Financial Considerations for Private Practices during the Current Health Crisis

Financial Considerations for Private Practices during the Current Health Crisis

The Panel of National Pathology Leaders is a national “think tank” dedicated to seeking practical solutions to challenges faced by Pathology practices.

In our previous quarterly newsletter (published on April 3, 2020), PNPL’s Panelists assembled several items for consideration to help Pathology practices conserve cash and offset a drop in volume and related collections.

A variety of new programs and guidelines have been issued. This is a summary of the newest information.

Paycheck Protection Program Flexibility Act (PPPFA)

On June 3rd, the U.S. Congress passed the Paycheck Protection Program Flexibility Act of 2020 (PPPFA), which modifies the Paycheck Protection Program (PPP) established through the Coronavirus Aid, Relief, and Security (CARES) Act.

This latest legislation changes the requirements that will lead to full forgiveness for most loans.

The chart below was excerpted from an article by Rebecca Farrington from Healthcare Administrative Partners on

financial crisis chart

Paycheck Protection Program Forgiveness (PPP)

  1. All practices that received a PPP loan will need to apply eligible payroll and expenses for full forgiveness
      • Salaries limited to $100,000 per employee
      • Compensation will be forgiven up to:
          1. $15,385 = $100,000 per employee x 8 weeks
          2. $46,152 = $100,000 per employee x 24 weeks
          3. $20,833 = the amount paid to owners
              • Inclusive of health for S corp owners
              • Inclusive of health and retirement for general partners
      • Benefits – Health/Dental/Vision and any Health Savings Account (HSA) plans (excludes Life and Disability)
      • Retirement plan
          1. Contributions up to the IRS max of $285,000
      • Rent, including any payments made to a hospital for technical services or for space to provide referred activity. This also includes rent adjustments such as property taxes and operating costs if the lease is net/net.
      • Utilities, including phone, gas, electric, water, cable/internet
      • Lease payments for equipment and furniture, including postage meter, copier, software
  2. Calculate the lowest FTE baseline:
      • As 02/15/19 – 06/30/19 or 01/01/20 – 2/29/20, and compare to the forgiveness period.
  3. Prepare the forgiveness application (SBA Form 3508 or 3508 EZ).
  4. SBA will publish data for PPP loans greater than $150,000.

Other Government Programs

  1. Medicare Grant
      • CDC issued a report showing payments for each provider.
      • The amount was based on 6.2% of Medicare payments for 2019 services.
  2. Provider Relief Fund (2% of 2019 or 2018 income)
      • Based on submitting loss of income for March and April 2020
      • Submitting tax return
      • Reduced by the Medicare Grant previously received
  3. Main Street Loans
      • The Main Street Lending Program is a new offering created by the Federal Reserve to help businesses during the ongoing COVID-19 crisis and accompanying economic downturn.
      • It offers an alternative to the Paycheck Protection Program (PPP), the Economic Injury Disaster Loan (EIDL) program and the Express Bridge Loan program.
      • Companies that have already applied to the PPP are also eligible for loans through the Main Street Lending Program.
      • Unlike other coronavirus relief efforts for small businesses, these programs are not connected to the Small Business Administration.


  1. Add an announcement to your website detailing back-to-work plans and other updates since the crisis began.
  2. If you are on social media, post updates corresponding with the ones on your website.


DISCLAIMER: Please check with your accountant or attorney before implementing any of the actions above. This information is provided as suggestions for consideration and is thought to be accurate as of the date of the publication. All action taken, or not taken, is the responsibility of the reader.

Slide 1

“PNPL provides real-time value to critical issues in healthcare/laboratory. I appreciate their coverage of relevant topics far enough in advance of changes being enacted, allowing more opportunity to act in our ever-evolving, complex businesses.”

James Deluca
John Stokes, Chief Financial Officer
Dallas, TX

“The PNPL library contents and access to the PNPL membership have been invaluable resources as we navigate challenges around topics such as recruiting, hospital contract negotiations, insurer contracting as it relates to professional charges on clinical pathology work, and the implementation of digital pathology.”

Sam Dean
Kim Ginevan, MD, Assistant Managing Director
Spectrum Healthcare Partners
Portland, ME
Slide 3

“After Joining PNPL, our pathology group in Arizona (one of the largest in the nation) found expert advice on billing, coding and digital pathology, as well as suggestions and support for our negotiations with United Healthcare. The PNPL team is full of experts in the pathology space who are sharing best practices, tools and templates that allow for knowledge in the industry. I highly recommend joining this think tank and look forward to continuing our relationship.”

Lucy Crowe
Sarina Rodriques, Chief Operating Officer
Pathology Specialists of Arizona
Phoenix, AZ
Slide 4

“Membership in PNPL has been extraordinarily valuable to PDPA by connecting us to a diverse group of thought leaders involved in the business of pathology and providing access to a curated reference library which has been very helpful in informing our decision making. We look forward to continuing our participation in PNPL.”

Farrah Lynch
Tarek Bishara, MD, President
Pee Dee Pathology Associates
Florence, SC
Slide 5

Smart Slider 3 is the best slider that i’ve tried so far. There’s so many useful functions and easy to understand how to use it.

“I value the access and information exchange with highly experienced and successful professionals in the pathology space.”

Jennifer Pinasco, MHA, Chief Executive Officer
Yosemite Pathology | Precision Pathology
Modesto, CA
Design Director
Slide 5

Smart Slider 3 is the best slider that i’ve tried so far. There’s so many useful functions and easy to understand how to use it.

“Membership in PNPL offers IU the ability to see the pathology field as a whole, rather than looking solely through the academic lens. The interaction with PNPL’s private practice groups allows me to understand their ‘pain points.’ Since our academic group includes community practices at the outlying hospitals, we too are feeling some of the same pain. Access to benchmarks from both academic and private practices has also been invaluable as I address issues on the academic side.”

Andrea Ligler, MBA, Vice Chair Clinical and Academic Administration
Department of Pathology and Laboratory Medicine
Indiana University School of Medicine
Indianapolis, IN
Design Director
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