Volume 39 Number 3 2013
prospectus The State of the Optometric Profession: 2013 Guest Editorial by Robert L. Owens, OD, FAAO, POA President
INSIDE THIS ISSUE State of the Profession: 2013...................1 Compliance date for new
HIPAArules is September 23...........2
NYSOA Wint❄rFest 2014...................2 AOA defends ODs agains new
attack on Harkin Law............................. 3
Wint❄rFest 2014 Program...................5
Optometry Student Corner.....................6 Health insurance marketplace
scheduled to open Oct. 1....................... 1 1
Protect your practice with
new AOA HIPPA notices.................1 2
2013 CVC Contributors.......................15 2013 NYSOA PAC Supporters............17 Prepare now for key health IT
milestones in 2014.............................2 0
Practitioners now have longer to pay
back overcharges to Medicare...........2 1
ODs can easily avoid PQRS pay
penalties with AMD codes...............2 2
Last 2013 Medicare EHR
reporting period begins Oct. 1..........2 3
Upcoming Events.................................2 6 Welcome New Members!.....................2 6 Contact Information.............................2 7 NYSOA Business Partners...................2 7 Prospectus (ISSN 1055-7407) is published by the New York State Optometric Association, Inc., 119 Washington Avenue, 2nd Floor, Albany, NY 12210. All issues are electronic. Yearly subscriptions $25.00, single copies $5.50. The views and opinions expressed are those of the signed author and in no way should be construed to reflect the opinions or position of the editorial staff of Prospectus, or the New York State Optometric Association, its officers, local affiliate societies, or administrative staff. All submissions are subject to editorial change with regard to clarity or length. Final decision regarding acceptance or rejection of any submission lies with the editor.
Robert L. Owens, OD, FAAO President, Pennsylvania Optometric Association www.poaeyes.org
An excellent program was presented by AOA Excel representatives at this year’s Optometry’s Meeting and I would like to share some of this valuable information with you.
Output
Optometrists perform an estimated 88 million refractive eye exams annually (85% of the total 104 million performed by all eyecare professionals) and prescribe at least 90% of vision correction devices. Comprehensive eye exams and corrective devices account for at least 80% of the optometrist’s revenue. Of the 97 million office visits in 2012, approximately 18 million were for medical eyecare services, accounting for approximately 17% of revenue. It is estimated that 80-85% of optometrists are involved with medical eyecare, but it is a major source of income in less than 25% of these offices. The typical patient is examined once every 25 months. AOA member surveys show that the average number of comprehensive exams optometrists perform per hour is around 1.1 per hour. Out of the 82.5 million pairs of glasses sold annually, corporate providers provided 54%, independent optometrists provided 32%, ophthalmologists provided 10%, and
independent opticians provided 4%. Since independent optometrists perform 44% of refractive exams, they have a capture rate of approximately 73% or about 9.8 million pairs of glasses. For contact lenses, optometrists provide about 90% of all contact lens prescriptions. It’s estimated that 16.1% of US adults wear contacts, a steady increase since the ‘70s, and account for 27% of the refractive exams performed by optometrists. Independent optometrists supply about 80% of their contact lens prescriptions. Take home message: 1) Improve recall processes; 2) Upgrade eyewear purchase experience; 3) Broaden your scope of practice; 4) Increase hourly production; and 5) Differentiate the practice value proposition.
Supply
In 2012, there were about 40,000 optometrists in practice as compared to about 18,000 ophthalmologists. At the end of 2012, optometrists accounted for 69% of eyecare professionals in practice, by 2020 they will account for around 72%. The number of practicing optometrists has had steady growth of 1.8%. It is estimated that practicing optometrist growth will increase to approximately 2% annually through 2020 and reach 46,300. It’s also estimated that about 1,550 optometrists
continued on page 9
2
Volume 30 Number 3 2013
Compliance date for new HIPAA rules is September 23 New rules for the updated Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule are effective September 23, 2013. The federal rule applies to health care providers, health plans and other covered entities and their business associates.
New Rule
The revisions, announced in March 2013 and effective September 23, require the following steps: • Conduct a security risk assessment; • Revise existing privacy, security, and breach notification policies and procedures; • Make copies of those revised privacy policies available to patients; • Amend business associate agreements to reflect the new regulations; and • Retrain practice staff on the revised policies. The new rule prohibits the sale of federally protected patient health information (PHI), and prohibits the use of PHI for marketing purposes without authorization from the patient.
In addition, a patient may request a practice to withhold disclosure of PHI related to a particular service to a health plan if the patient has paid for the service out-of pocket. Federal law requires practitioners to provide all patients with notices if the measures taken to protect patient information. Failure to provide the required HIPAA notices or meet standards may result in investigations and possible civil or criminal penalties.
HIPAA Resources
AOA is providing resources to help optometrists follow the mandatory HIPAA rules, including a newly developed HIPAA Compliance Section of the AOA website. Resources include: • Updated AOA HIPAA Security Regulation Compliance Manual (available free of charge to AOA members); • Sample HIPAA Business Associate Agreement; • Sample HIPAA Notice of Privacy Practices, developed by the AOA Office of Counsel for use in optometric practices, which are available to order.
Join the New York State Optometric Association for
A Fun-Filled, Family-Friendly Weekend in Lake Placid! Education... Recreation... Socialization...
Wint❆rFest 2014
Education: January 31-February 2 NYSOA Annual Meeting: February 1-2 High Peaks Resort Lake Placid, New York
What’s in it for you?
Earn 11 hours of COPE-Approved continuing education with CE-NY courses.
Wint❆rFest 2014
Enjoy all Lake Placid has to offer with your family, friends and colleagues. Join optometrists from throughout the state during the NYSOA Annual Meeting festivities. Find out more at www.nysoa.org.
february meeting.indd 1
8/11/13 7:38 PM
3 AOA defends ODs against new attack on Harkin law The AOA swiftly organized opposition to a bill that would repeal the Harkin law, a landmark provider nondiscrimination provision. The recently introduced H.R. 2817 would undo the progress the Harkin law has made for optometrists, other providers and their patients. H.R. 2817 is backed by ophthalmology and the American Medical Association. The bill was introduced by Rep. Andrew Harris, M.D., of Maryland, an anesthesiologist serving his second term. In response, the AOA mobilized a friendly coalition of 20 organizations, including the American Dental Association, committed to defeating the bill. The Patients’ Access to Responsible Care Alliance (PARCA) represents the interests of millions of health care providers and the patients they serve. The group drafted a letter urging lawmakers to oppose HR. 2817. The letter stresses the importance of the Harkin law in targeting unfair policies that limit patient access to needed care. The Harkin law is the first-ever federal ban on discrimination against ODs by health insurers, including Employee Retirement Income Security Act (ERISA) plans with a long history of bias. Originally authored by Sen. Tom Harkin (recipient of the 2013 AOA Apollo Award), the law was enacted in 2010. Whether anti-optometry groups like it or not, millions more Americans are gaining access to their local doctor of optometry because a new federal law we fought for specifically targets the discriminatory and anti-competitive practices of health plans,” said Mitchell T. Munson, O.D., AOA president. “Both
Republicans and The AOA is ready, willing and Democrats have able to fight back. supported us in the decadeslong struggle to assure fairness and patient choice in the delivery of the essential health care services optometrists provide, and we’ll continue our efforts in Washington, D.C., to ensure that continues. In fact, if we have to take on and defeat organized medicine all over again on this issue, then so be it.” The Fight Continues The Harkin law targets health insurance plans that have at times made it policy to deny coverage for the services of doctors of optometry and other health care providers in a purported effort to contain costs. Medical groups and insurers fought the Harkin amendment at each step of a nearly two-year legislative process. They have renewed the fight in recent months as federal agencies have prepared for full implementation. Nevertheless, the Harkin law remains on track to provide consumers with greater access to local optometrists of their choice. “The AOA is ready, willing and able to fight back,” Dr. Munson added. AOA members can read the latest from the AOA Advocacy Super Conference and contact their representatives in Congress to speak out against H.R. 2817. To learn more about this issue, supporting AOAPAC or joining the Federal Keyperson program, email Jon Hymes, AOA Washington office director, or call 800-365-2219.
Hailey’s Best Friend
Mom’s Plumber
Mom’s Mechanic
Hailey’s Classmate
Mom’s Student You, Hailey, and Hailey’s Mom
Hailey and Mom
Fact: 58% of new contact lens wearers report they are likely to stop wearing contact lenses and return to glasses.* That’s why it’s critical to start your new wearers off right in 1-DAY ACUVUE® MOIST® Brand Family, with exceptional comfort, handling, stability, and UV protection.† No wonder 88% of parents with teens in 1-DAY ACUVUE® MOIST® said they were likely to refer others to you. Start new wearers off right and grow your practice.
Mom’s Dentist
Hailey’s Classmate
Mom’s Neighbor
ACUVUEprofessional.com *Gallup Study of The Consumer Contact Lens Market, conducted by Multi-Sponsor Surveys, Inc. “Likely” is comprised of net respondents that selected “Very” or “Somewhat” likely. † WARNING: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses, because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE: Long-term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information. ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from VISTAKON® Division of Johnson & Johnson Vision Care, Inc., by calling 1-800-843-2020 or by visiting acuvueprofessional.com. ACUVUE®, 1-DAY ACUVUE® MOIST®, and VISTAKON® are trademarks of Johnson & Johnson Vision Care, Inc. © Johnson & Johnson Vision Care, Inc. 2013 ACU-39307Z January 2013
Mom’s Hairstylist
5
Wintâ?†rFest 2014 CE-NY Education: January 30-February 2 NYSOA Annual Meeting: February 1-2 High Peaks Resort, Lake Placid, New York
Earn up to 11 hours of COPE-approved CE!
Preliminary Schedule Thursday, January 30
3:00-4:00 4:00-5:00 5:00-6:00 TBA
Mark Dunbar, OD My Most Interesting Cases Mark Dunbar, OD Understanding and Interpreting OCT Mark Dunbar, OD Your Ticket to Optimal Posterior Segment Disease Treatment & Management Evening Reception
Friday, January 31
7:30-8:30 8:30-9:30 4:00-5:00 5:00-6:00
Mark Dunbar, OD The Battle of Resistance Patricia Modica, OD Approaching the Patient with Diplopia Joseph Sowka, OD Glaucoma Pharmacology: Prescribing for the Patient Joseph Sowka, OD Identifying Glaucoma Progression
Saturday, February 1 7:30-9:30 4:00-6:00 6:30-7:00 TBA
Patricia Modica, OD & Joseph Sowka, OD Current Prospective in Neuro-Opthalmic Disease Chrisit Llerena, OD New Approaches to Amblyopic Patients: Adults and Children NYSOA House of Delegates, Election of New Officers Evening NYSOA Annual Award Event
Sunday, February 2 8:00-12:00
NYSOA Annual Meeting
Pricing* NYSOA/AOA Member
Nonmember
Full Conference (11 hours CE)
$235
$425
Thursday PM / Friday All Day (7 hours CE)
$140
$290
Friday PM / Saturday All Day (6 hours CE)
$125
$260
Any 4 hours CE
$100
$175
A la carte - cost per CE hour
$35
$50
Pricing inclusing of CE courses. Registration and details soon to follow
*
6
Volume 30 Number 3 2013
Optometry Student Corner By Matt Roe,NYSOA Student Society Vice-President
By the middle of my first month
to someone else who could help. I left my first day truly
trying to figure out how to spend
experience for the patient. A large portion of the success in
at SUNY last fall, I was already the summer. It was daunting
when I realized that this would be my last summer off for the foreseeable future. Would I
Matt Roe, NYSOA Student Society Vice-President
appreciating the fact that the exam is only a portion of the
a practice involves the two or three people the patient meets before seeing the doctor, as well as the two or three people who they meet on their way out the door.
spend it relaxing in New York
After one week of seeing approximately 15-20 full patients
had missed out on because of
but was still afraid of answering the phones. However, the
hometown to save on rent? Or
the staff was more than happy to help ensure I did not make
City taking in all the sights I
a day, I saw that I had achieved the 15-minute pre-testing,
studies, or would I return to my
phones constantly rang, and throughout the entire summer
would I travel the country and
mistakes when making appointments.
visit friends from college? I even looked into visiting
continued on page 25
a good friend who was being sent to Germany for
six months for a job. The last thing on my list was
seeking an internship, and yet it was what I eventually decided was best for me by March of the spring semester.
YOUR PRACTICE WITH
My first day can be best described as eye-opening and humbling. I watched in amazement as the
testers performed autorefraction, NCT, FDT, retinal
Our membership consists of the MOST INFLUENTIAL EXPERTS in the eye care industry; their efforts have led to 20 years of company success
questionnaires, dialed in the patient’s Rx into the
Comprehensive and innovative PRACTICE AND PROFESSIONAL DEVELOPMENT tools
the instruments in under 15 minutes on a consistent
WORLD CLASS MARKETING EXPERTISE AND SERVICES for internal and external marketing, including a home office support staff
imaging, optomaps, auto-lensometry, contact lens
phoropter, brought up the images, and cleaned down basis. My first attempt doing all of this solo, after a
year of schooling, was somewhere around 22 minutes. I then received training on notifying patients when contact lenses and glasses come in, inputting codes into the system, finding charts, answering phones and making appointments. I watched the front
desk explain the paperwork to a patient while also answering questions for another patient on the
phone and never make a mistake. I felt incredibly inexperienced on everything involving insurance
and would constantly have to transfer the patient
UNMATCHED SAVINGS opportunities NEGOTIATED BY US — FOR YOU LOWEST COST OF GOODS (COGs) in the industry through collective BUYING POWER The power of 5000+ INDEPENDENT EYE DOCTORS UNITED AS ONE TEAM & FAMILY! Scan the code or go to www.vsadresponse.com/0614-nyosa
Visit us at www.VISIONSOURCE.com or call 1-888-558-2020 to learn more and to speak to our Member Services Team.
Vision Source ® is a registered trademark of Vision Source LP. ©Vision Source LP 2012.
DUST
LIPIDS DIRT
OUR SURFACE DEFENDS AGAINST DAILY DEPOSITS. Only AIR OPTIX® brand contact lenses have a unique surface technology that’s proven to maintain wettability1** and resist deposits better than other available two-week or monthly replacement SiHy lens.2,3† Superior Surface with Moisture and Consistent Comfort
††
Unique Plasma Surface Technology
Creates a Hydrophilic Environment
That Resists Lipids & Deposits
AIR OPTIX BRAND ®
Family of Contact Lenses
See our superior surface deposit resistance and wettability1-3** data at MYALCON.COM *AIR OPTIX® AQUA (lotrafilcon B) and AIR OPTIX® AQUA Multifocal (lotrafilcon B) contact lenses: Dk/t = 138 @ -3.00D. AIR OPTIX® NIGHT & DAY® AQUA (lotrafilcon A) contact lenses: Dk/t = 175 @ -3.00D. AIR OPTIX® for Astigmatism (lotrafilcon B) contact lenses: Dk/t = 108 @ -3.00D -1.25 x 180. **Compared to ACUVUE^ OASYS,^ ACUVUE^ ADVANCE,^ PureVision,^ Biofinity^ and Avaira^ contact lenses. †Superior lipid deposit resistance compared to ACUVUE^ OASYS,^ ACUVUE^ ADVANCE,^ PureVision,^ Biofinity^ and Avaira^ contact lenses. ††Image is for illustrative purposes and not an exact representation. ^Trademarks are the property of their respective owners Important information for AIR OPTIX® AQUA (lotrafilcon B), AIR OPTIX® AQUA Multifocal (lotrafilcon B) and AIR OPTIX® for Astigmatism (lotrafilcon B) contact lenses: For daily wear or extended wear up to 6 nights for near/far-sightedness, presbyopia and/or astigmatism. Risk of serious eye problems (i.e., corneal ulcer) is greater for extended wear. In rare cases, loss of vision may result. Side effects like discomfort, mild burning or stinging may occur. Important information for AIR OPTIX® NIGHT & DAY® AQUA (lotrafilcon A) contact lenses: Indicated for vision correction for daily wear (worn only while awake) or extended wear (worn while awake and asleep) for up to 30 nights. Relevant Warnings: A corneal ulcer may develop rapidly and cause eye pain, redness or blurry vision as it progresses. If left untreated, a scar, and in rare cases loss of vision, may result. The risk of serious problems is greater for extended wear vs. daily wear and smoking increases this risk. A one-year post-market study found 0.18% (18 out of 10,000) of wearers developed a severe corneal infection, with 0.04% (4 out of 10,000) of wearers experiencing a permanent reduction in vision by two or more rows of letters on an eye chart. Relevant Precautions: Not everyone can wear for 30 nights. Approximately 80% of wearers can wear the lenses for extended wear. About two-thirds of wearers achieve the full 30 nights continuous wear. Side Effects: In clinical trials, approximately 3-5% of wearers experience at least one episode of infiltrative keratitis, a localized inflammation of the cornea which may be accompanied by mild to severe pain and may require the use of antibiotic eye drops for up to one week. Other less serious side effects were conjunctivitis, lid irritation or lens discomfort including dryness, mild burning or stinging. Contraindications: Contact lenses should not be worn if you have: eye infection or inflammation (redness and/or swelling); eye disease, injury or dryness that interferes with contact lens wear; systemic disease that may be affected by or impact lens wear; certain allergic conditions or using certain medications (ex. some eye medications). Additional Information: Lenses should be replaced every month. If removed before then, lenses should be cleaned and disinfected before wearing again. Always follow the eye care professional’s recommended lens wear, care and replacement schedule. Consult package insert for complete information, available without charge by calling (800) 241-5999 or go to myalcon.com. References: 1. In vitro measurement of contact angles on unworn lenses; significance demonstrated at the 0.05 level; Alcon data on file, 2009. 2. Nash W, Gabriel M, Mowrey-McKee M. A comparison of various silicone hydrogel lenses; lipid and protein deposition as a result of daily wear. Optom Vis Sci. 2010;87: E-abstract 105110. 3. Ex vivo measurement of lipid deposits on lenses worn daily wear through manufacturer recommended replacement period; CLEAR CARE® Cleaning and Disinfecting Solution used for cleaning an disinfection; significance demonstrated at the 0.05 level; Alcon data on file, 2008. See product instructions for complete wear, care, and safety information. © 2012 Novartis 12/12 AOA13002JAD
Would you recognize this potentially life-threatening genetic disease?
Corneal opacity (corneal verticillata or vortex keratopathy) in Fabry disease.
You could change the course of a patient’s life by identifying Fabry Disease • Fabry disease is a progressive, inherited disorder that affects men, women and children of all ethnicities • Fabry disease can lead to life-threatening renal, cardiac, and cerebrovascular complications • Approximately 90% of patients with Fabry disease exhibit corneal verticillata (whorl-like radial lines emanating from a single vortex)1 • Ocular manifestations are detectable by slip lamp examination and typically do not affect vision
A geneticist can help establish a definitive diagnosis of Fabry disease and provide information on intervention.
• Other signs and symptoms include pain in the extremities, impaired sweating, heat intolerance, fatigue, hearing loss, and gastrointestinal distress • If you identify a patient with Fabry disease, family testing should be considered
Don’t wait, learn more today by visiting www.fabrycommunity.com/eye References 1 Franceschetti A. Fabry’s disease: ocular manifestations. In: Bergsma D, Bron AJ, Cotlier E (eds). The Eye and Inborn Errors in Metabolism. Vol. 12, No. 3. New York: AR Liss Co., 1976: 195-208. Eye images used with permission. RL Abbott, MD ©2012 Genzyme Corporation. All rights reserved. FABR-US-P600-09-12
9 The State of the Optometric Profession, continued
continued from page 1
will graduate and enter practice annually while about 750 optometrists will retire. There will also be an expected gender shift. Over the next ten years, 65% of new optometrists will be females and 90% of retiring optometrists will be males. Currently, the male/female ratio is 61%/39%; in 2022, it is likely to be a 48%/52% ratio. Approximately 57% of optometrists are in private practice, 24% have an optical chain affiliation; 8% are in an ophthalmology practice; and 5% are in other medical practices. The number of practicing optometrists will grow faster than routine vision care demand (a projected 11% vs. 9% through 2020) but more slowly than the demand for medical eyecare (a projected increase in cataracts [2.3%], diabetic retinopathy, POAG, ARMD [1.8% each] through 2020). Presently, optometrists perform approximately 45% of Medicarereimbursed comprehensive eye exams. The Census Bureau projects a 28% increase in individuals over 55 years of age between 2010 and 2020, while the total populations will grow by about 10%. … Optometry’s largest opportunity is to increase eyecare demand among existing patients, expanding care to the elderly and other populations at risk for treatable diseases.
A Historical Review
Optometry’s scope of practice continues to broaden…
1897: First bill introduced to license optometrists in New York 1901: First law licensing optometrists enacted in Minnesota 1921: Last state law licensing optometrists enacted in Texas (D.C. enacted in 1924) 1923: Pennsylvania College of Optometry awarded first Doctor of Optometry degree 1971: First state law allowing the use of diagnostic drugs enacted in Rhode Island 1976: First state law allowing Rx of legend drugs enacted in W. Virginia (and on a veto override) 1976: First state authorizing Tx of glaucoma enacted in W. Virginia 1977: First state authorizing Rx of oral drugs enacted in North Carolina 1997: Last state authorizing Rx of legend drugs enacted in
Massachusetts (D.C. in 1998) 1998: Authority to use therapeutic lasers enacted in Oklahoma 2011: Kentucky legislature becomes the first state to repeal a statutory prohibition on the performance of surgery by optometrists and the second state to authorize the use of therapeutic lasers 2013: Pediatric exams (and materials) decreed as an essential yearly health benefit, as the result of AOA legislative activity 2014: Under the ACA, increased insurance enrollment will expand accessibility to optometric eyecare …As you can see, we are a legislated profession and we can thank organized optometry for progressing optometry forward. Be involved as a volunteer and as a donator to PAC funds to assure the continued evolution of your profession…as newly elected AOA trustee Dr. Greg Caldwell says, ” for the love of optometry.”
THE COMPLETE
EYECARE EVENT
EXPAND YOUR FIELD OF VISION A COMPREHENSIVE CONFERENCE More than 325 hours of Continuing Education for every role and experience level
AN AFFORDABLE SOURCE FOR STAFF TRAINING Boot Camps and Flexible Package Pricing jumpstart competency and add value
EDUCATES MORE OPTOMETRISTS THAN ANY OTHER EYECARE CONFERENCE Delivers the knowledge and information to ensure you practice to the fullest extent of your license
AN AFFORDABLE AND FUN EXPERIENCE Discounts for hotels, travel, entertainment and free parties
FOR THE HEALTH OF YOUR PATIENTS. FOR THE HEALTH OF YOUR PRACTICE. NYSOA MEMBERS GET FREE EXHIBIT HALL REGISTRATION (A $75 SAVINGS) AND EXCLUSIVE DISCOUNTS OFF CONTINUING EDUCATION • • •
Buy a package of 6 hours CE and get 9 hours ($60 savings) Buy a package of 9 hours CE and get 13 hours ($100 savings) Buy a package of 13 hours CE and get 18 hours ($130 savings)
USE PRIORITY CODE WL22 OR WWW.VISIONEXPOEAST.COM/NYSOA
EDUCATION: MARCH 14-17, 2013 EXHIBITION: MARCH 15-17, 2013 New York, NY | Javits Center
www.visionexpoeast.com
JOIN US ON SOCIAL MEDIA
#visionexpo
11 Health insurance marketplaces scheduled to open Oct. 1 Many optometrists across the nation are now receiving solicitations from insurance companies regarding participation in exchange-based health plans with an embedded pediatric vision essential health benefit as mandated by the Affordable Care Act (ACA). As with all insurance programs, practitioners should thoroughly review provider participation agreements for the new plans, assessing the contract terms carefully, according to the AOA Third Party Center. For assistance, contact tpc@aoa.org. The insurers offering plans through the new marketplaces will generally be well-established companies such as Blue Cross/Blue Shield, Aetna, or UnitedHealth. “It will be up to those insurance companies to determine if they will use their existing provider networks for the new plans they offer through health insurance exchanges or if they will establish distinct new provider networks for their exchange-based plans. In some cases, insurance companies may issue separate contracts to health care practitioners for their new exchange-based plans, some of which will likely include lower reimbursement rates,” said Stephen Montaquila, O.D., chair of the AOA Third Party Center Executive Committee. Offers to become participating providers in exchangebased plans will come from insurance companies, not the management of the exchanges. “Many health care practitioners are under the impression that the exchanges are new payers providing insurance and contracting with doctors,” Dr. Montaquila said. “The exchanges have little, if anything, to do with provider contracting.” Through the exchanges, private insurance carriers will offer plans meeting specified criteria. Uninsured people will be able to log onto exchange websites, modeled after travel sites such as Travelocity or Expedia, review the
plans offered by the various insurance companies and then purchase a policy online. Many exchanges will offer 800 telephone lines and “walk-in” offices as well. Of the 51 health insurance marketplaces being developed across the U.S., 17 will be state-based exchanges, 27 will federally facilitated exchanges, and seven will be “partnership” exchanges, developed jointly by state and federal government. Specifics on the federally facilitated exchanges had not been announced at press time. However, websites for all state-based and partnership exchanges can be accessed now on the “Your State Marketplace” page of the federal government’s Health Care Reform web portal (http:// tinyurl.com/insurancemarketplace). The HHS also offers a state-by-state health insurance exchange locator (www. healthcare.gov/marketplace/individual). Optometrists can visit the websites to find contact information, organizational structure for the exchanges, and some information on how to apply to become providers. State optometric associations may provide additional information on exchanges for their members. Multi-state plans will be available in 31 states in 2014 and in all states by 2017. Multi-state plans were created through the ACA to address the lack of competition in the individual health insurance market. Multi-state plans will be operated by the federal Office of Personnel Management, which is the entity that runs health insurance programs for Congress and federal employees. All multi-state plans must cover the same pediatric vision services for children. AOA members can access a number of resources, including answers to frequently asked questions, to help explain the new insurance marketplaces and assess participation in these plans at http://tinyurl.com/AOAhealthreform. News from the AOA
12
Volume 39 Number 3 2013
Protect your practice with new AOA HIPAA notices Federal privacy protection standards have become more stringent. Make sure your practice is up to date with the AOA’s new Health Insurance Portability and Accountability Act (HIPAA) Notice of Privacy Practice forms. The new form reflects changes to HIPAA. Using it is one way to make sure you are in compliance with new rules, which technically took effect in March. You have until Sept. 23 to comply.
4. Stop using old notices Cease use of any old HIPAA privacy practice notice, but retain a copy along with any written acknowledgments of receipt from patients. The AOA HIPAA Notice of Privacy Practice form was developed by the AOA Office of General Counsel in conjunction with HIPAA experts at the nationally recognized law firm of Stinson Morrison Hecker. It is offered as a resource but is not intended to suit all optometry practices or to constitute legal advice.
To avoid penalties related to notices, take these steps: 1. Order new notices New HIPAA Notice of Privacy Practice forms are available from the AOA Marketplace. To order, email orders@aoa.org. Or call the AOA Marketplace at 800262-2210 between 8 a.m. and 4 p.m. CDT, Monday through Friday. Include your member number to qualify for a discount. HIPAA Notice of Privacy Practice forms are sold in pads of 100 and include acknowledgement of receipt slips. Pricing is: • 100 forms for $42 (members) or $63 (nonmembers) • 500 forms for $65 (members) or $97.50 (nonmembers) • 1,000 forms for $110 (members) or $165 (nonmembers) • Imprinting available for an additional $8 per pad 2. Provide new notices to patients Provide an updated HIPAA Notice of Privacy Practice to all patients. For new patients, distribute the notice during the first office visit. For existing patients, make the new policy available upon request. 3. Post copies in person and online Post a copy of the updated notice in a prominent location in your practice and on the practice website.
Be sure to review the form with your legal counsel to ensure it reflects any applicable state privacy protection regulations and the actual privacy protection measures taken in your practice. HIPAA resources The new HIPAA Compliance section of the AOA website at www.aoa.org/optometrists/tools-and-resources/ hipaa-compliance (member login required to view) includes: • Updated AOA HIPAA Security Regulation Compliance Manual (available free of charge to AOA members) • Sample HIPAA Business Associate Agreement • Sample HIPAA Notice of Privacy Practices, developed by the AOA Office of Counsel for use in optometric practices, which are available to order by calling 800-262-2210. On the AOAExcel™ HIPAA page at www.excelod.com (member login required to view): • AOA White Paper: Updated HIPAA Regulations-What Optometrists Need to Know, with questions and answers about the privacy regulations. News from the AOA
We Bring More to Your World allerganOptometry.com
OpTOmeTry JumpSTarT™
National and regional meeting Support
Dedicated Sales Team
Teaching and residency Support
practice management resources
The Allergan Commitment to Optometry Is Stronger Than Ever. With new programs designed for doctors at every phase of their career, there are more ways for us to work together than ever before. Visit AllerganOptometry.com to access a world of possibilities for your practice.
©2013 Allergan, Inc., Irvine, CA 92612 ® and ™ marks owned by Allergan, Inc. zymAxId® is licensed from Kyorin Pharmaceutical Co., Ltd., Tokyo, Japan. APC05mW13 130367
BENEFIT ICONSBENEFIT ICONS BENEFIT ICONS
PATIENTS | REVENUE | SUPPORT What if you could generate more opportunities to connect with patients and earn more? You can, through a game-changing business model called Premier.
REVENUE | PATIENTS | SUPPORT
ENEFITS SPECIFIC REVERSED BENEFITS SPECIFIC OUTREVERSED BENEFITS OUTREVERSED OUT Get on the path to Premier. To learn more, visit pathtopremier.com or call any one of your VSP Global® Representatives.
UPPORT PATIENTS | REVENUE | SUPPORT PATIENTS | REVENUE | SUPPORT | REVENUE ©2013 Vision Service Plan. All rights reserved. VSP Global is a registered trademark of Vision Service Plan.
15 Thank you to our 2013 CVC Contributors!* Diane T. Adamczyk, OD Faye D. Algranati, OD Matthew Allen, OD Kathy L. Allen-Aquilante, OD Robert J. Ancona, OD Lori E. Arbital, OD Samuel Arbital, OD Judith Archibold, OD Brent D. Arnold, OD Alan M. Bagun, OD Jerry L. Baker, OD Stephen M. Baker, OD Francesco J. Barbarossa, OD Sherry J. Bass, OD Justin Bazan, OD Robert E. Behan, OD Viktorya Belenkova, OD Edward Berger, OD Michael J. Benyo, OD Andrew Bienstock, OD Joseph C. Biondolillo, OD Brian E. Bleiler, OD Steven Bloom, OD Juliana E. Boneta, OD Carolee R. Boyd, OD Kenneth Braunstein, OD Nancy M. Bulas-Wadas, OD Brandon Butler, OD Theodore J. Calabrese Jr., OD Jeffrey Calhoun, OD Gina M. Cardone, OD Jill C. Chafitz, OD Thomas Chao, OD David B. Chau, OD Vicki L. Chenarides, OD Lillian F. Chin, OD Paul M. China, OD Ida Chung, OD Dawn Chivers, OD Gee Hyun Chun, OD Benjamin Chudner, OD David Ciccone, OD Ira Clement, OD *
Contributions through September 30, 2013
Allen H. Cohen, OD Jennifer Colavito, OD Christopher J. Colburn, OD Daniel Colino, OD Jason Compton, OD Timothy L. Comstock, OD Joseph D. Conigliaro, OD Vanessa Conenna, OD Jeannette Cooper, OD Jeffrey Cooper, OD Edward V. Cordes, OD Christopher S. Couzins, OD Shoshana B. Craig, OD Alexander R. Crinzi, OD Angela M. Croteau, OD Jennifer Cummings, OD Errol S. Daniels, OD Sara Dawson, OD David J. Dexter, OD Christopher Digiorgio, OD Anne M. Downey, OD David P. Dozack, OD Paul R. Edelman, OD Tybee Eleff, OD Rita Ellent, OD Marina Epelman Meyerowitz, OD Thomas M. Erichson, OD Burt S. Eschen, OD Jack Facchin, OD Barry J. Farkas, OD Daniel T. Farkas, OD Doron Feder, OD Harvey O. Feldman, OD Brian Fengel, OD Despina S. Fikaris, OD B. Scott Fine, OD Susan S. Fisher, OD
Robert S. Fox, OD Jack Fried, OD Richard A. Frio, OD Gregory Gaglioti, OD Paul R. Galstian, OD Joseph P. Gambacorta, OD Steven J. Ganz, OD Angela E. Gardner, OD Ilana Gelfond-Polnariev, OD Robert H. Geula, OD Valerie A. Giangrande, OD Maria Gibbons, OD Steven Givner, OD David Girardi, OD Gwenda R. Gnadt, OD Ronald S. Goldstein, OD Traci M. Goldstein, OD Timothy J. Grace, OD Vincent B. Graniero, OD Marina Grapp, OD Robert J. Grasso, OD Israel Greenwald, OD Peter F. Guidara, OD Thomas S. Gullotti, OD Vadim Guy, OD William Halpin, OD Demetra Hamakiotes, OD Paula Handell, OD Bruce R. Hankin, OD Gary Hanley, OD Elizabeth S. Harvey, OD Paul E. Harvey, OD Kimberly Heiligman, OD Sarah S. Helgeson, OD Elizabeth Hetrick, OD Gary Holtzberg, OD Mitchell Horowitz, OD
Steven N. Ihrig, OD Cheryl S. Israeloff, OD Nadine M. Jamal, OD Danielle James, OD Barri J. Jones, OD Arthur D. Jung, OD Allen I. Kaplan, OD Jordan Kassalow, OD Sanford J. Katims, OD Richard S. Kavner, OD Jaime L. Kenny, OD Mili Khanna, OD Daniel Kirchheimer, OD Barry T. Kissack, OD Sarah Boulais Klein, OD Linda M. Kleinhenz, OD Roy A. Kline, OD Martin Kornblatt, OD David M. Krumholz, OD Kristen Krummenacker, OD Jeffrey Kraushaar, OD Richard B. Krzyzak, OD Martin Kusnetz, OD Michele A. Lagana, OD Michael V. Landy, OD William J. Lapple, OD Eric W. Lau, OD Alan S. Lax, OD William J. Leahey, OD Kathy Lee, OD Gary A. LeeSue, OD Robert J. Lehrer, OD David L. Leibstein, OD Patti L. Leonard, OD Michael B. Levinson, OD Lawrence Z. Levy, OD Steven Lobel, OD Laurence Lonky, OD Martin S. Losito, OD Stella S. Lou Lee, OD Todd H. Lustig, OD Diana Ma, OD Jason K. MacLaughlin, OD
16
Volume 30 Number 3 2013
Thank you to our 2013 CVC Contributors!*
Michael Madigan, OD Richard J. Madonna, OD Marilyn Mann, OD Anthony Marinelli, OD Gary F. Marrone, OD Marie A. Marrone, OD Katherine M. Mastrota, OD J. Kent Maurer, OD John J. Maurillo, OD Mark R. Maxon, OD Lindsay May, OD Robert P. McCormick, OD Michael J. McGovern, OD Bradley R. Meltzer, OD Peter J. Micca, OD Maria A Michalski, OD Bari Miller, OD Dean M. Miller, OD Lawrence D. Miller, OD Arlene Minkoff, OD Daniel S. Mirkin, OD Jason W. Moore, OD Scott I. Morrison, OD James O. Morse, OD Edward Moylan, OD Joseph J. Mueller, OD Rebecca A. Nally, OD David L. Naparstek, OD Charles H. Neu, OD Vaishali Nigam, OD Michael J. O’Connor, OD Maureen O’Dwyer, OD Steven A. Ohlbaum, OD Kristin Orabone, OD Eric Orava, OD David S. Orenstein, OD Catherine Pace-Watson, OD Gina Parsloe, OD John Richard Paskowski, OD Viren R. Patel, OD Ralph Paternoster, OD Lucia Patino, OD Brian D. Peralta, OD Alec J. Perlson, OD
Elisa B. Perreault, OD Vernon A. Peryea, OD Benjamin P. Peters, OD Frank Pirozzolo, OD Raymond Pirozzolo, OD John P. Plow, OD Roman Polishchuk, OD Sebastian A. Polizzi, OD Joan K. Portello, OD Sophie Poselle,OD Ronald H. Poulin, OD Brian Powell, OD Carolyn Powell-Rivers, OD Elizabeth H. Pradhan, OD Ira M. Price, OD Richard S. Price, OD Ami C. Ranani, OD John Ray, OD Fran L. Reinstein, OD Barbara L. Reiss, OD Susan A. Resnick, OD Sheldon S. Retkinski, OD Scott J. Richter, OD Brian M. Rogoff, OD Miriam M. Rolf, OD Debbie C. Roodner, OD Deborah S. Rose, OD Kevin D. Rosin, OD Theresa Rostkowski, OD Jeffrey M. Roth, OD Neil Rubin, OD John Rundquist, OD Laurie Runnerstrom, OD Daniella Rutner, OD Andrew J. Sacco, OD Denise Samaroo, OD
Denise D. Saunders, OD David E. Sausner, OD Leonard J. Savedoff, OD Catherine Scandiffio, OD Jeff Schafer, OD Daniel E. Scheg, OD Terry R. Scheid, OD Alan B. Schlussel, OD
Steven Schoenbart, OD Elliot Schwartz, OD Steven H. Schwartz, OD Matthew E. Sendker, OD Aarti K. Sharma, OD Mary Rita Sheehy, OD Melanie B. Sheinheit, OD Eui-Hyun Shin, OD Christopher W. Shiomos, OD Margaret M. Siegrist, OD Jennifer Small, OD Lauren Smith, OD Duane R. Snyder, OD Richard M. Soden, OD Michael P. Spellicy, OD Laura C. Sperazza, OD
IntroducIng a revolutIon In progressIve lenses
ExpERiEncE fAStER ViSUAl REAction timE A revolution in personalization, Varilux S 4D ™ lenses are the most sophisticated level of advancement in the Varilux S Series™ portfolio. Only 4D Technology ™ factors in the leading dominant eye for faster visual reaction time. Ranked #1 on every lens feature by real patients in independent studies.
To learn more visit VariluxUSA.com. ©2013 Essilor of America, Inc. All rights reserved. Essilor and Varilux are registered trademarks of Essilor International. Varilux S Series and Varilux S 4D are trademarks of Essilor International.
17 Thank you to the following optometrists who have supported NYSOA PAC in 2013!* Elias S. Abboud, OD Diane T. Adamczyk, OD Valerie L. Albert, OD Faye D. Algranati, OD Matthew Allen, OD Kathy L. Allen-Aquilante, OD Robert J. Ancona, OD Lori E. Arbital, OD Samuel Arbital, OD Judith A. Archer, OD Judith Archibold, OD Brent D. Arnold, OD Alan M. Bagun, OD Jerry L. Baker, OD Stephen M. Baker, OD Francesco J. Barbarossa, OD Sherry J. Bass, OD Justin Bazan, OD Robert E. Behan, OD Viktorya Belenkova, OD Michael J. Benyo, OD Edward Berger, OD Brian K. Berliner, OD Andrew Bienstock, OD Joseph C. Biondolillo, OD Teresa Blackstone, OD Brian E. Bleiler, OD Steven Bloom, OD Casimir K. Bobowski, OD Juliana E. Boneta, OD Carolee R. Boyd, OD Kenneth Braunstein, OD Andrea J. Britvan, OD Anne Brunenavs, OD Daniel Brunenavs, OD Brandon Butler, OD Paul Caito, OD Theodore J. Calabrese, Jr., OD Jeffrey Calhoun, OD *
Contributions through September 30, 2013
Gina M. Cardone, OD Eric R. Carson, OD Jill C. Chafitz, OD Thomas Chao, OD David B. Chau, OD Vicki L. Chenarides, OD Tiffany Cheng, OD Lillian F. Chin, OD Paul M. China, OD Dale Ching, OD Dawn Chivers, OD Benjamin Chudner, OD Gee Hyun Chun, OD Ida Chung, OD David Ciccone, OD Ira Clement, OD Alan Cohen, OD Allen H. Cohen, OD Roy B. Cohen, OD Jennifer Colavito, OD Christopher J. Colburn, OD Daniel Colino, OD Jason Compton, OD Timothy L. Comstock, OD Joseph D. Conigliaro, OD Vanessa Conenna, OD Jeannette Cooper, OD
Jeffrey Cooper, OD Edward V. Cordes, OD Gail E. Correale, OD Paul R. Cosenza, OD John J. Costello, OD Christopher S. Couzins, OD Mario J. Craig, OD Shoshana B. Craig, OD Alexander R. Crinzi, OD Jennifer Cummings, OD Errol S. Daniels, OD Allan E. Davis, OD Sara Dawson, OD Regina M. Devito, OD Jack L. Devore, OD David J. Dexter, OD Christopher Digiorgio, OD Michael J. Dolan, OD Anne M. Downey, OD David P. Dozack, OD Paul R. Edelman, OD Tybee Eleff, OD Rita Ellent, OD Richard L. Erenstone, OD Thomas M. Erichson, OD Burt S. Eschen, OD Dorothy Anne Ewald, OD
Original photo of New York State Capitol Building courtesy of the Albany County Convention & Visitors Bureau.
Jack Facchin, OD Barry J. Farkas, OD Daniel T. Farkas, OD Doron Feder, OD Harvey O. Feldman, OD Brian Fengel, OD Despina S. Fikaris, OD B. Scott Fine, OD Murray Fingeret, OD Susan S. Fisher, OD Jennifer P. Flynn, OD Kirk C. Flynn, OD Lawrence Forur, OD Robert S. Fox, OD Peter Freitag, OD Jack Fried, OD Richard A. Frio, OD Gregory Gaglioti, OD Paul R. Galstian, OD Joseph P. Gambacorta, OD Steven J. Ganz, OD Angela E. Gardner, OD Ilana Gelfond-Polnariev, OD Robert H. Geula, OD Valerie A. Giangrande, OD Maria Gibbons, OD Steven Givner, OD Gwenda R. Gnadt, OD Ronald S. Goldstein, OD Traci M. Goldstein, OD Brad C. Gollinger, OD Steven I. Goodman, OD Timothy J. Grace, OD Vincent B. Graniero, OD Marina Grapp, OD Robert J. Grasso, OD Robert S. Greenbaum, OD Joel Greenberg, OD Mark L. Greenberg, OD
18
Volume 30 Number 3 2013
Thank you to the following optometrists who have supported NYSOA PAC in 2013!* Israel Greenwald, OD Anne Griffin, OD Peter F. Guidara, OD Thomas S. Gullotti, OD Shari L. Gustin, OD Scott F. Hage, OD William Halpin, OD Demetra Hamakiotes, OD Joseph Hargrave, OD Paula Handell, OD Bruce R. Hankin, OD Gary Hanley, OD Elizabeth S. Harvey, OD Paul E. Harvey, OD Kimberly Heiligman, OD Sarah S. Helgeson, OD Elizabeth Hetrick, OD Gary Holtzberg, OD Mitchell Horowitz, OD Steven N. Ihrig, OD Cheryl S. Israeloff, OD Nadine M. Jamal, OD Danielle James, OD Barri J. Jones, OD Arthur D. Jung, OD Nina M. Kalmanson, OD Thomas M. Kaminska, OD Allen I. Kaplan, OD Jordan Kassalow, OD Sanford J. Katims, OD Andrew J. Katz, OD Richard S. Kavner, OD Jaime L. Kenny, OD Mili Khanna, OD Daniel Kirchheimer, OD Barry T. Kissack, OD Sarah Boulais Klein, OD Linda M. Kleinhenz, OD Roy A. Kline, OD Donald B. Knapp, OD Leslie R. Kolker, OD Martin Kornblatt, OD Jeffrey Kraushaar, OD
David M. Krumholz, OD Kristen Krummenacker, OD Richard B. Krzyzak, OD Martin Kusnetz, OD Michele A. Lagana, OD Lori Marie Landrio, OD Michael V. Landy, OD William J. Lapple, OD Eric W. Lau, OD Alan S. Lax, OD William J. Leahey, OD
Kathy Lee, OD Gary A. LeeSue, OD Robert J. Lehrer, OD David L. Leibstein, OD Patti L. Leonard, OD Michael B. Levinson, OD Lawrence Z. Levy, OD Rocco F. Loccisano, OD Laurence Lonky, OD Martin S. Losito, OD Stella S. Lou Lee, OD Todd H. Lustig, OD Diana Ma, OD Jason K. MacLaughlin, OD Michael Madigan, OD Richard J. Madonna, OD Marilyn Mann, OD Sergio Marano, OD Anthony Marinelli, OD Gary F. Marrone, OD Marie A. Marrone, OD Katherine M. Mastrota, OD Gerald G. Mattison, OD J. Kent Maurer, OD John J. Maurillo, OD Mark R. Maxon, OD Lindsay May, OD Robert P. McCormick, OD Michael J. McGovern, OD Ronald A. Meeker, OD Bradley R. Meltzer, OD Peter J. Micca, OD
Maria A. Michalski, OD Bari Miller, OD Lawrence D. Miller, OD Arlene Minkoff, OD Daniel S. Mirkin, OD Henry W. Mole, OD Anthony Mondo, OD Jason W. Moore, OD Al M. Morier, OD Scott I. Morrison, OD James O. Morse, OD Harvey G. Moscot, OD Edward Moylan, OD Joseph J. Mueller, OD Rebecca A. Nally, OD David L. Naparstek, OD Charles H. Neu, OD Vaishali Nigam, OD Maureen O’Dwyer, OD
Steven A. Ohlbaum, OD Kristin Orabone, OD Eric Orava, OD David S. Orenstein, OD Catherine Pace-Watson, OD Brett M. Paepke, OD Charles W. Paepke, OD Eugene Parker, OD Gina Parsloe, OD John Richard Paskowski, OD Nehal P. Patel, OD Viren R. Patel, OD Ralph Paternoster, OD Lucia Patino, OD Brian D. Peralta, OD Alec J. Perlson, OD Elisa B. Perreault, OD Vernon A. Peryea, OD Benjamin P. Peters, OD
IF YOU KNOW THE WORLD’S FIRST CORRIDOR-LESS PROGRESSIVE...
THEN YOUR PATIENTS ARE WEARING HOYA® iD MYSTYLE® PROGRESSIVE LENSES
A Free-Form Lens Measuring Device HOYALUX iD MyStyle® can now be realized in all independent practices thanks to the development of Spectangle. Spectangle is an App that addresses many of the drawbacks required to prescribe personalized progressives including time necessary to take frame and fitting measurements, equipment investment and ease of operating measuring devices. ASK YOU’RE HOYA SALES REPRESENTATIVE TODAY HOW YOU CAN ORDER SPECTANGLE FOR YOUR PRACTICE!
www.thehoyafreeformcompany.com ©2012 HOYA Corporation. HOYA and HOYALUX iD MyStyle are registered trademarks of HOYA Corporation. The HOYA Free-Form Company, Integrated Double Surface Technology, iDentifier, and HOYA Free-Form are trademarks of HOYA Corporation.
19 Thank you to the following optometrists who have supported NYSOA PAC in 2013!* Frank Pirozzolo, OD Raymond Pirozzolo, OD John P. Plow, OD Roman Polishchuk, OD Sebastian A. Polizzi, OD Joan K. Portello, OD Sophie Poselle, OD Ronald H. Poulin, OD Brian Powell, OD Carolyn Powell-Rivers, OD Elizabeth H. Pradhan, OD Ira M. Price, OD Richard S. Price, OD Kelly M. Primeau, OD Todd D. Punim, OD Arthur M. Purvin, OD Ami C. Ranani, OD John Ray, OD Tina M. Reeves, OD Fran L. Reinstein, OD Barbara L. Reiss, OD Susan A. Resnick, OD Sheldon S. Retkinski, OD Douglas G. Rickert, OD Brian M. Rogoff, OD Debbie C. Roodner, OD Deborah S. Rose, OD Kevin D. Rosin, OD
Theresa Rostkowski, OD Jeffrey M. Roth, OD Neil Rubin, OD John Rundquist, OD Laurie Runnerstrom, OD Daniella Rutner, OD Andrew J. Sacco, OD Nicolette Sacco-Brown, OD Denise Samaroo, OD Philip A. Sarikey, OD Denise D. Saunders, OD David E. Sausner, OD Leonard J. Savedoff, OD Catherine Scandiffio, OD Jeff Schafer, OD Daniel E. Scheg, OD Terry R. Scheid, OD Alan B. Schlussel, OD Steven Schoenbart, OD James A. Schultz, OD Terry R. Schultz, OD Elliot Schwartz, OD Steven H. Schwartz, OD Matthew E. Sendker, OD Aarti K. Sharma, OD Mary Rita Sheehy, OD Melanie B. Sheinheit, OD Eui-Hyun Shin, OD
Christopher Shiomos, OD David A. Siegel, OD Margaret M. Siegrist, OD Jennifer Small, OD Andrew P. Smith, OD Lauren Smith, OD Duane R. Snyder, OD Richard M. Soden, OD Michael P. Spellicy, OD Laura C. Sperazza, OD James E. Stafford, OD Joseph M. Stamm, OD Diane Suarez, OD Libby Sukoff, OD Carissa L. Swanson, OD Dora Szymanowicz, OD Wayne Tabachnick, OD Barry Tannen, OD Grace Tan, OD Andrea P. Thau, OD Pamlea E. Theriot, OD Rajiv Trivedi, OD Frank S. Verdone, OD Justin J. Verrone, OD David J. Vinci, OD Ralph R. Vogel, OD Kai Wing Wai, OD William J. Waldron, OD
Larry B. Wallace, OD Maureen K. Wallen, OD Michael R. Waterman, OD Thomas P. Webb, OD David L. Weinberger, OD Gary M. Weiner, OD Patricia Weisenreder, OD Bernard H. Weitz, OD Jan Weitz, OD Vincent Wesolowski, OD Denise M. Whittam, OD Aleksandra Wianecka, OD Jeffrey S. Williams Jr., OD Yvonne M. Williams, OD Reem K. Wlaschin, OD Russell M. Wohl, OD Thomas A. Wong, OD Eva Yan, OD Anupama Yennamandra, OD Heidi Ying, OD Lori A. Youngman, OD Michelle Zalaznick, OD Shandor Zelenger, OD Wei Zhang, OD Abraham Zlatin, OD Allen F. Zuck, OD Joseph Zupnick, OD
*
Thank you to our 2013 CVC Contributors! James E. Stafford, OD Joseph M. Stamm, OD Marjorie J. Strelzyn, OD Diane Suarez, OD Libby Sukoff, OD Carissa L. Swanson, OD Dora Szymanowicz, wOD Wayne Tabachnick, OD Grace Tan, OD Barry Tannen, OD Andrea P. Thau, OD
Pamela E. Theriot, OD Rajiv Trivedi, OD Tara Cecilia Vaz, OD Frank S. Verdone, OD Justin J. Verrone, OD David J. Vinci, OD Ralph R. Vogel, OD Kai Wing Wai, OD Larry B. Wallace, OD Maureen Wallen, OD Michael Waterman, OD
David Weinberger, OD Gary M. Weiner, OD Patricia E. Weisenreder, OD Bernard H. Weitz, OD Jan Weitz, OD Vincent A. Wesolowski, OD Denise M. Whittam, OD Aleksandra Wianecka, OD Yvonne M. Williams, OD Reem K. Wlaschin, OD Russell M. Wohl, OD
Thomas A. Wong, OD Eva Yan, OD Lori A. Youngman, OD Michelle Zalaznick, OD Shandor Zelenger, OD Wei Zhang, OD Abraham Zlatin, OD Allen F. Zuck, OD Joseph Zupnick, OD
20
Volume 30 Number 3 2013
Prepare now for key health IT milestones in 2014
Health insurance market reforms, authorized under the federal Affordable Care Act, will take effect on New Year’s Day 2014. However, the year will also see a number of landmark events in the federal government’s eHealth Initiative – a $26 billion, multi-year effort to establish a nationwide electronic health information technology (HIT) system. The following is an overview of important e-health dates, along with links to resources, tools, and information to help optometrists prepare for e-health implementation in 2014 and beyond.
Jan. 1, 2014 • Medicare electronic funds transfer
– Administrative Simplification operating rules for electronic funds transfers (EFT) and remittance advice go into effect. (See http:// go.cms.gov/ 1c8H6x5)
• Medicare and Medicare EHR
programs – Eligible professionals (EPs) beginning Stage 2 with their third or fourth year of participation in the Medicare and Medicaid EHR incentive programs. To learn more, see http://go.cms. gov/ OzQYnb or http://www.excelod. com/ehr. Stage 2 Meaningful Use requires EHR interconnectivity. Optometrists are encouraged to consult AOAExcel™ for information on the OcuHub™ EHR interconnectivity network
(www.excelod.com/home-toolkit).
Medicare practitioners in their second year or beyond of demonstrating meaningful use need to electronically report their clinical quality measures (CQMs) for the full calendar year of 2014 (Jan, 1, 2014, to Dec. 31, 2014). Practitioners will then submit their CQM data during a two-month reporting period from Jan. 1, 2015, to Feb. 28, 2015.
• Medicare e-Prescribing (e-Rx)
Program – To be considered a successful electronic prescriber for the 2013 e-Rx Incentive Program, and potentially qualify to earn a 0.5 percent incentive payment, an individual EP will have had to report the e-Rx measure for at least 25 unique electronic prescribing events in which the measure is reportable by the EP during 2013. For more information, visit http:// go.cms.gov/11pVajA or www. excelod.com.
Feb. 28, 2014 • Medicare Physician Quality
Reporting System (PQRS) – Practitioners must submit their calendar year (CY) 2013 data to receive a Physician Quality Reporting System (PQRS) incentive payment for 2013 by this date. It is also the last day for Medicare EPs participating in the Electronic Reporting
Pilot to submit quality data to satisfy both PQRS and the CQM requirement of the EHR Incentive Program. Learn more about the PQRS program at http://go.cms. gov/18DfttF, www.aoa.org/ PQRS, or www.excelod.com/ PQRS. For information on the EHR Incentive Program Electronic Reporting Pilot, see http://go.cms. gov/1bUXtPh.
• EHR attestation – This is also
the deadline for practitioners to register and attest to demonstrating meaningful use for the Medicare EHR Incentive Program to receive an incentive payment for the 2013 reporting year. Medicaid registration and attestation deadlines may differ by state. For additional information, see http:// go.cms.gov/HLRApo.
Oct. 1, 2014 • ICD-10 – This is the official
transition date from ICD-9 to ICD-10 codes for diagnoses in health care practices and all other health care settings, as well as for procedures in hospital inpatient settings. Step-by-step CMS resources can help practitioners make sure they are prepared for the transition (http://go.cms.gov/ Xe9zeO).
• EHR meaningful use – This is the last day for practitioners who have
21 not yet participated in the Medicare EHR Incentive program to begin their 90 days of meaningful use in 2014. Medicare practitioners will not be able to earn incentives for participation in the program after this date and will be subject to payment adjustments. Payment adjustments start at 1 percent and are cumulative for every year an EP does not participate (see http:// go.cms.gov/OpAA6N).
Nov. 5, 2014 • Health Plan Identifier
– This is the deadline for large health plans to obtain a Health Plan Identifier (HPID). Small health plans have until Nov. 5, 2015 (see http://go.cms.gov/ Qn77dS).
Stay up to date For optometrists, becoming an integral part of the nation’s emerging e-health system is essential, according to AOA President Mitchell T. Munson, O.D. “America is transitioning to a health care system
heavily focused on primary and preventive care,” Dr. Munson said. “Optometrists have the potential to play a key role in the nation’s transformed health care system, but only if they become part of the e-health systems that will support it. That means optometrists must meet all pertinent e-health deadlines over the coming months.” The AOA and its AOAExcel™ subsidiary offer a range of guidance and services specifically designed to ensure optometrists can meet each of those deadlines. The CMS frequently updates the information available to health care practitioners on its e-health programs. Changes in e-health program rules, regulations, criteria or deadlines are possible, the AOA Advocacy Group noted. Optometrists should make a point to stay up to date with the developments related to e-health by following the AOA on Twitter (@AOANews and @ AOAConnect) and online at aoa.org/news. News from the AOA
Practitioners now have longer to pay back overcharges to Medicare Health care practitioners may now have up to five years to return overpayments to Medicare under a newly revised Extended Repayment Schedules (ERS) program that takes effect Sept. 3. Under the revised program, Medicare payment contractors may authorize extended repayment periods ranging from six to 36 months. Longer repayment schedules, up to 60 months, may be approved by U.S. Centers for Medicare & Medicaid Services (CMS) staff. Medicare generally requires return of overpayments within 30 days but the CMS may grant extensions if a practitioner
demonstrates immediate repayment would represent a “hardship.” Until now Medicare payment contractors could only give practitioners an extension of up to 12 months to return overpayments, although CMS officials could allow longer repayment periods if warranted. Practitioners should note unreturned overpayments are subject to substantial interest. For additional Information, visit http:// tinyurl.com/mq6a9gf. News from the AOA
22
Volume 30 Number 3 2013
ODs can easily avoid PQRS pay penalties with AMD codes Optometrists can still avoid having Medicare
This month, AOA News is focusing on the reporting of
Physician Quality Reporting System (PQRS) if they see a
glaucoma and diabetic retinopathy quality measures will
reimbursements docked 0.5 percent in 2015 under the
Medicare patient with diabetes, open-angle glaucoma, or
age-related macular degeneration (AMD) by the end of the year. All that is necessary is “a good-faith effort” to provide quality patient care by taking the measures encouraged
under the program, such as discussing the benefits of the Age-Related Eye Disease Study (AREDS) formulation
of antioxidant supplements or providing dilated macular examinations when patients present with AMD.
“With Medicare planning to increase its quality reporting requirements over coming years, practitioners have reason
to make a real effort to use PQRS codes on a regular basis,” notes Rebecca Wartman, O.D., of the AOA Third Party Executive Committee. “By doing so now, practitioners
could not only avoid the coming PQRS payment penalty in 2015 but quite possibly still earn a PQRS bonus this year.” AOA polls consistently show optometrists are already
taking the steps encouraged under the PQRS to ensure high quality of care – such as providing dilated eye
examinations and discussing the AREDS formula with AMD patients – so all most practitioners need to do
AMD quality measures through the PQRS. Features on follow in the coming months.
Two PQRS measures relate to the diagnosis of AMD:
• Measure 14 – Age-Related Macular Degeneration: Dilated Macular Examination
• Measure 140 – Age-Related Macular Degeneration: Counseling on Antioxidant Supplement
Practitioners may use one or both measures with any of the following three AMD diagnoses codes:
• 362.50 – Macular degeneration NOS • 362.51 – Macular degeneration, non-exudative • 362.52 – Macular degeneration, exudative
Measure 14, reported on claims using QDC 2019F,
indicates the provider had a dilated view of the macular and documented whether macular thickening and hemorrhages were present or not.
The provider must dilate and record findings once per a 12-month period or once per a reporting period.
is properly report those services to Medicare using the
However, the quality data code QDC must be used on
appropriate quality reporting code.
the dilated macular examination was performed during a
standard Medicare 1500 claim form along with the
Medicare considers a good-faith effort to mean as little
every claim submitted for the AMD diagnosis even when previous patient visit.
as providing PQRS quality-of-care measures to a single
For cases in which the practitioner could not provide a
practitioners need to do is use the PQRS codes once – on
can be noted on claims with the following modifiers:
appropriate patient over the course of a year, so all one claim form for one patient – during 2013.
dilated examination, the PQRS provides exceptions that
23 1P: Medical reason for no dilated macular view.
2P: Patient’s reason for no dilated macular view.
8P: Other reason for no dilated macula view.
However, practitioners should use such
exceptions, particularly 8P, judiciously.
Measure 140, reported on claims using QDC 4177F, indicates the
when the AREDS
Last 2013 Medicare EHR reporting period begins Oct. 1
during a prior patient
For first-year participants
discussion occurred visit.
in the Medicare Electronic
The only exception
Incentive Program, the last
for 4177F is 8P – No
reason for not discussing AREDS.
The AMD quality
measures are applicable
only to patients age 50 or older.
Health Records (EHR) day to begin reporting for 2013 is Oct. 1. Practitioners attempting to qualify for second-year EHR incentives during 2013 must demonstrate adherence to the government’s meaningful use standards for a full year.
provider discussed the
For additional
formulation of antioxidant
the AOA Summary
practitioners who have
visit www.excelod.com/
reporting period can access
pros and cons of AREDS supplements and made
proper recommendations for the individual
and documented the discussion per the AREDS report.
This discussion and documentation of
recommendations must
occur once per 12-month period or once per
reporting period for each
unique patient. However,
information, including
First-year health care
Chart of PQRS coding,
already completed their
pqrs.
several tools to help prepare News from the AOA
for attestation.
• The CMS Meaningful Use Attestation Calculator (www. cms.gov/apps/ehr) and Attestation User Guide for Eligible Professionals (http:// tinyurl.com/96el9ht) can also help health care professionals to successfully attest to meeting meaningful use. Health care professionals can find other important dates related to the EHR incentive program by visiting http://tinyurl.com/8dsufkn
• Practitioners can use
or reviewing the “Important
the CMS Eligible
Dates” section of the CMS
Professional Attestation
EHR Incentive Programs’
Worksheet (http://
Overview page (http://
tinyurl.com/8enndss) to
tinyurl.com/93383wf).
record their meaningful use measures to reference when attesting for the
the QDC must be used
program in the CMS
for the diagnosis, even
and Attestation System
on every claim submitted
(ehrincentives.cms.gov).
Web-based Registration
For additional information, including webinars, articles, FAQs and more, visit www. ExcelOD.com/EHR. News from the AOA
24
Volume 39 Number 3 2013
Vision West is the preferred optical buying group of the Help Vision West New York State Optometric Association (NYSOA). 1.5% of your Vision West billing goes back to help you support support the NYSOA! the New York State To date Vision West has given the NYSOA over $250,000 back in support! Optometric Association! No membership fee and no minimum purchase or volume requirements
Give us a 3 month trial You have nothing to lose and everything to gain — no administrative fee charges for 3 months! For more information and to join today, just call a Customer Service Specialist at 800.640.9485.
Competitive discounts on the largest selection of optical, lab and business service vendors in the industry. Premium Customer Service and 24/7 online account access and Practice Management tools No hassle, no fee early credit service
www.vweye.com
25 continued from page 6
Optometry Student Corner, continued
By July, the number of times I asked for help each day had
They fully expected
an average of seven minutes.
abnormalities I
dropped greatly, and I had cut down my pre-testing time to
While this experience alone was more than enough to help me have extreme appreciation towards all who work at
the front desk or as a tech, what really made this summer incredible was the mentorship provided by the doctors at
the practice. Each one took me under their wing, showing me tips on how to get the best optomap image, how to
handle patients who just aren’t having a good day, and on
one occasion bringing me in to witness my first corneal scar.
me to mention any
My first day can be best described as eye-opening and humbling.
noticed in imaging
or inconsistencies in
pre-tests, and would call me over if I missed something. On one instance, a doctor showed me a picture of a myelinated RNFL and helped me through the steps to achieve the proper diagnosis. I was able to witness firsthand nevi,
melanoma, retinal detachments, and asteroid hyalosis, all conditions that I had only seen thus far in textbooks or powerpoint slides in lecture.
As a student entering my second year, this
internship has made more of an impact on me
than I could have ever imagined. It’s something I
TITAN MINIMAL ART. THE ICON. MODERN. DYNAMIC. CUTTING-EDGE.
believe to be an invaluable learning experience for
any student who is seeking firsthand experience in a real-world scenario. But what a lot of classmates and I found to be difficult this past semester was
finding practices who were willing to hire students. Chelsea Ashlaw (current President of SUNY’s
NYSOA chapter) and I have discussed this point in great depth, and have decided to create a database
of NYSOA optometrists willing to take on students during the summer off between first and second year. Whether it is as a full-time internship, a
part-time employment, or even allowing students Titan Minimal Art. The Icon. The newest iteration of a classic icon, with a colorful, sportier appeal. The Icon is designed for a perfect, customizable fit; perfect for everyday wear.
to shadow at the practice, having such a database
would provide students with an easy access to obtain experience that will greatly affect how they will practice in the future.
If you are interested in being a part of this database or have any questions, please send an e-mail to Contact your Silhouette Sales Representative for more information or call 1-800-223-0180 w w w. s il h o u e t t e . c o m
nysoastudents@gmail.com. We look forward to
working with you to help future optometry students gain invaluable real-world experience.
26
Volume 30 Number 3 2013
Upcoming NYSOA Events CE-NY
November 3, 2013 The Lodge at Welch Allyn Skaneateles Falls, NY
Wint❆rFest 2014
NYSOA Board of Trustees Meeting
CE-NY Education: January 31-February 2 NYSOA Annual Meeting: February 1-2 High Peaks Resort Lake Placid, NY
November 17, 2013 Hilton Albany Albany, NY
Welcome New NYSOA Members! *
There’s a better way to soothe end-of-day contact lens discomfort.
Central
Ihor Dilaj, OD Eui-Hyun Shin, OD
Eastern
Jennifer Tribley, OD
Switch to Avaira®
Offer your patients all-day comfort.
Nassau
Joy Scharf, OD
Northern
Mark Hershowitz, OD
OSCONY
Ekaterina Kruger, OD Sharon Park, OD *
OSCONY
Lucia Patino, OD Olesya Semchenkova, OD Stephanie Tin, OD
Rochester
Tiffany Cheng, OD Meredith Jansen, OD
Suffolk
Jennifer Ceonzo, OD
WRP
Tania Mathai, OD Hiral Patel, OD Jisoo Shin, OD
June 1, 2013 through September 25, 2013
prospectus
Prospectus New York State Optometric Association 119 Washington Avenue Second Floor Albany, NY 12210 800-342-9836 P 518-449-7300 F 518-432-5902 nysoa2020@gmail.com www.nysoa.org NYSOA Elected Officers
Diamond
President Susan Fisher, OD N. Bellmore, NY
President-Elect Christopher Colburn, OD Jamestown, NY Vice President Ida Chung, OD New York, NY
Platinum Silver Bronze Support NYSOA Business Partners!
Secretary/Treasurer Michele Lagana, OD Rochester, NY Immediate Past-President Tom Landry, OD Corning, NY
Executive Director Jan S. Dorman nysoa2020@gmail.com