Optometry’s Priority Issues in the 110th Congress Michele Haranin, OD March 10, 2007

1. AOA Federal Relations Committee Optometry’s Priority Issues in the 110th Congress Michele Haranin, OD March 10, 2007

2. 2005/2006 Wrap Up • AOA Board of Trustees, AOA President Crooks & Dr. Mike Jones commit to strengthened AOA advocacy programs & Washington Office • Washington office team adds lobbying fire power – four new lobbyists and outside firms added • Improved communications with state leaders & staff, and creation of the AOA Washington Office Report

3. 2005/2006 Wrap Up • Proactive approach to legislative and regulatory issues that impact optometry • Strengthened emphasis on AOA PAC • Updated Keyperson program and AOA online Legislative Action Center • New Leadership in Advocacy Meeting, Chicago, 10/06

4. Optometry’s Accomplishments in Washington, DC • AOA-backed bills (S. 1932 and HR 6111) to correct anticipated cuts in both 2006 and 2007 in Medicare physician re-imbursement rates – PASSED BY CONGRESS, SIGNED INTO LAW BY THE PRESIDENT • S. 172, the AOA-backed bill to ban the over-the-counter sale of decorative contact lenses – PASSED BY CONGRESS, SIGNED INTO LAW BY THE PRESIDENT • HR 5688, the “Sullivan Scope of Practice Restriction Bill” aimed at attacking the education and standing of ODs and other non-MD health providers – KEY CO SPONSORS PERSUADED TO WITHDRAW AND DEFEATED IN ELECTIONS. BILL IS DEFEATED

5. Optometry’s Accomplishments in Washington, DC • S. 1955, small business health plan bill, successfully amended by acceptance of AOA-backed "Collins-Murkowski Amendment" to safeguard patient access to optometrists – S. 1955 THEN FAILED IN A PROCEDURAL VOTE • HR 2238, the AOA-backed bill to provide $75 million to state children's vision initiatives – 204 CO-SPONSORS ADDED • Congressional Committee Directive on inclusion of ODs in the National Health Service Corps student loan program – PASSED BY CONGRESS

6. Optometry’s Accomplishments in Washington, DC • 1-800 CONTACTS' legislative attacks on Optometry – DEFEATED • Contact lens prescription verification abuses by 1-800 CONTACTS and other Internet sellers – EXPOSED AND REPORTED TO THE FEDERAL TRADE COMMISSION FOR ENFORCEMENT ACTION

7. Optometry’s Accomplishments in Washington, DC • RECENT SUCCESS!! Optometrists are now acceptable medical sources to make disability determinations for the Social Security Administration.  • On April 2, 2007, optometrists will be able to examine patients for visual impairments (applicants for SSA benefits).  Optometrists may now be considered as acceptable consultants to states for visual determinations. 

8. Unfinished Business • Patient Access (Small Business Health Plans, Medicare Managed Care) • 2008 Medicare Physician Fee Cut • Involvement in Quality Reporting Programs • National Health Service Corps • Funding for Children’s Vision • Crackdown on unscrupulous Internet CL sellers

9. Mission Impossible???

10. Challenges Ahead • Patient Access (Small Business Health Plans, Medicare Managed Care) • AOA leads re-establishment of PARCA Coalition with focus on access to non-MD providers. • Building support for a meaningful Patient’s Bill of Rights

11. Challenges Ahead • 2008 Medicare Physician Fee Cut • 10% cut projected to take effect January 1, 2008 • Sustainable growth rate formula (SGR) is fundamentally flawed and must be replaced that reflects increases in practice costs. • Optometrist must continue to make their voice heard on this issue despite recent years efforts by Congress to avoid cuts. These were temporary fixes, not a long-term solution.

12. Challenges Ahead • Reform of the Healthcare System - Value Driven Health Care Initiative • Increase Transparency In Pricing. • Increase Transparency In Quality. • Encourage Adoption Of Health Information Technology (IT) Standards. • Provide Options That Promote Quality And Efficiency In Health Care.

13. Challenges Ahead • “Pay for Performance” – Quality Reporting • Optometry must be involved in the development of quality standards and reporting of measures that will be linked to Medicare reimbursement • CMS Physician Quality Reporting Initiative (PQRI) www.cms.hhs.gov/PQRI • AOA Quality Reporting Web Page: www.aoa.org/x7506.xml

14. Quality Reporting Optometrists who successfully report on at least 3 of the 8 established eye care measures on claims for dates of service from July 1 to December 31, 2007, may earn a 1.5% bonus payment, subject to a cap. PQRI Eye Care Quality Measures: Primary Open Angle Glaucoma: Optic Nerve Evaluation Age-Related Macular Degeneration: Age-Related Eye Disease Study (AREDS) Formulation Prescribed/ Recommended Age-Related Macular Degeneration: Dilated Macular Examination Cataracts: Assessment of Visual Functional Status Cataracts: Documentation of Pre-Surgical Axial Length, Corneal Power Measurement and Method of Intraocular Lens Power Calculation Cataracts: Pre-Surgical Dilated Fundus Evaluation Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care Challenges Ahead

15. Challenges Ahead • National Health Service Corps • Build on committee directives to win inclusion of ODs in student loan repayment program • National Rural Health Association has offered their support for the inclusion of optometrists to the list of health care professions included in NHSC programs as part of their 2007 Policy agenda

16. Challenges Ahead • Funding for Children’s Vision • HR 507 (sponsored by Rep. Bill Pascrell (D-NJ), Rep. Gene Green (D-TX), and Rep. Ileana Ros-Lehtinen (R-FL) – The Vision Care for Kids Act of 2007 – would provide first ever Federal funding for kids vision treatment programs in the states. Currently has 39 cosponsors. • This is a consensus bill supported by AOA, AAO, and Vision Council of America • Senate bill expected to be introduced this month by Sen. Kit Bond (R-MO) and Sen. Chris Dodd (D-CT)

17. Challenges Ahead • Optometric Clinical Education Funding Initiative • Joint effort with ASCO to win Federal support for optometric education • Crackdown on unscrupulous Internet CL sellers • Build support for Whitfield/Allen bill • Be prepared for more midnight maneuvers that would jeopardize patient safety

18. If doctors of optometry do not step up to the plate to secure the future of the profession – who will?