AOA reports $1.69 billion in federal relief for practices, leaders pledge continued advocacy

Doctors of optometry nationwide accessed over $1.69 billion in federal relief options to help offset coronavirus-related hardships as the AOA continues advocating for optometry’s inclusion in federal crisis measures.

Provided by the Coronavirus Aid, Relief and Economic Security (CARES) Act, federal relief provisions, such as the Paycheck Protection Program (PPP) and Department of Health and Human Services’ (HHS’) physician relief grants, have been a lifeline for many optometry practices as doctors of optometry report a 20-40% year-over-year reduction in patient visits. To date, the AOA estimates PPP loans and physician relief funding combined have allocated an estimated $1,699,664,386 at a time when it was desperately needed for America’s primary eye care providers.

Specifically, the AOA notes that 16,782 optometry practices received forgivable PPP loans with over 1,700 practices receiving loans of more than $150,000 for an estimated total of $694.3 million. Over 15,000 practices received loans of $150,000 or less for a total of $657.3 million.

Additionally, the AOA estimates approximately 21,747 of the 29,791 doctors of optometry who bill Medicare received an HHS physician relief grant, based on responses from the AOA Health Policy Institute’s pandemic survey. Therefore, it’s estimated a total of $347.9 million in HHS physician relief grants went to optometry. Factored as a 2% reported gross revenue from patient care, these physician relief grants averaged about $16,000 per eligible doctor of optometry by AOA’s estimate.

Combined with the AOA’s advocacy to ensure optometry’s inclusion in the CARES Act and other federal relief measures, and the AOA’s multifaceted COVID-19 response, the AOA also helped doctors gain access to and make best use of
Economic Injury Disaster Loans (EIDL), federal student loan payment deferments and expanded Medicare telehealth provisions.

“Over the past several months, the AOA has focused on ensuring that doctors of optometry across the nation have the support they need to withstand the significant impacts this pandemic has had—and continues to have—on our patients and our profession,” says William T. Reynolds, O.D., AOA president.

“Through AOA’s steadfast advocacy in Washington, D.C., and all-out reprioritization in these challenging times, we can proudly say tens of thousands of doctors of optometry have been able to access these federal relief opportunities to ensure their patients and communities won’t go without essential primary eye health and vision care.”

In March, the Centers for Disease Control and Prevention (CDC) issued guidance that instructed health care providers to postpone elective visits. Nearly overnight, doctors of optometry faced patient flow reductions approaching 90%.

As such, the AOA Board of Trustees approved an unprecedented plan to fully align the association’s efforts behind crisis relief and recovery assistance to members, as well as prioritize AOA’s advocacy in federal physician relief measures and emergency laws or regulations. And members took notice.

Kimberly Friedman, O.D., who operates a private practice in Moorestown, New Jersey, says the guidance from the AOA and her local state association were invaluable at a time of such confusion.

“Whether it was helping us all throughout the COVID-19 pandemic by assisting us with finding personal protective equipment for our office, or helping us navigate the myriad of government applications that we needed to do as small business owners—I’m not sure where we might’ve been without the support of our national and state organizations,” Dr. Friedman says.

As part of the AOA’s efforts over the past six months, the AOA’s COVID-19 Crisis Response page was developed to provide doctors a one-stop shop for the latest information and guidance, including the highly viewed #AskAOA webinar series. To date, the AOA volunteer-led #AskAOA series has offered 10 webinars on timely COVID-19 issues, including federal relief and loans. In fact, the first #AskAOA webinar came out only days after the CARES Act was signed into law, March 27, allowing some attendees to be more knowledgeable about federal relief efforts than even their business or financial advisors.

“There is no doubt that COVID brought immense uncertainty and that is what brought about these PPP webinars—nobody knew which way was right,” says Jeff Michaels, O.D., AOA Quality Improvement and Registries Committee member and lead presenter on several #AskAOA webinars. So, Dr. Michaels read the PPP and Families First bills cover to cover.

“Our members quickly found out that with the information we presented on March 31, they already knew more than their bankers, accountants and other advisors. That was a proud moment for me—to put our members first on information so they could make decisions that would become the most important of their year, and for some, the most important decision for the next few years.”

Lauren Haverly, O.D., who practices in St. Paul, Minnesota, had just opened her own practice three weeks prior to the sudden limitation on routine eye care services. By attending the #AskAOA webinar series, Dr. Haverly knew not only how to position her burgeoning practice to survive the shutdown but also how to reopen.

“It was hard but having the AOA on my side made it easier—I was more informed from those incredible webinars, and I was even telling some of my family and friends how to use the PPP and EIDL, and so forth,” Dr. Haverly says. “Thanks to my AOA family, I have been able to survive this.”

Provider relief fund taxation penalties

Even now, the AOA and a coalition of other health care provider organizations, are diligently working to ensure the relief monies that providers received to recoup dramatic losses won’t harm them in the form of additional taxes.

Introduced in both chambers of Congress with bipartisan support, the Eliminating the Provider Relief Fund Tax Penalties Act of 2020 (H.R. 7819 and S. 4525) would prevent taxation on aid received from the Provider Relief Fund and guarantees expenses attributable to the relief fund are tax deductible. Without such a legislative fix, many providers stand to lose more than a fifth of their grant funds.

The AOA officially endorsed the legislation and will continue advocating to correct any unintentional tax consequences of policies meant to provide vital funds to providers on the front lines of care. The legislation was just one of several measures that AOA-member doctors of optometry advocated for in meetings with members of Congress during the Virtual AOA on Capitol Hill, Sept. 9-10. Other COVID-19 priorities included: 

• Medicare accelerated and advance payment programs.
• Liability reform.
• Hazard pay for primary eye care providers.
• Expanded public health and social services emergency fund.
• Relief for optometry students and new doctors.
• COVID-19 testing eligibility.
• Business interruption credit for self-employed doctors.

“Doctors of optometry, students and staff appreciate what Congress has already done to help mitigate the impact of the pandemic—PPP, EIDL, loans, HHS physician grants, student loan deferments—they’ve all helped; however, we feel that more can and must be done,” noted AOA Federal Relations Committee member Adam Parker, O.D., during Virtual AOA on Capitol Hill.

Find the latest COVID-19 information for optometry on the AOA’s COVID-19 Crisis Response page or send questions to AskAOA@aoa.org.