AOA petitions NAVCP member plans temporary relief during emergency

AOA presses vision plans to ease burdens on doctors and patients during COVID-19 emergency

"Doctors of optometry need additional relief to maintain their practices, regardless of whether they are closed or seeing patients for essential care."

Federal guidance advising only essential procedures during the COVID-19 pandemic prompted an AOA petition of the National Association of Vision Care Plans (NAVCP) for practical, temporary relief throughout this national emergency.

In a March 23 letter addressed to the NAVCP, the AOA cited profession-wide disruption from doctors of optometry limiting their practice to emergent care only or closing altogether as a result of the Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) guidance for only essential procedures during this pandemic, in an appeal for additional flexibility among traditional vision plan requirements.

Typically, this being the time of year that many vision plans begin notifying doctors of optometry about contract renewals, the AOA requested visions plans first consider delaying these communications and extending credentialing requirements. As current circumstances dictate restricted practices or office closures, there is a high likelihood that many doctors will miss these communications or deadlines.  

Therefore, the AOA requested the NAVCP and member plans to immediately consider the following actions:  

  1. Extend deadlines for recredentialling and/or revalidating doctors' credentials for vision plan networks for three months.
  2. Refrain from requesting doctors verify their credentials or directory information for three months.
  3. Provide a dedicated, single, toll-free phone number, email address and/or online form for doctors to voluntarily self-report temporary practice updates (e.g., hours of operation, emergency contact information) that can be added immediately (with data of update) to online network provider directories.

Additionally, the AOA requested temporary revisions in plan administration, such as the temporary changes that the CMS announced to provide greater access to care. These CMS actions included waiving application fees, postponing all revalidation actions and expediting pending or new applications from providers, as well as now requiring Medicare Advantage plans to cover services for enrollees at out-of-network facilities and to charge enrollees affected by the emergency no more than they would pay for in-network services. So, too, CMS is expanding telehealth services to provide greater access to Medicare beneficiaries.  

"We believe vision plans should provide the same flexibility," reads the letter from AOA President Barbara L. Horn, O.D. "Due to many offices being closed, both patients and doctors need some relief from traditional restrictions."

Given the small business concerns for optometry practices, the AOA also requested the NAVCP and member plans take additional actions throughout the national state of emergency to enhance flexibility and reconsider policies that are no longer practical in the current pandemic situation.

"Doctors of optometry need additional relief to maintain their practices, regardless of whether they are closed or seeing patients for essential care," Dr. Horn's letter notes. "We encourage NAVCP and its member vision plans to consider the recent actions taken by CMS to clear administrative roadblocks and take similar action to ensure ongoing patient access to care."

In response to the AOA's requests, the NAVCP acknowledged the significant challenges facing the eye health and vision care community and agreed to share the AOA's concerns with individual plans. Additionally, the NAVCP notes several plans have already enacted some of these requests. However, given different business models and benefit designs, some plans may not address suggestions in the same way or may not be able to implement such flexibilities at all, NAVCP notes.

The AOA will continue working with specific plans to address concerns in this time of national emergency, and as part of that payer advocacy effort, the AOA is able to relay the latest guidance on plans' new or revised telehealth policies.

While many Americans face stay-at-home orders or voluntarily choose to remain at home, the AOA is providing doctors of optometry with individual plans' latest guidance or statements regarding the furnishing of telehealth services during the COVID-19 pandemic. Doctors can find that information on the AOA's comprehensive COVID-19 resource page.

Stay in the know: AOA's COVID-19 resource page

The AOA continues to closely monitor all developments in the U.S. public health response to COVID-19, as well as institute an all-out mobilization on behalf of the profession that includes not only 24/7 advocacy for optometry in Washington, D.C., but also launching an unprecedented, multifaceted relief and recovery package.

Given the serious, evolving nature of this pandemic, the AOA remains committed to providing doctors of optometry and their practices the most up-to-date information, relevant care guidance and timely reports on federal actions possible. The AOA's COVID-19 updates page includes:

Doctors of optometry are encouraged to be cognizant of the COVID-19 situation in their communities and stay attuned to the latest guidance.

March 31, 2020

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