AOA advocacy helps shape ‘Cures Act’

Bipartisan legislation intended to accelerate the pace of disease cures in the United States heads to the U.S. House floor including a number of AOA priorities, reflecting months of advocacy work.

"The AOA is going to continue to make certain that lawmakers always have an informed debate about telehealth proposals."

Unanimously passed by the House Energy & Commerce Committee on May 21, H.R. 6, the "21 ^st Century Cures Act," seeks to streamline the federal drug and device approval process, and provide additional funding and responsibilities to the National Institutes of Health (NIH) in order to hasten "discovery, development and delivery of 21 ^st-century cures."

Championed by Reps. Fred Upton (R-Mich.) and Diana DeGette (D-Colo.) , the bill represented a number of potential opportunities and threats for optometry that the AOA recognized and actively addressed from the start.

Standing firm on telehealth

Early on in the committee's deliberations, the AOA came out strongly against proposals to expand unproven telehealth products and programs, including into Medicare. This included some proposals that sought new authority and reimbursement to replace face-to-face care regardless of a patient's medical needs.

While backing new technologies to help doctors advance patient care, the AOA stood firm on the urgent need for full safeguards to ensure patient health and safety will not be compromised by claims that in-person care is unnecessary. 

With support from key members of Congress who heeded the concerns of their ODs, the current version of H.R. 6 does not include telehealth expansion language made part of earlier drafts at the behest of opposing special interests. After reversing the misguided language, the AOA won a key concession for patients and the profession. H.R. 6 now states that in a future review of potential areas of telehealth expansion, the Centers for Medicare & Medicaid Services (CMS) should only consider a telehealth service as a substitute when it meets or exceeds the scope of service aimed to be replaced.

"The committee's work represents an important win for us and our patients," says Steven A. Loomis, O.D., AOA president-elect. "Going forward, we'll need to continue to make certain that lawmakers always have an informed debate about telehealth proposals, and that there's full understanding about false product claims, the added risks patients could face for delayed care and completely missed diagnosis, and the alarming potential for disruption of the doctor-patient relationship."

"We applaud members of Congress for listening to our concerns loud and clear, for taking needed steps to ensure the telehealth technologies will be held to the same standards of care as in-person visits, and for agreeing with us that there really is no substitute for an in-person, comprehensive dilated exam provided by an eye doctor."

Advancing priorities

As a result of AOA's work, H.R. 6 also includes expanded hardship exemptions for ODs and other physicians in a provision that would help make EHR systems more interoperable; a provision that would exempt from Open Payments reporting certain support for continuing education for optometrists and other physicians; and language to bring greater transparency to the local coverage determination process under Medicare.

Further House action on H.R. 6 is expected in the coming weeks, while the Senate also works on a similar bill, albeit on a slower timeline and with slightly different policy priorities.

Take action

The AOA continues to fight for what's best for patients and the profession, and members can get involved. Join the AOA Federal Keyperson program and serve as a conduit for the profession, or donate to AOA-PAC, one of the most effective ways to participate in the political process.

AOA members seeking additional information or looking for ways to get involved should contact AOA advocacy at advocacy@aoa.org.