NAAOP Hosts Virtual Congressional Fly-In to Advocate for O&P Legislation

On December 8, 2021, NAAOP hosted a Congressional “Fly-In” to advocate for passage of orthotic and prosthetic legislative priorities. The event was virtual and designed as a “pilot” to assess the feasibility of conducting such events in the future. The pandemic has made telephonic visits to Capitol Hill offices much more common, and this enabled NAAOP to proceed with this event. Over twenty board members, NAAOP fellows, and members in key Congressional districts participated in over 30 meetings with Congressional leaders. The timing of this advocacy event could not have been better, with Congress poised to pass a massive, year-end spending bill to fund the federal government and debating a major COVID-19 relief package. These pieces of legislation are considered “must-pass” which presents an opportunity to attach O&P-specific bills to this legislative vehicle.

NAAOP focused on three issues, passage of the Medicare O&P Patient-Centered Care Act, passage of the “Triple A” Study Act, and introduction to a new issue, the importance of recognizing the medical necessity of prosthetic limbs and other technologies to enable people with disabilities to exercise and remain fit and healthy. NAAOP members and friends who wish to help advocate for passage of the two bills can go to the Legislative Action Center on the NAAOP website at www.naaop.org.

In virtually all of our Congressional meetings, the three issues we discussed were well received and there is reason to be optimistic for action on this legislation in the future. However, these bills are not necessarily considered linked to COVID-19 and, therefore, not necessary to include in the end-of-year packages. There are so many pressing matters before Congress that several champions of our legislation cautioned that inclusion of our provisions in year-end bills would be a huge lift, notwithstanding their support for the contents of our proposals.

The Patient-Centered Care Act is bipartisan and has champions on both sides of Congress. A Congressional Budget Office estimate of its cost is not yet complete and this is a necessary step for Congress to proceed. If action is not taken this year to advance that bill, AOPA has learned—and the lead sponsors NAAOP met with confirmed—that this legislation will be re-introduced in the new Congress. The Triple A Study Act was introduced in August 2020 at the behest of the Amputee Coalition. Our advocacy centered around building awareness of and support for the legislation and the value of obtaining the wealth of information on O&P insurance coverage, demographics, and access to care the bill would produce. NAAOP also highlighted a position statement and policy paper from Nicole Ver Kuilen, NAAOP board member and Inaugural NAAOP Fellow, on the right of people with disabilities to exercise. The issue received broad support and encouragement to return to the next Congress to discuss further.

NAAOP would like to thank all of those who participated in this successful advocacy event on behalf of the O&P profession and the patients we serve.

  • Written by opie-admin

Election Results Set Stage for Health Care Policy Changes

2020 Election: President-Elect Biden’s win in the 2020 election was muted by weeks of controversy over vote counts and legal challenges but the transition to a Biden Administration is now underway. The expected “blue wave” did not materialize as some expected, with Democrats losing several seats in the House, making the 117th Congress one of the slimmest Democratic margins in recent memory. Senate Republicans lost one seat and retain control of that chamber to date, but two runoff elections scheduled for January 5th in Georgia will determine whether Republicans or Democrats control the Senate. If Democrats win both seats, an unlikely prospect, Democrats will be able to pass budget legislation with a simple 51-vote majority, but most legislation will still require bipartisan cooperation to prevent a 60-vote Senate filibuster. Either way, the mixed results place tremendous emphasis on the need for bipartisan cooperation.

Prior Authorization: Prior authorization of six lower limb prosthetic HCPCS codes will be implemented nationwide on December 1, 2020 as the four-state pilot program, which began September 1st, is expanded. By all accounts, the program has been more successful than expected, with relatively quick prior authorization approval times. The upside of prior authorization is that claims for payment are afforded some degree of finality, with less risk that such claims will be audited by Medicare contractors and the funds recouped. If you experience problems with the nationwide rollout of prior authorization, please report your experiences to NAAOP and ask your patients to call 1-800-Medicare to lodge a complaint with the program.

OTS Competitive Bidding: The Medicare program is pressing forward with implementation of competitive bidding of certain off-the-shelf (“OTS”) orthotics in 127 competitive bidding areas (“CBAs”) throughout the United States on January 1, 2021. Despite requests to delay the program due to the pandemic and the lack of sufficient notice to providers, CMS is rolling out the program which applies to 23 HCPCS codes for OTS knee and back braces. The program was able to achieve, on average, 30% to 35% reductions in reimbursement amounts, varying by geography. According to Medicare data, certified and/or licensed orthotists provide less than 20% of these orthoses, with physicians, therapists, DME suppliers and pharmacies providing the bulk of these orthoses. Claims submitted for these 23 OTS codes will not be paid if the supplier does not have a competitive bidding contract.

NAAOP Virtual Congressional Fly-In: NAAOP is hosting a “pilot” virtual Congressional Fly-In to promote passage of O&P legislation including the Medicare O&P Patient-Centered Care Act (S.4503) and the Triple A Study Act (S. 4343). The Fly-In is a pilot to test the effectiveness of a virtual model as Congressional members and staff adapt to advocacy during a pandemic. Over 20 board members, NAAOP Fellows, and key NAAOP members will participate in over 50 telephonic meetings on December 8, 2020. NAAOP will assess the effectiveness of this model and decide whether to host these fly-ins in the future.

Thanksgiving: It has been a very difficult year by all accounts, but NAAOP is optimistic that better days lie ahead. We at NAAOP take this opportunity to wish all NAAOP members and friends a Happy Thanksgiving in the safest and most meaningful way possible. And, as always, we thank you for your membership and support!

  • Written by opie-admin

Health Care on the Ballot as America Votes

Health care is playing an outsized role as the 2020 election is underway and the Senate is poised to install a 6-3 conservative majority days before the U.S. Supreme Court hears arguments about the Constitutionality of the Affordable Care Act (ACA).

President Trump and former Vice President Biden face off on November 3rd but the election is already well underway.  At the time of this writing, early 18 million people have already voted in states that permit early voting.  Turnout is expected to break records.  One of the dominant campaign themes has been health care including the national response to the pandemic and the threat to health care access through challenges to the Affordable Care Act.

The Biden Campaign offers extensive detail on health care policy, including reducing the age to 60 (from 65) for individuals eligible to join the Medicare program, establishment of a “public option” for the uninsured to obtain health insurance in order to drive down the cost of health care while enhancing access, bolstering existing aspects of the ACA, reducing the cost of prescription drugs, and coordination of a national plan to combat the pandemic.

The Trump Campaign did not issue a policy platform this year so details of what a second Trump term would mean for health care policy is not entirely clear.  But it is likely the next four years would include continued efforts to reduce the price of prescription drugs, limit “surprise” medical bills, provide greater transparency in health care pricing, and implement additional reductions in regulatory burdens on health care providers.  Although the President professes strong support for protecting people with pre-existing conditions, his Administration is poised to argue before the Supreme Court that the ACA is invalid and should be entirely struck down.

An accelerated effort to replace Justice Ruth Bader Ginsburg with Judge Amy Coney Barrett is being driven, in part, by a desire to fill this court vacancy before the election and have a full court in place to hear the latest legal challenge to the ACA.  A lower Texas court determined that the ACA is invalid because Congress eliminated the monetary penalty for failure to satisfy the individual insurance mandate that is critical to achieving near universal coverage, which accompanies protections from pre-existing conditions, community rating, non-discrimination based on health status, protection from lifetime and annual caps, and other provisions.  If there is no monetary penalty for failing to have insurance, the Texas court argued, then Congress’ authority to pass the ACA based on its taxing power is invalid.  The lower court struck down the entire 1100-page law but the result was “stayed” until the Supreme Court could hear the case.

That case is scheduled for argument on November 10, 2020 and a decision will be rendered sometime in June of 2021.  At stake are numerous insurance protections cited above that impact millions of Americans, as well as health care coverage for 20 million people from expanded Medicaid and private insurance under the health insurance exchanges.  Despite the expected conservative majority hearing the case, there is a real chance the court will not strike down the entire ACA.  The real question before the court is whether the individual mandate can be severed from the existing law while the rest of the law survives.  This is the most likely outcome, but there are no guarantees with any case before the highest court.  NAAOP will continue to keep our members and friends informed as developments occur.

We urge all members of the O&P profession to VOTE on November 3rd!

  • Written by NAAOP

Major Bills Introduced and Policies Advanced as COVID-19 Drags On

Significant developments occurred over the past several weeks impacting the orthotics and prosthetics community including the following:

  • Introduction of Senate Bill 4503: Senators Daines (R-MT), Warner (D-VA), Cassidy (R-LA), Duckworth (D-IL), and Cornyn (R-TX) and introduced S. 4503, a companion bill to H.R. 5262, the Medicare O&P Patient-Centered Care Act of 2020.  This long-awaited legislation is bipartisan, mirrors the House version of the bill, and provides the O&P community with a legislative goal in the Senate. S. 4503 separates DME from O&P clinical services, reinstates Congressional intent on the meaning of off-the-shelf (OTS) orthotics for purposes of competitive bidding, exempts certified and licensed orthotists and prosthetists from OTS competitive bidding, and prohibits “drop shipping” to patients homes of any orthoses or prostheses that require clinical services. NAAOP supports this legislation and encourages our members and friends to write your Senators seeking cosponsorship of the bill by clicking on https://naaop.org/congressional-action-center/.
  • S. 4343; The Triple A Study Act: The Amputee Coalition of America recently announced introduction of the Triple A Study Act, bipartisan legislation sponsored by Senators Blackburn (R-TN) and Duckworth (D-IL) that would collect nationwide data on limb loss and limb difference and update our collective knowledge base of the patients served by the O&P profession. NAAOP supports this legislation and will be advocating for its passage.
  • Medicare Audits and Prior Authorization: Having suspended Medicare audits and implementation of prior authorization for six lower limb prosthetic codes due to COVID-19, CMS has now reengaged these programs. As of August 3, 2020, Medicare contractors are permitted to begin audits of Medicare providers and suppliers but have been instructed by CMS to accommodate those providers overwhelmed by COVID response. CMS is also pursuing prior authorization of six lower limb prosthetic codes beginning September 1st in four states (i.e., TX, CA, MI, and PA) and will implement the program nationally on December 1st. In addition, lower limb prosthetic components described by these six codes must be verified by the PDAC by January 1st. For more information on the prior authorization program, Noridian will be hosting a webinar on September 10th at 12:00 Noon, Central Time.  Click here to sign up for this webinar.
  • OIG Orthotics Reports Continue to Alarm the O&P Community: In the past several weeks, three separate HHS Office of Inspector General (OIG) reports have been issued on suppliers of orthotics, asserting very high error rates, in some instances 100% of the claims reviewed. The suppliers under review typically employ a business model reliant upon drop shipping certain typically off-the-shelf orthoses directly to patients’ homes. The OIG asserts that a simple physician prescription is not enough to justify medical necessity and that suppliers are obligated to verify the medical necessity of the orthoses they bill to the Medicare program. These reports reflect negatively upon the orthotics community, but they also provide evidence of the need for Congress to pass the Medicare O&P Patient-Centered Care Act and are helpful in making that case to legislators.
  • Nicole Ver Kuilen Just Felt Live Running: Nicole Ver Kuilen, the NAAOP Inaugural Fellow and one of our newest NAAOP board members, announced on July 20th, in conjunction with the 30th Anniversary of the Americans with Disabilities Act, a virtual race to be held on October 3rd across the country to promote exercise among people with disabilities.  The race is being organized by Nicole’s organization, Forest Stump, and is designed to highlight the discriminatory effect of coverage denials by insurance companies of prosthetics, orthotics, and assistive devices and technologies that allow people with disabilities to be physically fit and active.  The virtual race will culminate in Washington, D.C. with the delivery to Congress of a petition to make this point.  To support this incredible effort, please click on the following link. www.ForrestStump.org/Take-Action  Congratulations Nicole on this innovative advocacy project! NAAOP is with you all the way!

  • Written by Web Updates

Major Medicare and VA Developments Impact O&P Care

As the Trump Administration continues to grapple with the rising number of COVID-19 cases across the nation, the Centers for Medicare and Medicaid Services (“CMS”) and the Veterans Health Administration (“VHA”) recently announced policy developments that impact the provision and reimbursement of orthotic and prosthetic care.

 

CMS Moves Forward with Prior Authorization for Six Lower Limb Prosthetic Codes

 

On July 1, 2020, CMS announced that it will require prior authorization for six lower limb prosthetic Healthcare Common Procedure Coding System (“HCPCS”) codes (L5856, L5857, L5858, L5973, L5980, and L5987) with dates of service on or after September 1, 2020, in four states—Texas, Pennsylvania, Michigan, and California.  CMS will then expand prior authorization nationwide beginning on December 1, 2020.  Prior to the COVID-19 public health emergency, CMS stated that the six lower limb prosthetic HCPCS codes would be subject to prior authorization as a Medicare condition of payment in these same four states beginning May 11, 2020, and nationwide beginning October 8, 2020.

 

In addition, on June 26, 2020, the Durable Medical Equipment Medicare Administrative Contractors (“DME MACs”) and the Pricing, Data Analysis, and Coding Contractor (“PDAC”) published a joint announcement and a revised Lower Limb Prostheses Local Coverage Article announcing that claims will not be paid for these six prosthetic codes with dates of service on or after January 1, 2021 unless the particular prosthetic component has undergone code verification by the PDAC and approval to bill a specific prosthetic L-code has been published on the appropriate Product Classification List.

 

NAAOP believes the circumstances that prompted CMS to delay prior authorization still exist and, in fact, have gotten worse.  NAAOP does not believe it is an appropriate time to impose new documentation requirements on health care providers and is taking steps to convey its position to CMS.

 

CMS to Resume Medicare Fee-for-Service Audits

 

On July 1, 2020, CMS also announced that medical review activities—including pre-payment audits conducted under the Targeted Probe and Educate program and post-payment audits—will resume beginning on August 3, 2020.  CMS previously suspended most Medicare Fee-for-Service medical reviews in light of the COVID-19 public health emergency.  CMS notes that providers selected for review should discuss with their DME MAC any COVID-19-related hardships they are experiencing that could affect audit response timeliness.

 

VHA Publishes Directive Regarding the Use of Not Otherwise Classified (“NOC”) Codes

 

On June 24, 2020, VHA released VHA Directive 1045 establishing the policy and responsibilities for developing and utilizing appropriate coding, market analyses, and contract guidance for prosthetic limbs and/or custom orthoses.  Among other things, VHA Directive 1045 confirms that the Department of Veterans Affairs (“VA”) may assign codes (i.e., miscellaneous “not otherwise classified” codes) to prosthetic limbs and custom orthoses, although the directive lacks details regarding the VA’s coding process.  NAAOP suspects that VHA published this directive in response to the Department of Veterans Affairs Office of Inspector General’s report entitled, “Veterans Health Administration: Use of Not Otherwise Classified Codes for Prosthetic Limb Components.”  A key conclusion of the directive is that the VA retains independent authority to code new technologies when CMS has not yet assigned—or does not intend to assign—a billing code.  This is a very positive development that NAAOP will pursue in the future.

 

NAAOP will continue to keep our members informed as regulatory developments continue.  Please consult our website for more information.

 

  • Written by NAAOP

NAAOP Works with O&P Alliance to Request Telehealth Coverage of O&P Care

In response to member requests, NAAOP has been working with the Orthotic and Prosthetic Alliance organizations over the past several weeks on a proposal for the Centers for Medicare and Medicaid Services (CMS) to authorize appropriately credentialed orthotists and prosthetists to submit claims for certain Medicare services furnished virtually (through telehealth) during the COVID-19 public health emergency.  This initiative culminated in an O&P Alliance letter submitted to the Secretary of Health and Human Services (HHS), Alex Azar, as well as the CMS Administrator, Seema Verma, on June 11, 2020.  A copy of the letter can be viewed here.

The letter states that in the case of senior and disabled Medicare beneficiaries who are at increased risk for COVID-19, “it is especially important that certified and/or licensed orthotists and prosthetists be able to assess, triage, and provide ongoing orthotic and prosthetic care to individuals who remain safely at home.  Under normal circumstances, patients would simply visit their orthotist or prosthetist when they were experiencing problems with fit, comfort, or function of an orthotic brace or prosthetic limb.  In a pandemic environment, the patient must weigh the prosthetic or orthotic problem against the risk of potential infection by visiting their orthotist or prosthetist in person.”

The letter makes the case that the COVID-19 pandemic has exposed an inequity in reimbursement of O&P clinical services that NAAOP and the Alliance believe should be rectified.  The letter cites a number of clinical examples of services that are not reimbursable to appropriately credentialed orthotists and prosthetists outside of the 90-day window after delivery of an orthosis or prosthesis, but are separately reimbursable to physicians and therapists under the CPT coding system.  Some of these clinical services include:

  • Reinforcing the appropriate wearing schedule;
  • Confirming the prosthesis or orthosis is being worn properly;
  • Evaluating the function of the device;
  • Assessing the need for any ancillary supplies;
  • Addressing fitting problems based on a change in the patient’s condition; and,
  • Observing any potential or actual skin breakdowns.

The COVID-19 pandemic has exposed this inequity and prompted NAAOP and the O&P Alliance to press forward with a request for CMS to authorize separate reimbursement of these clinical services through telehealth during the public health emergency.  Utilizing telehealth would allow these elements of care to be accomplished without placing orthotic and prosthetic practitioners or patients at unnecessary risk of contracting the COVID-19 virus.   

The letter recommends that CMS grant authority for appropriately credentialed practitioners to use either certain L codes or K codes to submit claims for these services, but is open to ongoing discussions with the agency to discuss alternatives in this regard.  NAAOP and the Alliance organizations will continue to work with CMS to advance this issue and will report back to our membership as developments occur.

  • Written by NAAOP

Update on COVID-19, Joint Statement on Race Relations, and O&P Policy Agenda

The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) is proud to stand alongside our sister organizations in the O&P profession in signing and supporting this statement.

As a result of recent events in our country, we want all members of the O&P community to know that your O&P professional organizations stand together against racism. We are steadfast in our commitment to fairness, justice, and respect for all. We remain dedicated to open dialogue, active listening, and working toward enhancing diversity at all levels of our profession.

American Academy of Orthotists and Prosthetists (AAOP)
American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC)
American Orthotic and Prosthetic Association (AOPA)
Board of Certification/Accreditation (BOC)
National Association for the Advancement of Orthotics and Prosthetics (NAAOP)
National Commission on Orthotic and Prosthetic Education (NCOPE)

 

Update on COVID-19, Joint Statement on Race Relations, and O&P Policy Agenda

COVID-19:  NAAOP is pleased to welcome back our General Counsel, Peter Thomas, who, along with his parents and sister, acquired COVID-19 last month.  Peter is now healthy and back on the job to help the O&P community advance policies that benefit orthotists, prosthetists and the patients they serve.  Peter offers his sincere gratitude to all of those who reached out and offered their condolences and support to him upon the passing of his parents to COVID-19. His sister, Kathy, has also fully recovered. NAAOP also reiterates the importance of the O&P provider community remaining vigilant in protecting themselves, their staff, and their patients from COVID-19 transmission as the field begins accelerating the delivery of patient care.

Race Relations:  In the wake of the horrific events involving George Floyd and others, as well as the national protests that have ensued, NAAOP and its sister O&P organizations (AAOP, AOPA, ABC, BOC, and NCOPE) today issued a joint statement as follows:

 “NAAOP is proud to stand alongside our sister organizations in the O&P profession in signing and supporting this statement. As a result of recent events in our country, we want all members of the O&P community to know that your O&P professional organizations stand together against racism. We are steadfast in our commitment to fairness, justice, and respect for all. We remain dedicated to open dialogue, active listening, and working toward enhancing diversity at all levels of our profession.”

NAAOP recognizes it is not a “profile in courage” to state that we, as an organization, are opposed to racism, and in favor of fairness, justice, and respect for all.  Racial discrimination existed long before the recent events occurred but we feel strongly about being on record and hope that the widespread debate taking place across the country is a step forward in helping to resolve these intractable problems.

O&P Policy Update:  NAAOP is pleased that CMS suspended the pilot project on Medicare prior authorization of six prosthetic HCPCS billing codes in four states (i.e., CA, MI, PA and TX) originally scheduled to be implemented on May 11, 2020.  NAAOP advocated for this suspension because implementation of a new documentation system for certain prosthetic components during a pandemic created a major risk of delay and denial in access to patient care.

The Paycheck Protection Program (PPP) has been funded at over $600 billion to assist small businesses, including O&P practices, during the COVID-19 pandemic.  Many O&P practices have taken advantage of this program.  Recently, new legislation was enacted to modify the terms of the PPP such as extending the time period to expend the funds, the time period for paying back the loan (if it does not qualify as a forgivable loan), and increasing the share that businesses can expend on non-payroll expenses.  NAAOP encourages all O&P practices to examine this program to see whether it makes sense to apply.

Finally, NAAOP has been working with its O&P Alliance partners to explore ways for orthotists and prosthetists to be reimbursed for O&P telehealth services provided to O&P patients, outside of the 90-day window after delivery of an orthosis or prosthesis.  We will update NAAOP membership as this issue progresses.

  • Written by NAAOP

A Very Personal COVID-19 Update

As our country begins to reopen from the pandemic and O&P practices begin to return to some sense of normalcy, NAAOP encourages all O&P members and friends to redouble their efforts to take steps and implement procedures to minimize the spread of the COVID-19 virus. This virus is anything but contained, is highly virulent, and can have a devastating impact on those who acquire it. We reiterate the importance of protecting yourselves, your families, your staff, and your patients as you provide vital O&P services to patients in the future.

NAAOP’s General Counsel, Peter Thomas, lost his parents in the past two weeks to COVID-19 and now has the virus himself. Without the ability to mourn his parents in any traditional way, NAAOP is sharing a tribute he wrote to honor his parents and we invite you to read it to reflect on their exceptional lives. You can read the Bill and Anita Thomas tribute here. Thank you.

  • Written by NAAOP

O&P Practices Included in Stimulus Funding: Check Your Medicare Account Today

This morning (and throughout the day), the Centers for Medicare and Medicaid Services (CMS) directly deposited grants to ALL Medicare providers and suppliers, including O&P practices.  NAAOP encourages all O&P practice owners to check their Medicare accounts to ensure the funds were received.

The funds are part of the stimulus funding enacted under the COVID-19 legislation that passed two weeks ago today, known as the CARES Act.  The legislation created a $100 billion fund to assist health care providers to weather the pandemic.  The first $30 billion in stimulus funding is being distributed today.

These are grants and do not need to be paid back.  The amount of each O&P practice’s payment is determined automatically, based on the portion that the Medicare program paid each provider or supplier last calendar year.  Even as recently as last evening at 6:00 p.m., it was not clear whether O&P practices would be included in this initial round of stimulus payments. The fact that O&P practices were included should be welcome news to the O&P profession after another tough week.

Each recipient of funding must also agree to certain terms and conditions but these are fairly easy to meet.  These payments are separate and distinct from Medicare advance payments and any small business loans/forgivable loans for which O&P practices may have applied.

For a more detailed description of the program, please click here.

NAAOP will work in concert with its O&P Alliance partners over the coming days to submit suggestions to CMS as to how the agency should distribute the remaining $70 billion in funds, as they pertain to the O&P profession.  Among NAAOP’s priorities will be O&P practices located in COVID-19 hot spots throughout the country and O&P manufacturers and suppliers, who were not included in this first round of funding because they do not directly bill the Medicare program.

Please contact NAAOP if you have questions or comments related to these stimulus payments.  Thank you.

  • Written by NAAOP

COVID-19 Paycheck Protection Program Summary: Apply Today to Help Protect Your O&P Practice

As of Friday, April 3, 2020, the Small Business Administration (SBA) is accepting loan applications from lenders under the Paycheck Protection Program (PPP), enacted March 27th.  NAAOP strongly advises all O&P practices to explore this program to see if you are eligible and wish to participate in this first-come, first-served $349 billion program. Once these dollars are exhausted, the program will not accept additional applications. PPP loans do not have to be paid back if borrowers use at least 75% of the loan to retain employees and cover other specified expenses over an eight-week period. For more information on the PPP, please consult a detailed memo here, visit the SBA’s dedicated website here, and review the Interim Final Regulations, detailed guidance published April 2, 2020, here.

What is Available?

Under the PPP, small businesses and 501(c)(3) nonprofits may apply for loans of up to $10 million, based on a formula tied to the entity’s payroll costs. These loans may be applied to payroll costs between February 15 and June 30, 2020, including the costs of benefits (including healthcare and retirement), employee leave, insurance premiums, state and local taxes on employee compensation, mortgage interest, rent, and interest on outstanding debt. Loans may be forgiven in whole or in part if certain criteria are met, described below.

Who is Eligible?

Small businesses who are eligible for PPP loans generally must have fewer than 500 employees and must have been in operation as of February 15, 2020. This means that the vast majority of orthotic and prosthetic (O&P) practices across the country are eligible for these loans,

What Happens After I Apply?

Once an application is submitted and approved, the loan will carry an interest rate of 1.0% for a maximum term of 2 years. No personal guarantee or collateral will be required, and the borrower pays no fees. Loans do not have to begin to be repaid for six months, but interest accrues during that time. Loan funds used for payroll costs, mortgage interest payments, rent, and utility payments, up to the full amount of the loan (and interest) may be forgiven. At least 75% of the forgiven amount must be used for payroll costs. The loan forgiveness amount will be reduced if the borrower cuts their staff during the eight weeks after the origination date of the loan or reduces salaries or wages of any employee by more than 25%. The PPP was intended to keep workers employed, so borrowers are incentivized to do so via the loan forgiveness option.

How Do I Apply?

Applications may be submitted to any lending institution currently approved by the SBA or the Treasury Department, with additional lenders expected to join the program. The SBA has prepared a sample application form for participating entities, available SBA anticipates lenders can start processing applications beginning April 3, and the program will be open to applicants through June 30, 2020, but because of extraordinary demand, applicants are encouraged to apply immediately. It all starts by contacting your commercial lender. Additional resources provided by congressional offices on the PPP process can be found here and here.

  • Written by NAAOP



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