Help for Tumultuous Times: An Overview of Payments and Supports to Physicians during Covid-19
Sebastien Chevrier - Jun 08, 2020
For physicians, economic fallout from the pandemic may include cash flow challenges and financial hardship. Learn about the tax and business support, and enhancements to family benefits that could help.
The impacts of the COVID-19 pandemic continue to evolve and physicians are striving to keep up with emerging information, government directives and clinical protocols.
Along with the clinical and medical challenges, you may be facing serious financial disruptions as a result of the COVID-19 pandemic. Fee-for-service physicians may find themselves with reduced income, no assurances of cash flow and no real timeline for when things will stabilize. Newly practicing physicians may be facing uncertainty about employment in general and the financial impact of that.
There are several programs in place that may relieve some of the financial pressure you could be facing in the coming months. Read below to learn more.
Ontario OHIP Update
Virtual Care Codes Payment (*UPDATED)
Many physicians have been faced with changing the way they practice and have had to shift the bulk of their work to virtual care. In Ontario, there had been a delay in receiving payment for these codes due to technology issues at the Ministry of Health. The system changes have now been implemented and physicians may submit claims for reimbursement, as of May 5, 2020, for the following codes: K080A, K081A, K082A, K083A, H409A and H410A, for services rendered on or after March 14, 2020.
Physicians providing services at the Designated Assessment Centres (H409A, H410A) are required to submit their claims in conjunction with the group number that can be obtained for their assessment centre administrator.
OHIP Top-Up Advance Payments (*UPDATED-see italics)
Meanwhile, as doctors grapple with decreased billings and cash flow, the Ontario Ministry of Health has announced it will automatically make top-up advance payments (as an interest free loan) to physicians for the months of May to July 2020. Each monthly payment – in May, June or July – is to bring physicians’ monthly income up to 70 per cent of their expected monthly income. Expected income is determined by monthly income over the 12 months ended March 31, 2020. The plan calls for the top-ups to be clawed back over November 2020 to March 2021. This program is designed to reduce the immediate extent of financial disruption of COVID-19 at its peak, when revenue is expected to be at its lowest. However, physicians are concerned that they may not be able to easily make-up for the lost revenue during the payback period due to the limitations around how many patients can be seen in a given day and there is no assurance as to when ‘usual business’ will actually take place. This may result in an ongoing reduction of income to the end of the repayment period.
You have been given the option to opt out of the payments which would involve managing the current decreased cash flow by other means. While not listed in the INFOBulletin, If you choose to opt out you may do so in advance (from July onward, May and June have already been processed) by contacting Service Support Contact Centre. The deadline to opt out for July is June 15, 2020.
You may also return the government cheques once payment has been made (if you have not opted out in advance). Click here for details.
Deciding which path to pursue will require some thought and consideration in the context of your current financial situation, alternate options available to you and with respect to what you anticipate for your personal practice as well as your clinic/business operations over the coming months, if this applies to you.
Other new fee codes and compensation models specific to certain practice environments and circumstances have also been put in place within all the provinces. Physicians can learn more by accessing their respective provincial association websites.
General Financial Support Relevant to Physicians
The current crisis leaves many physicians struggling to meet multiple financial obligations … including as an employer and business owner, not to mention personal and household expenses.
As federal and provincial governments continue to roll out economic supports, we are providing the following summary (and updating it as new information becomes available) to help you navigate the complexities of the current environment and hope you will gain some clarity as to how to optimize your financial circumstances with the available supports.
Canada Emergency Business Account (CEBA) - LOAN (UPDATED)
If you own a clinic/business or are an incorporated physician, this may be relevant to you.
- What it is: Announced by the federal government in late March, and updated on May 19, the program, known as CEBA, provides an interest-free loan of up to $40,000 for small businesses. The loan is intended to help eligible businesses pay operating expenses, payroll and other expenses that cannot be deferred, and are necessary for the business to continue.
- Who qualifies: To be eligible, the business must have had a payroll between $20,000 and $1.5 million in 2019 and be experiencing reduced revenues currently because of COVID-19. As announced on May 19th, corporations that pay employees through dividends rather than payroll are now also eligible.
- How it works: A business owner (including medical professional corporations) must enroll in CEBA through their bank’s business banking department. No interest applies until January 2023 and, if you pay 75 per cent of the loan by December 31, 2022, then the remaining 25 per cent will be forgiven. So, for example, if you have a maximum loan of $40,000, then $10,000 will be forgiven if you pay on time. Get more information on the Government of Canada’s CEBA website, or by contacting your bank.
- Related notes: More recently, on April 24, Ottawa announced a rent relief plan, in conjunction with the provinces, that would provide non-repayable loans to commercial property owners to cover 50 per cent of rent payments for April, May and June. The loans will be forgiven if the property owner agrees to cut the rent by at least 75 per cent for those months and does not evict the tenant. The tenant (small business owner) must cover the remainder of the rent. Qualifications include revenue and rent thresholds.
If you operate a clinic/business under a landlord/tenant agreement this may be relevant to you.
Canada Emergency Wage Subsidy (CEWS) WAGE SUBSIDY
As an individual, if you have employees on a payroll or if you receive a salary from a medical professional corporation, and have seen a reduction in gross revenue, this may be relevant to you.
- What it is: Aid to businesses that are not publicly funded, and which are experiencing a decline in gross revenue because of the pandemic. As announced, the program covers the 12 weeks from March 15 to June 6, 2020.
- Who qualifies: Businesses of all sizes across all sectors – including corporations, non-profits and charities – that have seen a 15% or greater reduction in revenue in March, and a 30% or greater reduction in April or May. The revenue drop is measured against gross revenue in the same month last year. However, there is an option to compare revenues in each of those three months with the average of revenues in January and February 2020 – helpful for new businesses which may have no or little revenues in 2019.
- How it works: The subsidy of 75 per cent applies to the first $58,700 of a worker’s salary, which translates to a benefit of around $847 per week per employee – the amount an employer is eligible for depends on the wages paid to employees. Employers are expected to try to top up the remaining 25 per cent to make their workers’ income whole.
- Related note: The CEWS was announced shortly after the Temporary Wage Subsidy (TWS) was introduced and is an enhanced version of the earlier program. Should your business not qualify for the CEWS, it may qualify for TWS, a wage subsidy of 10 percent of remuneration paid from March 18 to before June 20, 2020, up to $1,375 for each eligible employee and to a maximum of $25,000 total per eligible employer.
- How to apply: Find full details at the Finance Canada website and apply through the Canada Revenue Agency’s My Business Account portal.
Canada Emergency Response Benefit (CERB) EMERGENCY BENEFIT
If you have had to lay off employees this is relevant to them, or if you have not been working for the minimum defined period (14 days) due to Covid-19, this may be relevant to you.
- What it is: Payment of $500/week for up to 16 weeks to workers who are not receiving income because of the pandemic. The payment is taxable.
- Who qualifies: Workers who must stop work for at least 14 days because of COVID-19 and don’t qualify for paid leave or other income sources. This includes those with income loss who are salaried, contract or self employed. Loss of income may be due to sickness, quarantine or caregiving responsibilities either for someone who has COVID-19 or children who are at home because schools and daycares are closed.
- How it works: Available to everyone; however, workers who are receiving the Canada Emergency Wage Subsidy from their employer can’t receive the CERB. At the time of writing, a requirement to apply is to have at least $5,000 in taxable income in 2019 or the 12 months before your application. You can earn up to $1,000 per month while collecting the CERB.
- How to apply: Starting April 6, recipients can apply online at Canada.ca and must confirm their eligibility for the program every four weeks. There is no need to register for the CERB if you have already applied for Employment Insurance (EI) as eligible EI applications will be automatically moved to the CERB. Apply through the Canada Revenue Agency portal.
Deferral of tax payments and extended due dates for returns
The federal government has deferred the deadlines for filing and paying taxes owing.
- Personal taxes: The deadline for filing your 2019 personal tax return has been extended to June 1 from April 30, and you have until Sept. 1, 2020 to pay any taxes owing. For personal tax returns with business income or self-employment income, the due date of June 15 remains unchanged but the date by which you must pay any taxes owing, including the June 15 instalment payment, has been extended from April 30 to Sept. 1, 2020.
- Corporations: The filing date for the current tax year is now June 1, 2020 if you have a filing date between March 18 and June 1, 2020. (Corporate tax returns are generally due six months after the corporation’s fiscal year ends.) The deadline for payments of tax owing and instalments has been extended: Payments due to be paid between March 18 and Sept. 1, 2020 are now due on Sept. 1, 2020 with no interest or penalties.
- GST/HST Remittances: The Canada Revenue Agency is allowing businesses to defer, until the end of June 2020, any GST/HST payments or remittances that become owing on or after March 27, 2020, and before June 2020. No interest will apply on payments or remittances made by the end of June 2020.
Payments to families with children
Federal and provincial governments are providing enhanced and new payments to help families with children. We have provided details here of the federal Canada Child Benefit enhancement and the Ontario support program. Outside Ontario, be sure to check for family support programs in your province.
- Increased Canada Child Benefit (CCB): The federal government will provide a one-time extra $300 payment per child through the Canada Child Benefit for the 2019-2020 benefit year if you were eligible for the program in April of 2020. The extra $300 will be paid with the scheduled CCB payment in May. Those who already receive the CCB do not need to reapply. Go to Canada Child Benefit on the Government of Canada website for more information or apply if you are not already receiving it.
- Ontario – Support for Families: The Ontario Ministry of Education is providing a one-time per child payment to help with the costs of educational resources during school and childcare closures. There is no income threshold requirement for this benefit – parents are eligible for $200 for children to age 12, and $250 for children with special needs to age 21. Parents/guardians must submit one application per child. Get more information on the supports available to families in this province.
The National Student Loans Service Centre (NSLSC) has announced that Student Loan repayment and interest will be suspended from March 30 until September 30th, 2020.
If your loan was issued by NL, NB, ON, SK or BC, this applies to both the federal and provincial portions of your student loan.
If your loan was issued by PEI, NS, AB or MB, NSLSC only administers the federal portion of your loan, and therefore, this applies to your Canada Student Loan only. However, your province may already have announced similar measures for the provincial portion of your loan; please contact the issuing province for more information. Click here for important information related to how to manage your paused payments for a full description of the program.
For additional province specific relief measures, refer to your provincial website for further information.
We’re here to help
This post focuses on select recently announced government initiatives that may support your practice and is current at the time of writing. Several additional measures are in effect that could help, and public health and government responses continue to evolve with the changing situation.
If you need help navigating the current financial environment, we are here to support you. Like you, we have shifted to a virtual format to accommodate our clients’ needs and would be happy to meet with you online.
Contact us to learn more.
*Keep Up To Date*
We will be updating this article regularly. Sign up here to receive updated versions of this article as programs and information evolves.