AOA legislative arm works to protect patients
BOSTON – Representatives from the AOA’s federal legislative and third party committees updated the House of Delegates on their successes and challenges here at Optometry’s Meeting.
Stephen Montaquila, OD, chair of the Third Party Center Committee, stressed the importance of every state having a proactive working relationship with their insurance commissioner.
The National Association of Vision Care Plans said it is moving toward a uniform credentialing model, with the original goal of simplifying things for doctors who accept multiple vision plans, he said.
“This year it became clear that their intent was to build a barrier between optometry and the health care delivery system,” Montaquila said.
“The AOA Third Party Center and state third party committees are only a piece of a much larger advocacy puzzle. Ninety-eight percent of states have active third party committees. Thank you for answering that call. Your input is vital,” he continued.
“We are trying to take an industry that is satisfied with how they’re participating in the system and teach them why they should not be satisfied,” Montaquila said. “The services we provide are not ancillary, and we have to ensure they’re not delivered in a way that’s ancillary to the medical system.”
The AOA has hired a communications firm to better deliver its messages to key decision makers.
“Diabetes is the first chronic systemic health condition that has a touchpoint to optometry that has a fire under it right now,” he said. “This has never happened in our history. Optometry plays a role in managing these patients. It really has to do with these alternate payment models being developed. It’s about taking care of patients ultimately, but what drives this whole system is money.”
Montaquila explained that Healthcare Effectiveness Data and Information (HEDIS) scores are quality measures used to assess physicians in alternative health care delivery and payment models. The eye exam equates to 1% to 1.5% of the total health care spend for patients with diabetes.
“It’s as simple as educating patients about who we are, what we do and how to get to us,” he said.
Roger Jordan, OD, chair of the Federal Relations Committee, said the AOA is “taking the fight directly to those with an anti-optometry agenda and those who seem to undermine the profession and leading the public into believing substandard care is OK.”
He explained that his committee works with agency officials and members of Congress. HR 3323, also known as the Dental and Optometric Care (DOC) Access Act, is one of its top priorities. Introduced in Congress by Rep. Buddy Carter from Georgia, HR 3323 applies to federally regulated health, dental and vision plans.
“It is meant to balance the playing field,” Jordan said.
According to the legislation, optometrists would not have to accept a vision plan to be on a medical plan, doctors can choose their own lab and other services would not have to be discounted.
The legislation needs more support. “All ODs should get your colleagues to send letters to your senators on this issue,” he said.
Jordan also discussed S.2777, which was introduced by Sen. Bill Cassidy, MD, from Louisiana.
“It is meant to complement and tighten up some of the problems that the Fairness to Contact Lens Consumers Act is not addressing at the moment,” he said.
He explained that the legislation would ban the use of “robo” calls, allow doctors to choose the method of communication, hold sellers accountable for illegal sales tactics and require a patient hotline to address contact lens prescription issues.
Jordan noted that a survey found that one in four patients have reported receiving a different contact lens brand than prescribed, one in three have had an online retailer recommend a substitution due to supply issues, and one in three were able to buy lenses with an expired prescription. The survey was sponsored by Johnson & Johnson Vision Care.
“We have worked with the Federal Trade Commission to enforce that law [Fairness to Contact Lens Consumers Act], and they have not met our standards,” Jordan said. “We are meeting next week with the FTC to address these issues. Every 10 years there’s a review and comment period for the Fairness to Contact Lens Consumers Act, which was this year, and we submitted comments.”
Jordan mentioned the online refractive service, Opternative.
“We will work towards addressing this substandard care using technology,” he said. “We have been able to get Opternative to stop saying they’re FDA approved.”
Other efforts address eye care for veterans.
Technology-based eye care services are being used in the Atlanta area for rural veterans who are not located near a full service clinic, Jordan said. He explained that when a veteran enters one of these clinics, an ophthalmic technician uses an autorefractor to create a prescription and takes IOP and retinal photos, which are stored and forwarded to an eye care provider to review. He said the intent is to take this practice nationwide in the VA system.
“We don’t feel our veterans should be getting this type of care,” Jordan said. “This is being led by an ophthalmologist in Atlanta.”
Jennifer Planitz, OD, said the top priority of the Federal Legislative Action Keyperson Committee, which she chairs, is the DOC Access Act.
“We have 56 co-sponsors and we need over 70 to keep it moving,” she said. “Contact your reps and Congress people. Everyone can use the AOA political action committee app to contact their legislators.
She noted that there are no keyperson vacancies at the moment, “for the first time ever.” – by Nancy Hemphill, ELS, FAAO