CARES Act & Emergency Stimulus Relief


Have questions about how the recent stimulus and relief packages support your practices? The AOA has answers.

New Legislation Allows Flexibility in PPP 
PPP Loan Forgiveness Application and Webinar
Updated PPP Rules
HHS Relief Funding


Update: New Legislation Allows Flexibility in Paycheck Protection Program 

On June 5, the President signed the PPP Flexibility Act ("Flex Act") into law. This provides business-friendly new rules to the Paycheck Protection Program (PPP). On June 17, Treasury and SBA clarified how these Flex Act rules are applied.

Now PPP borrowers can:

• Spend PPP funds over 24 weeks instead of 8 weeks. Funds must be spent by December 31 for Forgiveness.

• Spend up to 40% of funds on non-payroll costs like rent and utilities instead of 25%.

• Spend at least 60% on payroll instead of 75%.

• Borrowers that received PPP prior to June 5 can abide by these new Flex Act 24-week rules or self-elect to use the old 8-week rules (75/25). There is no form or communication required to elect using the new Flex Act rules. 

• If you are using 24 weeks, the maximum OWNER pay is calculated differently under Flex Act rules. It is your 2019 ÷ 12 x 2.5 up to a maximum $20,833. The $15,385 rules still apply for using the 8-week rules.

• The maximum non-owner pay for 24 weeks Flex Act rules is now $46,154.

• Extends the first loan payment to 10 months after their PPP Covered Period ends instead of six months from loan origination.

• FTE rehire relief is available as a Safe Harbor now if the business was impacted by stay-at-home orders, social distancing, or other worker/patient safety concerns related to COVID-19.

• Loan maturity (payback) is a five-year term if your loan originated after June 4.  

• Loan maturity (payback) is still a two-year term for everyone with a PPP originated by June 4 but you can negotiate up to 5 years if your lender agrees.

• There are two different applications to apply for Forgiveness depending on your FTE circumstances. Both are new, shorter applications than the original one that released.   

• The deadline to apply for Forgiveness is 10 months from the date your Covered Period ends. That means you have your 8- or 24-week period plus an additional 10 months before you have to apply for Forgiveness.  (you have time to digest this new info)

Learn more about the provider relief opportunities that remain available from the Small Business Administration. Jeff Michaels, OD moderates this recorded webinar


Doctors receive HHS relief funding following AOA advocacy

Doctors of Optometry who billed Medicare in 2019 began receiving payments from HHS in early April, stemming from a $100 billion provider relief fund outlined by the CARES Act. The money provided by HHS is not required to be repaid.

Doctors are required to accept the Terms and Conditions of the funding within 30 days of receipt of payment via the CARES Act Provider Relief Fund Payment Attestation Portal and should document how this money is spent. The funds may be used either for health care-related expenses or for lost revenues that are attributable to COVID-19 and aren't exclusively for hospitals or practices directly engaged in patient care of confirmed COVID-19 cases. 

Signed into law March 27, 2020, the CARES Act included the AOA-backed provision to create a new, $100 billion fund for provider relief. But, soon after its enactment, stakeholders urged earmarking funds for purposes other than Congress intended. The AOA not only worked with legislators to ensure the funds would be directed to frontline providers, including Doctors of Optometry, but also delivered a letter to HHS urging the direct payments. 

Important Update: Additional funding aimed to relieve doctors of optometry 

HHS is distributing additional relief funds in accordance with AOA-backed provisions in the Coronavirus Aid, Relief, and Economic Security Act (CARES). Action is needed to access the funds: 

  • Doctors who already received funding from HHS may be eligible for these additional funds and will need to submit information through the General Distribution Portal.
  • Doctors who have not received any HHS relief as of April 24, 5 p.m. ET, may be eligible for support through other mechanisms, including upcoming Targeted Distributions. More information on these distributions is expected in the coming weeks. AOA is working with Congress and HHS 24/7 to ensure all doctors of optometry receive much needed relief. We will continue to share the latest information related to funding and the various distribution methods. If you have not yet received HHS funding, please contact Kara Webb

HHS Issues Medicaid, CHIP Relief Funds

Medicaid and Children's Health Insurance Program (CHIP) participating doctors of optometry who missed out on coronavirus-related relief funds may be eligible to collect payments as the U.S. Department of Health and Human Services (HHS) issues Medicaid, CHIP relief funds.

On June 9, HHS announced disbursement of an additional $15 billion in Provider Relief Funds to eligible Medicaid and CHIP providers, roughly 38% of whom did not previously receive a relief payment under the $50 billion Provider Relief Fund General Distribution provided for under the Coronavirus Aid, Relief and Economic Security (CARES) Act.  

Additionally, HHS launched an enhanced Provider Relief Fund Payment Portal for eligible Medicaid and CHIP providers who have not previously received any disbursements from the Provider Relief Fund, to report their annual patient revenue, used to determine payment, HHS says. These payments will be at least 2% of reported gross revenue from patient care, while a final amount will be determined after data is submitted.

How to apply

To be eligible for the Medicaid and CHIP Provider Relief Fund, providers must not have received general distribution relief funds and either have directly billed their state Medicaid or CHIP program, or Medicaid managed care plans, for health care-related services between Jan. 1, 2018, and May 31, 2020. The AOA advises doctors to read the full instructions and application before entering the portal.  


CARES Act - Assistance for Small Businesses

SBA Coronavirus Relief Options

Coronavirus (COVID-19): Small Business Guidance & Loan Resources

Paycheck Protection Program

Fast Facts on the Paycheck Protection Program

CARES Loan Spending Tracker Spreadsheet

Small Business Survival Guide to Combat COVID-19


COVID-19 and the American Workplace - Paid Leave under the Families First Coronavirus Response Act