Senate's pandemic relief bill will help optometry practices nationwide; AOA to seek additional support

Doctors of optometry and optometry practices across the U.S. will be immediately eligible for emergency loans and other crisis relief support under a $2.2 trillion economic rescue package now advancing in Congress and expected to be signed shortly by the President.

The "phase three" COVID-19 bill approved by the Senate early Thursday and expected to be voted on by the House of Representatives on Friday is seen as a major step in addressing damage to businesses and the millions of jobs lost due to the pandemic. The AOA, which has been ensuring that the concerns of doctors of optometry nationwide have been front and center on Capitol Hill, is now planning to mobilize to ensure that optometry practices are able to fully access new crisis relief programs.

Although this legislation does not include an AOA-backed, physician-specific crisis relief provision ( S. 3559 / H.R. 6365), the bill will make much-needed continuity support available to doctors of optometry, optometry practices and optometry students through new crisis recovery programs and funding. This includes $350 billion in emergency 7(a) loans to be made as soon as possible through local lenders, which would be completely forgiven if used for legitimate business purposes.   

"While the physician-specific relief was not added to this bill, doctors and optometry practices will be helped by these emergency, 'forgivable' business loans in the near future," says AOA President Barbara L. Horn, O.D. "In addition to ensuring that optometry is treated fairly under the 7(a) program, the AOA will continue working with Sens. Michael Bennet and John Barrasso, and other champions, to secure additional, targeted physician relief we need and deserve."  

Already, support is growing for the S. 3559/H.R. 6365 physician relief plan that AOA will continue to advocate for in the days ahead, especially as a potential "phase four" bill works through Congress.  

Overall, the $2.2 trillion plan provides a one-time $1,200 check to individual taxpayers and a $2,400 check for married filers (phase-out begins at $75,000 single and $150,000 married), with an extra $500 per child. The bill expands unemployment insurance with additional federal monies of $600 per week to combine with state funds and help workers get back to near 100% of their previous wages. Additionally, the bill expands access to unemployment for part-time and self-employed workers.  

Doctors can learn how this package directly supports practices by registering for a special AOA webinar, which will provide details regarding new changes for sick leave and Family Medical Leave Act requirements, as well as review financial support options for doctors resulting from this legislation.  

CARES Act specifics

In reviewing the phase three bill, the AOA called out specific provisions that will impact doctors of optometry, their practices and patients, and students :

• New 7(a) 'forgivable' small business loans.
  The "Paycheck Protection Program" plan sets aside $350 billion for a new program to quickly get financial resources out to optometry practices and other small businesses, then forgives that loan later if used for a legitimate business expense during the covered, 8-week period.

  The program allows loans up to $10 million (actual amount tied to payroll costs) and utilizes 7(a) lenders (many private lenders participate). The loan is fully guaranteed by the federal government and eligibility is based not on ability to repay but rather on being a business in operation at the time of COVID-19 outbreak. The loan will be forgiven if funds are used for specific business-related expenses, such as payroll costs, rent, interest on mortgage obligations and utilities. The amount of loan forgiveness will be reduced by the number of employees no longer retained and by a significant reduction in salaries.

  There also is an incentive to hire back previously laid-off workers (laid off after Feb. 15, 2020) as employers will not be penalized for having a reduced number of workers for purposes of loan forgiveness if workers are rehired. Canceled debt under this program's loan forgiveness will not be treated as taxable income.

• Emergency Economic Injury Disaster Loan (EIDL) grants.
  This provision provides an immediate $10,000 grant for eligible businesses suffering economic harm due to COVID-19. Businesses that apply for an EIDL would be given the $10,000 advance within three days to maintain payroll, provide paid sick leave and to service other debt obligations. Applicants will not be required to pay back the advance payments, even if they are denied for an EIDL loan.
  
  
• New limitations on small business paid family and medical leave.
  This provision authorizes the U.S. Treasury to provide small businesses with an advance tax credit instead of waiting to be reimbursed quarterly for fulfilling new requirements to provide paid sick and family leave during this public health crisis. The provision also limits employer liability to $5,110 in aggregate for sick leave, $2,000 in aggregate to care for a quarantined individual or child due to COVID-19 for each employee, and $10,000 aggregate for each employee under all leave. It also allows a rehired employee who was laid off after March 1, 2020, to have access to COVID-19 paid sick and family leave.
  
  
• Expanding Medicare telehealth flexibilities.

  This provision eliminates the requirement that limits the Medicare telehealth expansion authority during the COVID-19 emergency period to situations where doctors of optometry and other physicians have treated the patient in the past three years.

• Suspension of Medicare sequester.

  This provision temporarily lifts the Medicare sequester that reduced payments to doctors of optometry and other Medicare providers by 2%, from May 1 to Dec. 31, 2020.

• Small health care provider quality improvement grant program.
  This provision makes doctors of optometry eligible for five years of small health care provider quality improvement grant. The funds will be used to better connect doctors of optometry and others with other health care providers in their area to help increase care coordination, enhance chronic disease management and improve patient health outcomes.
  
  
• Public health and social services emergency fund.
  A new, $100 billion Health and Human Services (HHS) program will provide grants to doctors of optometry and other eligible health care providers for health care-related expenses or lost revenues (not otherwise reimbursed) that are attributable to COVID-19. Providers or suppliers must be Medicare or Medicaid enrolled.
  
  
• Small business loan repayment assistance.
  This provision provides a new subsidy for certain small business loan payments—existing 7(a) Small Business Administration (SBA) loan (including Community Advantage) 504, or microloan product. Paycheck Protection Program loans are not covered. This provision requires the SBA to pay the principal, interest and any associated fees that are owed on the covered loans for a six-month period starting on the next payment due.
  
  
• U.S. Public Health Service modernization.
  Based on an AOA and Armed Forces Optometric Society-backed bill (S. 2629) that would establish a Ready Reserve Corps to ensure enough trained doctors—including doctors of optometry—and nurses are available to help the nation better respond to public health emergencies.
  
  
• Employee retention credit for employers subject to COVID-19 closure.
  This provision provides a refundable payroll tax credit for 50% of wages paid by employers to employees during the COVID-19 crisis. The credit is available to employers whose (1) operations were fully or partially suspended due to a COVID-19 shutdown order, or (2) gross receipts declined by more than 50% when compared to the same quarter in the prior year.
  
  
• Delay of payment of employer payroll taxes.
  This provision allows employers and self-employed individuals to defer payment of the employer share of the Social Security tax they otherwise are responsible for paying with half of the amount required to be paid by Dec. 31, 2021, and the other half by Dec. 31, 2022.
  
  
• Temporary relief for student loan borrowers.
  This provision requires the federal government to defer student loan payments, principal and interest for six months, through Sept. 30, 2020, for optometry students and others without penalty for all federally owned loans.

Stay informed with the AOA's COVID-19 guidance and resources

AOA members can connect with vendors through AOAExcel^®'s group purchasing organization (GPO) for long-term access to hospital-grade, quality-controlled PPE at competitive pricing.

The AOA continues to closely monitor all developments in the U.S. public health response to COVID-19, as well as institute an all-out mobilization on behalf of the profession that includes not only 24/7 advocacy for optometry, but also launching an  unprecedented, multifaceted relief and recovery package.

Given the evolving nature of this pandemic, the AOA remains committed to providing the most up-to-date information, relevant care guidance and resources, and timely reports on federal actions through  AOA's COVID-19 Crisis Response page. This online resource includes:    

• New recommendations for the reactivation of optometry services in the form of  AOA's Optometry Practice Reactivation Preparedness Guide.
• The AOA Health Policy Institute's  "Doctors of Optometry and COVID-19" statement and  FAQ.
• #AskAOA COVID-19 webinar series.
• State-by-state COVID-19 resources and information.
• Latest information from  CDC and  White House Coronavirus Task Force.