*Updated: 3/31/20
Added: Paycheck Protection Program Information Sheet: Borrowers, Paycheck Protection Program Application Form, Small Business Exemption to the New Federal Laws, Small Business Owner’s Guide to the CARES Act

As a reminder, AmeriBen will only be answering questions on the Pandemic Unemployment Assistance program in the CARES Act bill that passed last week. That means, they can’t give you any advice on what the loan programs or tax credits look like, how you apply, or what are the criteria. There are also other provisions regarding hardship loans from 401K and other relief for employers in the Act that they can offer their employees. AmeriBen strongly suggests you work with your accountant or tax professional or your business/tax attorney to find out what other programs might be available to you under the Act.

*The information provided to you via this webpage should not be taken as medical or legal advice. Please consult the CDC, your local COVID-19 response teams, and human resources professionals as needed.

As the national and international response to the growing threat from COVID-19 continues to escalate, our world is changing very quickly.

PECAA is closely monitoring updates and recommendations from public health agencies regarding the global outbreak of the Coronavirus Disease 2019 (COVID-19), specifically as it relates to the optometric industry, and we are actively working to keep our members informed on steps they can be taking to keep their businesses operating as smoothly as possible.

This webpage will continually be updated with new resources and business-related articles as they become available. Feel free to consume the information at your convenience.

Vendor Support 

Our Vendor Partners express their unwavering commitment to support you and your patients during these uncertain times! They are eager to provide tools, resources, assistance, and special programs to help you. As we receive them, Partner news, updates, and offers will be added here, so we encourage you to check back regularly!

Vendor Support Resources

Preparing For Your Financial Future

Paycheck Protection Program (PPP)

New information was released today on the Paycheck Protection Program (PPP) and banks are now getting information on how these loans will be processed.

We encourage you to contact your local bank for details. In the meantime, please view the resources below:

Paycheck Protection Program Information Sheet: Borrowers

Paycheck Protection Program Application Form

Information on the Stimulus Bill

This week the Senate passed the $349 billion stimulus bill called The CARES Act.  Much remains to be seen and many questions remain. We have received a number of technical questions on the bill that we won’t know answers on until the Treasury & Small Business Administration provide guidance for banks who will be participating in the program. The government wants essentially every bank to participate, even those who traditionally don’t offer SBA 7(a) loans. While it is a great idea to reach out to your local bank and make contact with your lender, they will likely have very little details at this point in time. Remember, this isn’t even a law yet and is an unprecedented program they have never seen before. They still need details on how the application process will work.

Here is a summary of what we know so far about the package…

Read Full Article

Small Business Owner’s Guide to the CARES Act

Banking and Financing

Practices should be reaching out to their financial institutions for potential loan and lease relief programs. We are seeing commercial banks already put in place programs to help practices. PECAA partner Columbia Bank has instituted a 90 day payment deferral plan. Please contact your local lender for further details. There may be opportunities with credit cards and personal loans as well, depending on the institution. 

The SBA (US Small Business Administration) has disaster loans available to businesses of all size. Standards have been relaxed this week to help businesses affected by COVID-19. These loans, which can be up to $2 million, are low interest (3.75%) and can be used to pay fixed debts, payroll, accounts payable and other debts that can’t be paid due to the COVID-19 impact. Further information can be found at www.SBA.gov/disaster. While currently only a handful of states qualify, expectations are that this list will grow quickly.

SBA’s Economic Injury Disaster Loans

*There is currently a proposal in place which references frogiven loans based on retaining employees. Please note that this is only a proposal at this time and a long way from becoming a reality. 

Landlords

We are hearing that some landlords are willing to provide assistance during the time, particularly if your business has closed. Note that this is not widespread at this time, but worth the question for those who have had to close down. Most landlords are going to want to fully understand how the practice’s business has been affected before reducing rent. Common requests would be for the following information:

  • Last two years tax returns
  • Bank Statements
  • 2019 P&L
  • 2020 YTD P&L

Having this information ready to send may help expedite the process and increase the likelihood of a reduction. If your practice is within a one year window of lease renewal, now will be a good time to begin negotiations as they will want to maintain good tenants. Should you have any questions regarding your lease, please contact PECAA partner CARR Healthcare Realty. CARR Healthcare Realty provides a full suite of real estate services exclusively to healthcare providers and at no charge to PECAA members.

Accounting

The Treasury Department and the Internal Revenue Service are providing special relief in reaction to COVID-19. The filing deadline and payment due date will automatically be extended to 7/15/20. (Note: this is an update from originally only the payment deadline being moved) If you are due a refund, those will be made on a normal schedule based on filing date. The normal 6 month filing extension is still available to those who need.  Please contact your accountant or tax professional for full details and any further questions.

Developing Your Contingency Plan

Here are some things to consider as you create a plan specific to your practice:

  • What is your current PTO/sick leave policy?
  • Will you be sending home employees who show symptoms of illness (not just COVID-19)?
  • What is the plan if your schedule is significantly impacted? Will you be changing employee schedules?
  • Will you require employees to exhaust all available PTO before unpaid time off?
  • Will you pay employees if your practice is forced to change operating hours or close for a short time?
  • Work with your medical insurance provider to see what benefits, such as telehealth or mental health services, are available to staff members. Share this information with your employees.
  • Be sure your policy follows local, state and federal laws – you can verify by communicating with PECAA vendor partner AmeriBen
  • Be prepared for employee leave: COVID-19 & paid leave scenarios and health & safety procedures.

Where Does Telemedicine Fit In?

A Message From Dr. Paul Karpecki, OD, FAAO, PECAA’s Director of Clinical Education

Finding optimism in situations like this can be difficult but we must try because we will look back on this time as a true time of change but a small blip in the spectrum of time. This is in no way meant to lighten things for those who have lost of suffering family, friends or acquaintances, but to help us put things in perspective. It’s tough and it’s going to get tougher for most of us before we see the light again. As I write this, the CDC recommended the discontinuation of routine examinations (not mandated but a recommendation), which affects most of our profession and optometry practices aren’t truly set up for a situation like this. Most of us can’t afford to close the door for 3-4 weeks and not feel a significant impact. For many optometric practices, its survival mode is the hope that this pandemic doesn’t last too long.

Read the full article to learn how practices can respond to COVID-19 and how telemedicine fits in.

Read Full Article

A Message From Teri Thurston, PECAA’s Billing & Coding Advisor

On Thursday March 17, 2020 the Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of health care services from their doctors without having to travel to a health care facility. Beginning on March 6, 2020, Medicare— administered by CMS—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country. For the complete news release, please click here

This expansion has temporarily changed the landscape in how physicians can provide Telehealth and Telemedicine services to patients within their communities. While we await how payers outside of the Medicare and Medicaid program will adjust to these changes, there are a few payers that have already stated they will accept these new expanded telehealth rules during the COVI-19 crisis. To date the major commercial payers (Aetna, Blue Cross Blue Shield, Humana, Cigna, United Healthcare) will be expanding their telemedicine services as well. However, it is strongly recommended to contact your specific insurance payers in your area for coverage details. Keep in mind any State level mandated rules or policies will override these Federal rules.

Brief Telehealth Overview

Telehealth Service Codes

CMS Telehealth Services

HIPAA & Telehealth

Telehealth Billing Codes for Eyecare

*Telehealth Billing Codes for Eyecare provided by PECAA’s newest Vendor Partner, EyecareLive!

Frequently Asked Questions

Answers provided by PECAA vendor partner AmeriBen

What Are the Current Recommendations for My Practice?
The following Urgent Patient Care Advisory for Doctors of Optometry from the CDC was posted March 17, 2020—5:50 p.m. ET to healthcare facilities and clinicians to prioritize only urgent and emergency visits now and for the next several weeks. Here were the recommendations for keeping staff and patients safe:

  • Delay all elective ambulatory provider visits
  • Reschedule elective and non-urgent admissions
  • Delay inpatient and outpatient elective surgical and procedural cases
  • Postpone routine dental and eye care visits


The American Optometric Association is closely monitoring the situation and is a resource for you right now. Checking it several times a day will give you the most up-to-date information in your industry.
I Need to Reduce My Staff. What Do I Tell Them?
You need to be as open and transparent as you can and tell them you need to lay them off until the crisis has passed, and you can resume business operations as normal.
Is It Better to End Their Employment, Or Have Them Wait It Out?
If you lay them off and end their employment, they can apply for state resources like unemployment insurance, subsidized health care, food assistance and other similar programs. If they have any paid time accrued, you may want to discuss having them take that all before ending their employment as then they can stay on your health insurance plan through the end of their paid time off.
Are There Other State Programs That Might Apply?
Individual states have programs that allow for reduced hours, partial employment and standby status. You may want to explorer your state’s offerings in this area.
How Will This Affect My Unemployment Insurance (UI)?
At this point, we don’t know. Many states are rolling back restrictions on UI at this point as we are in an unprecedented situation where the government is ordering closures of businesses. Some states are suspending the 5 day waiting period for UI but not all of them, so it is best to check with your local UI office. Others are suspending the requirement that a person be actively looking for unemployment to qualify for UI given the social distancing recommendations from the CDC. It is really a state by state issue right now. However, this is one way for your employee to have some source of income during the suspension of services in your industry until you can open back up your doors and re-hire them.
With Regard to Unemployment, What If I'm Self-Insured?
You will need to check with how you have set up your self-insurance program for the answers to these questions.
Is There Anything Special I Need to Do Since This Is a Lay-Off and Not a Fire?
From a practical perspective, no. The process is the same for final paycheck, paying out any accrued vacation or sick leave that your policies say will be paid at the end of employment, and providing them with continuation of benefits information. I would be transparent with them about what they can expect in the future as far as coming back to work for your practice. If you think it will take a significantly longer period to bring them back due to business operation concerns, you may want to let them know that so they can make other plans for future employment.
What Else Should I Be Thinking About?
We recommend calling your insurance broker to talk about the fact that your active employee count has dropped to possibly you and one or two other employees. It may or may not make a difference, but they can help you navigate the insurance situation, including answering questions about continuation of coverage under COBRA if that is part of your obligations.
How Do I Know If I Have COBRA Obligations?
Continuation of health insurance coverage under COBRA applies to private employers with 20 or more employees. If you have less than 20 employees, you need to check if there is a state version of COBRA that applies to you as there are states that mandate continuation coverage for employers with less than 20 employees. Your insurance broker should know what your state mandates are in this area.

Staying Open?

Here are some precautions and best practices to begin implementing in your office:

Communicating With Staff

This is a time where over-communication isn’t a concern.

Use these 6 posters provided by the Centers for Disease Control to educate employees and patients on COVID-19.

Why not post them in your breakroom, waiting room and restrooms?

View Informational Posters

Employee Essential Business Sample Letter

Communicating With Patients

Craft a statement to your patients and post it in your office, on your website, and on your social media pages. If you have the ability to send it as an e-blast or text it, do that too.

View Sample Messages

Create patient communication scripts for your staff to use.  This will help to support staff when confirming appointments and greeting patients. Draft statements such as, “If you feel you have been exposed, or if you are feeling ill in any way, please reschedule your appointment.” Or “If you have a cough, fever, or experiencing breathing problems, we will reschedule your appointment.

Emphasize Good Hygiene

  • Place posters that encourage staying home when sickcough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.
  • Provide tissues and no-touch disposal receptacles for use by employees.
  • Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol, or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.
  • Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations or in conference rooms/break rooms to encourage hand hygiene.
  • Encourage employees to visit the coughing and sneezing etiquette and clean hands webpage for more information.
  • Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
  • Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.

Actively Encourage Sick Employees to Stay Home

  • Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
  • Ensure that your Paid Time Off policies are flexible and consistent with public health guidance and that employees are aware of these policies.
  • Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
  • Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.

Download Our Ultimate Checklist for Running a Successful Optometry Practice

This checklist will help audit key areas of your practice and guide you toward sustainable, long-term success and growth.

Please complete the following form to download the ultimate checklist for running a successful optometry practice

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