How AOA advocacy, teamwork lead to change for ODs
"This was AOA's longest letter in response to any issue."
AOA-backed measures that appear in Medicare's 2015 physician fee schedule are a prime example of how the power of advocacy and the tireless efforts of AOA volunteers and staff make a difference.
When the comment period opened for the proposed fee schedule last year, the AOA's Federal Relations Committee (FRC) wrote a detailed letter to the Centers for Medicare & Medicaid Services, seeking changes that would benefit the profession.
AOA on a regular basis provides detailed comments on federal policy issues, not just on Medicare. However, "this was AOA's longest letter in response to any issue," says FRC Chairman Roger L. Jordan, O.D. AOA staff drafted the letter with input from the FRC Committee.
The detailed letter reflects the broad range of issues AOA addressed, including physician issues, Accountable Care Organizations (ACOs), and the Open Payments (Sunshine Act) program.
Big wins for ODs in 2015
According to the AOA, FRC's persuasive and well-constructed letter led to important changes in the final rule, which was issued last November:
- The diabetic eye exam is now included as a reportable measure in CMS's Medicare Shared Savings Program (MSSP). ACOs that participate in the program must ensure that diabetic Medicare patients receive eye exams. This opens a huge window for optometrists to approach ACOs to help them meet MSSP's 33 quality measures. The change "recognizes the importance of optometry in the health care system and our recognition as a primary health care provider," Dr. Jordan says.
- The diabetic eye exam measure also appears in the Group Practice Reporting Option (GPRO) under the Physician Quality Reporting System (PQRS).
- ODs also were able to retain paper claims as a means to report PQRS codes. The other option was registry only—which the AOA is going to have in place in 2015 for eventual reporting.
AOA serves as guide to changes
The AOA will continue to provide invaluable education and resources to members to help them transition through these changes, Dr. Jordan says.
In the area of ACO participation, the AOA's Third Party Center Executive Committee and staff "can be a huge help in the how tos," Dr. Jordan says.
More work lies ahead in 2015: A nearly 21 percent cut to Medicare payments goes into effect on April 1 if Congress does not address the sustainable growth rate (SGR) issue.
AOA has been very involved in the writing and refining of legislation to replace the SGR—and will continue to advocate for Congress to step in and replace the scheduled cut.