that you can get paid almost for any patient versus having to be a covid-19 patient because they might have been a covid-19 patient.13:23You just didn't know I guess that's a and that and that's what I'm not sure how the government is going to do this because everything I'm saying, they're not saying you have to have a covid diagnosis because the patient may not have covid and So I just think that's a positive there.?I'm just reading as I go here and there even saying that Medicare services not covered by traditional Medicare will also not be covered by this program and it said any treatment without a covid-19 prime primary diagnosis except for pregnancy when covid may be listed as secondary.?So Medicare will say yet does have to have a covid related diagnosis.?I correct myself.?Okay.?All right.?That's what I have bought.14:14And I think it goes without saying for everybody on this call that all of these documents that we see coming from the government have what I'm going to call whistleblower encouragement Clauses where the document says that the medical practice can't do anything to restrict or pull back or stop a whistleblower.?So there are going to be a lot of whistleblowers and there's going to be Decades of litigation and there's going to be indictment.14:40So if you're in doubt as to what to do Definitely ask a lawyer asked a CPA whoever's within the area of expertise document that you've relied on them that you've done the best.?You can to try to comport to comply with these rules so that you've got the best chance of not getting prosecuted now page 86 we have the actual cares act language which we went over last week.15:10Now the Eid L program, which was supposed to give us all ten thousand dollars within three days after we applied according to this SBA chart.?A lot of money has gone out under Eid l in fact Floridians have apparently received 272 million dollars and I don't believe it.?I'm sorry 200.?Yeah 272 million.?I don't believe it because we certainly haven't seen anywhere anything to indicate that people have received.15:40Million 293 million dollars in Eid l so just to keep you posted if anyone has received their $10,000.?Please let us know so that we can share it now again on page 93 and I'm sorry.?I apologize.?I'm skipping around but 75 billion was set aside by the cares act to reimburse Healthcare Providers and companies.16:10I and II of the bottom paragraph funds appropriated will be available for building or construction of temporary structures leasing of properties medical supplies and equipment personal protective equipment.?Testing supplies, increased Workforce trainings emergency retrofitting and surge capacity to be eligible submit an application includes a statement justifying the need of the provider for the payment.16:38So one of the attestations is I We need this money.?So if you are a pulmonologist and your hospital-based and you're making more money right now than you ever made before.?This is not a program for you according to the language of the of the program.?So and that brings me and we have a lot of different applications here and resources, but this brings me to an article that we published Monday night.17:10On the line bird system and I apologize.?I keep getting booted out of PowerPoint.?The PowerPoint keeps crashing on us for some reason.?Yeah might be SBA watching.?Who knows.?However, right the the PPP program.17:28Language attestation required you to say that you needed the PPP loan to facilitate the continued operation of your business.?And the question is what is your quote-unquote necessary for the operation of your business see the words they're necessary to support the ongoing.17:58Tons of the business so when Ruth Chris and the Lakers and I think a hundred other big companies got more than 2 million to more than 2 million each, of course secretary muchin and Marco Rubio both said, wait a minute.?It's not for you.?And in fact Marco Rubio put in a Twitter.18:23It was a articulate Twitter, but it was still a Twitter that this is just for people whose revenues can't cover their expenses right now, but that's not what the law says.?The law says necessary to support the ongoing operations of the business.?It doesn't say how long it doesn't say this month.?So if you're in a business that is slowing down and may fall off the cliff in the next few weeks or months.?It appears.?It seems to me that necessary to support the ongoing operations of the business.18:57means that if you need an extra couple or three hundred thousand dollars in your checking account to get you through what could be a one-year storm here that this would be necessary necessary to support the ongoing operations of the business, but the government has announced that anyone who gets I think more than a two million dollar loan will definitely be audited and they have already set up an audit Center so that Loan recipients should do what you can to document that this was reasonably necessary for the survival of your business.?And there's a few ways to do that one way would be to set out a budget to actually budget and say well my revenues are down to 30 percent right now and while they're covering the expenses if they continue to go down.19:55Or we have a lull or if I get sick and can't work for six weeks because I get covid-19.?Then this business may not survive.20:07So what we think having, you know done as much reading as we could and as much thinking on this as possible is that you are going to probably see some overzealous law enforcement types FBI agents who get assigned to research covid-19 crime and when they find somebody who has done some questionable stuff and they decide to throw throw everything in against the person they're going to say, yeah and also, Didn't need this loan because you already had a hundred thousand in your account.?You only had a deficit of 30,000 a month.?You could have gone three months.?You really didn't need this one and you know that may become a criminal situation violation of the attestation provision.?If you do it knowingly causes a crime of a penalty of up to a million dollars and up to 30 years in jail.21:05It is based on what you knew and thought on the day you signed the application now also in the very recent past the SBA issued a fact a in answer and question which apparently has regulatory Authority which said Can public companies borrow under the PPP program.21:34And the answer said all businesses didn't say just public companies.?The answer said all businesses.21:44That borrow must confirm that they need the funds and a publicly traded company or a hedge fund has access to Capital.?They're on the stock market.?They can sell more stock.?So they do not meet the test of having this money be necessary to support their ongoing operations.22:08Now, none of the big companies that have borrowed the money have spoken up and Add wait a minute.?This is what law said.?It said was it necessary to support the ongoing operations of my company.?My company is losing money hand over fist.?And yes, this is reasonably necessary to support our ongoing operations instead.?I think 20 of the 200 entities that borrowed two million or more have paid it back the other 180 have been silent and the regulations give them until May 7 to pee.22:44It back without a question.?So if you are conservative and you don't want a potential situation with the government that might penalize you certainly would require you to pay the loan back.?Even if you spent it on forgivable items and possibly could end up with a Criminal like caller investigation.?Then you have until May 7 to give it back.?And in the meantime, you might want to see if you can get an opinion or some sort of comfort.23:14Letter from a professional lawyer or CPA saying yes for the following reasons.?This was reasonably necessary.?There's a good article on this that you can see on the Forbes blog by Bruce brumberg that I am noting here on page 119 and then we go into a lot of analysis of what the word needs means what the word necessary.23:44Means and in the u.s.?Case law going back to the US Supreme Court in 1813.23:53Necessary means appropriate and helpful.?It doesn't mean crucial and we weren't able to find anywhere where the word necessary meant.?Absolutely necessary.24:08Or the sole way to accomplish something in Internal Revenue code the words reasonable and necessary business expense include limousines for executives taking spouses on business trips almost any payment that you would make to an unrelated third-party as a normal business expense including risky things like advertising.24:38Conferences in Las Vegas, etc, etc.?So as tax advisors, we when we advise clients as to whether something is reasonably needed we think in that way we don't think in the way that Senator Rubio is thinking and fortunately Twitter Publications is not the same as putting something in a regulation.25:01And those of you who are on this call who were lawyers or CPAs recognize the accumulated earnings tax and what What reasonable needs of the business mean under the section 537 regulations which allow you to have a lot of capital including capital for things that might happen like product liability loss reserves.?That's right in the regulation.?So what about a covid crisis might extend through a whole year Reserve if you're listening to Bill Gates, he's an experienced business person.25:33He says don't expect this to lift for a year you also have We call fairness opinions were in the Securities world where valuation of companies and necessary operational capital is commonly a pint upon so probably a lot of CPA firms and a lot of law firms are going to start issuing these opinions and then Brandon, what is the what is the standard for the Eid L loan??It's even a higher standard, isn't it??Yeah, it's it's here on the bottom of slide 1.26:0826 for the Eid alone.?You have to have substantial economic injury and they basically say that that's a decrease in revenue or a significant increase in expenses with the result being that the business is unable to meet its obligations to pay its ordinary necessary operating expenses in the normal course of business.?So that is I think a little bit higher standard than just having the necessary because you actually have to have an issue with paying your ongoing operations and don't have Revenue coming in to support those.26:38And especially in this is situation where even if you get your 10,000, it causes 10,000 of your PPP to not be forgiven.?It would seem like if you get your 10,000 just send it back because the Eid L is a harsher.27:01Standard.?Yeah, so the other thing is if you're going to apply for the PPP loan, I don't think that it's going to be any there's no reason to delay at this point.?I know some of you think well the fact that it will be forgiven based on my payroll in the eight weeks after I may not have a payroll I may be downsized but I can tell you on the other hand.27:23These rules are not going to get any gentler because these this money is going out the door so much faster than People thought that it would so page 131 or I have more CMS type of slides page 139 just to mention as we did last week.?There is an internal revenue code 139.27:47It's on page 141, which says that an individual who receives reimbursement of reasonable and necessary personal family living or funeral expenses incurred as the result of a qualified disaster can receive that that money and not pay income tax on it even though the employer who makes the payment and characterizes it as reasonable compensation gets the deduction and has no employment taxes on it has no Pension Plan contribution on it.?So it's a nice idea to reach out to your employees and say hey, we are allocating three hundred dollars per employee or reimbursement of these expenses.?Just let us know what your extra expenses.28:31Ben now you're using ship you're paying more for groceries.?Your Netflix bill is higher because you have to stay at home and keep your children from lighting your house on fire.?So what's reasonable and necessary again.?Lots of things are reasonable and necessary including repair and Rehabilitation of the residents and making changes to it to make it more virus safe.28:55So that's section 139 now amount you pay your employees under section 139 I do not think will count towards the PPP loan forgiveness in the succeeding eight weeks.?So we for those of you who are CPAs, we do have guidance.?Now we do have the blue book has come out the Joint Committee of taxations description of the cares act.?It's very well written.29:26It's not taxpayer friendly as I hoped it would be But it is now available.?If you'd like a copy.?Just let us know what we've got some excerpts here.?I'm not going to cover the payroll taxes and the $5,000 per employee credit.?But if you decide you don't want a PPP loan have your accountant run the numbers on the credit.?29:50If you meet one of these two tasks, the business was fully or partially suspended due to two orders from the government that certainly applies to most medical practices or receipts are less than 50% for the same quarter last year.?That's also a medical practices that instead of the PPP loan.?You can get a credit of up to $5,000 per employee per month.?So just limited total to five thousand dollars.?It's not a per month payment.?So I write five thousand dollars per employee per quarter.30:29Not per quarter.?Just total at all under this program.?Okay.30:34I'm glad I've invited you Brandon.?Yeah.?All right.?So we have more information on that.?We also have an article here on page 152 if you're a landlord, can you get PPP money??No, because you have to have payroll most landlords don't have payroll.?If you are a landlord with payroll to an employee you can get bit of PPP money.?But Brandon what's also the hold back on landlords getting Eid El money?31:04Yeah, well, the the other whole back is the issue of whether or not they're considered to be an actual Trader business for purposes of actually applying for the loan because in order to apply and receive the loan you have to be a business and the SBA has guidance out that says if you are a passive business in real estate that you're not going to qualify for this loan, you have to be an active business or you have to be a landlord that rents to another active business.31:30So if you have you know, if you have a building that's a medical practice and you're running to the doctor then that is allowed because the doctor would then be considered to be an active Trader business, but just residential real property.?If you have you know, two or three properties, you're probably not going to qualify as a business under this SBA guidance.31:51Okay, very good.?Now we have an article on the craft if you have real estate that's leveraged in and I'll see that stacked as a partnership or disregarded.?If you think there may have to be alone work out which there were a lot of them in 2008 through 2011.?Read our Crest article here at 162.?You may want to update your operating agreement to take this planning into account.?We also have our creditor protection.32:20And in view of the virus article, which has 22 definitions 30 strategies 38 traps for the unwary that is in your materials as well.?You're having trouble sleeping because you can't get tranquilizers.?You could always read that article.?It's proven to cause sleep.?Here's the ark here's where Newton says that people with loans above 2 million will get a full audit.?So hopefully they'll borrow less and leave more for us.32:51Brandon in three minutes or less what other developments have happened in the PPP program since a week ago when we last gave this talk.?Yeah, we had a couple of new frequently asked questions issued by the SBA the main one covers, you know, what is considered to be necessary to support the ongoing operations, which we discussed.33:13They provided some guidance on how we're calculating our total number of employees for applying the employee limit and they basically told us that we're including all of our full-time part-time anybody that you've paid payroll W-2 wages during the year that that applies you have to count them as an employee.33:34It's a little different test for purposes of determining how much our loan forgiveness is because when we have when were measuring our loan forgiveness, we're looking at our total number of employees we have in this eight-week covered period compared to the total number of Employees we had in a prior period And if we have if we fire employees or lay off employees, they basically set up a proportion of our loan forgiveness is going to be decreased because they want to keep you maintaining your payroll.?They don't want you to accept this money and then keep it all for yourself and not paid out to your employees.?So they have certain tests that apply to us for purposes of that measurement.?We're using a full-time equivalent measurement, which we think is basically adding up the number of hours your employee works.34:20Based upon a 30-hour week if they hit the 30-hour they are considered a full-time equivalent and employee so slightly different test there and there's guidance issued on how we're calculating those amounts as well.?So I think that is the most recent update for the PPP program touching on the main points, and there's still a lot of unanswered questions as to how we're calculating loan forgiveness, and they're expected to issue regulations on those items in the next couple of days.34:50I will definitely come out and provide you with those when they're available.34:54Very good.?Now Monday was the first day that individuals who own businesses and their personal names or under llc's that are disregarded.?We're able to apply for PPP loans.?The bankers are not very enthusiastic about it.?They're both still earning.?The banks are getting paid five percent of the amount of the loan, but obviously working with the smaller entities.?It's going to be smaller loans and really small because the independent contractors and sole Proprietors.35:24Are not able to borrow based upon two and a half months of very much.?They can get two and a half months of their net profit from last year, but no credit for health insurance cost.?No credit for pension costs no credit for state employment taxes and nothing for more than a hundred thousand.?So they basically just get a 20,000 $833 PPP loan.?I mean, that's something that's not nothing, but that would be a lot more.35:54or if they were had been in an S corporation and and then their payback is Automatically considered to be 15,000 385 forgiven because that's what they would have earned on average.?They made a hundred thousand a year.?So they paid so they borrow about 21,000.?They are automatically forgiven 15,000 again, that's assuming they make a hundred thousand a year or more last year.?36:24And then they can spend money on utilities interest and rent.36:31But only if these utilities interest and rent, first of all were in place February 15th and second they had expenses for each of these last year.?So if you didn't have any rent expense last year and you have rent expense this year, then it's not it doesn't count towards the Forgiveness.?So we have a whole hour and a half on independent contractors which were obviously not going to go through here.36:58I don't think I have a slide for the fact that Governor DeSantis is order preventing elective surgeries is set to expire and he's letting it expire so certainly hospitals and surgery centers are gearing up to reopen May 11th.?Now the political winds are still blowing so there is no definition as to what a safe.37:28Elective surgery is if it's a surgery that could easily be put off another six months without inconveniencing the patient or their family then it's going to be safer for them to push it off and there's going to be I'm sure medical malpractice cases where doctors do cataract surgeries and other surgeries that are considered to be delay able based upon the facts and circumstances of the patient certainly have the patient sign a waiver.37:58A separate waiver that they understand that whatever they're doing does subject them to the risk of the covid virus have them sign that waiver.?Well before the procedure remind them of the waiver because over and over again patients indicate that they didn't understand they were signing a waiver.?It was never explained to them have a nurse or other Personnel in the room when you explain to the patient that you have discouraged the elective surgery.38:28Are the ones who want it the covid-19 and other risks are specifically out there and make sure that you comply with all CDC guidelines.?All AMA guidelines all medical industry guidelines to protect that patient and your team your employees and contractors from getting the infection.38:54If you have employees, they can't sue you under the workers comp statute unless you were violating the law.?So make sure you don't violate any laws or encourage them to violate any laws or any safe practices if in doubt let that elective surgery be pushed back even farther, but obviously you have to balance finances and most important the welfare of the patient.39:21Now we have a CMS waving some of the Stark law requirements to basically allow you to refer covid-19 patients or patients who need Diagnostics that would cause them to be candidates for covid-19 to your spouse's business or to practice or a business that you own this allows hospitals to lease space right now from doctors for even more.39:51More than it's worth but be very careful.?There was no rollback of the Stark law requirements or how a group practice shares its money and the State of Florida did not roll back its anti-kickback statute did not roll back its self-referral acted not roll back its patient brokering act.?So try to keep things as you did before don't assume that you can do silly stuff.40:21Just because some of these things are being waived but we do have information on the waivers for you.?Some of them may apply to you.?We also have Medicaid waivers in Florida.?We have a letter here in our materials.?I believe this is the last thing we have to cover.40:41March 16th where CMS wrote a letter specifically to Florida Medicaid waving a number of Medicaid requirements.?So you are now able to do more things without pre-approval more things that Medicaid wasn't paying for.40:58It's worth reading this if you are a Medicare provider Okay.?Well that concludes our presentation Jeff.?Do you have anything to add Alan I'm just sitting here thinking I think the main thing is just be cautious before you sign up for any of these programs make sure that you can attest honestly to how the funds are being spent if you get more than $150,000.?Remember you have to do a quarterly attestation as you and I discussed earlier.?We don't know how long that quarterly attestation would go.41:32One would think it would stop on the funds are accounted for but we have not been able to find a definition on that.?I think the key is make sure that you're documenting well where the funds are going and make sure it's not going to Physicians bonuses and make sure it's going to legitimate cost of the practice to keep the practice moving forward and treating patients.41:56By the way, last week Jeff had a fantastic list that we had worked on together of 15 or 16 things that you can be doing for your practice that your staff can be doing to improve or increase the value of the practice to increase the profitability of the practice to increase the efficiency of the practice.?So these things are most of them are no-brainers.?They're also in the grow your medical practice book for the most part.42:25The big the big question for many of us when this is finally over six months to a year from now or six weeks from now, who knows is not going to be how much did it cost me in money or how much did it hurt me in my day-to-day life.?I think the question we're going to ask ourselves is what did I do about it??How did I perform??How did I help others?42:53How did I continue to attend and protect my All the health of my family my mental health the health of my family.?We are all on everyone on this call is a leader and a professional and this has been a great opportunity for all of us to grow as leaders and to grow as professionals and to be able to be proud of what we achieve and what we endure and and what and what how we handle things today through the end of this crisis.43:25So again, you have our email addresses here a gasman at Gaston Brandon it gasping Jeff H.?@r A Howard .?Please let us know your questions comments and suggestions will set up another update or medical practices and Physicians when we get a few new breaking things, May the rest of your day be enjoyable and productive.?Thank you.?Thank you.RE-GENERATE TRANSCRIPTSAVE EDITS ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download