On Dec. 27, President Trump signed the “Consolidated Appropriations Act, 2021”, a COVID Relief and Omnibus Spending Bill, which also includes surprise billing legislation and health extenders. The relief package passed in the House and Senate on Dec. 21 and included several provisions on which NADP has advocated.

  • State APCD Provisions

The Consolidated Appropriations Act does include compromise legislation to limit surprise billing (No Surprises Act). Congress has been working on surprise billing reform for more than a year and talks were previously stalled by competing interests and opinions on settling out-of-network billing disputes. The legislation does not include standalone dental plans in the surprise billing provisions. The relief package includes provisions regarding State All Payer Claims Databases (APCD), including a grant program to incentivize states to create and improve State APCDs which may include dental claims. The compromise APCD provisions align with several of NADP’s policy positions including progress toward standardization, state flexibility on collection of dental claims, and limiting cost and administrative burden by not establishing a federal APCD. 

  • Dental Insurance Costs Covered in PPP Loans

The relief deal also includes a clarification that specific group insurance payments such as ”group life, disability, vision, or dental insurance” are included in the definition of payroll costs for Paycheck Protection Program (PPP) loan forgiveness and expenditure calculations, providing much-needed clarity to small businesses.

In April, NADP sent comments to the Small Business Administration (SBA) and Senate Business Committee seeking clarification that that the costs of dental benefits paid by employers are both included in the definition of group health plan costs and payroll costs in the CARES Act (and subsequent Interim Final Rule). On Aug. 11, the SBA updated the FAQs for the PPP on the inclusion of dental and vision benefits premiums in the definition of payroll costs. The language in the Consolidated Appropriations Act codifies NADP’s request for clarification.

  • Expanded PPP Eligibility to Nonprofits

The package also includes expanded Paycheck Protection Program (PPP) eligibility for 501(c)(6) nonprofits. In September, NADP and more than 2,300 other state and national organizations joined forces to request that Congress treat 501(c)(6) nonprofit organizations, such as trade associations, on equitable equal terms relative to other borrowers (e.g., same employee caps).   


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