How the AOA and affiliates are fighting for reimbursement and coverage fairness

The AOA and affiliates’ multi-pronged approach to achieving coverage and reimbursement fairness has gained momentum in 2024.
The year kicked off with a virtual, profession-wide town hall, convened by the AOA Board of Trustees, with more than 700 participants logging on. The board gathered reports from doctors detailing concerns about devaluation of care, plan-imposed barriers, sneak marketing tactics and harmful contracting, and sales and marketplace strategies employed by the industry. Participants were polled about their concerns to help further focus 2024 advocacy planning. The results showed:
- 93% believe that vision plan policies create a barrier to delivering quality care
- 94% believe that vision plan policies do not support the patient-doctor relationship
The most immediate reported plan-imposed burdens facing practices today
- Valuation of care: 55%
- Tying vision plan participation to medical plan participation: 27%
- Lack of lab choice: 9%
- Being excluded from certain networks: 7%
On Oct. 29, the AOA will host a second town hall to update the profession on health and vision plan advocacy efforts. Optometry's advocates will share critical insights on how they and AOA are working to ensure optometry practices receive fair treatment from vision benefit managers (VBMs), free from interruption in your doctor-patient relationships.
Read more VBM abuse advocacy highlights of 2024.
1)‘Profits over patients cannot continue’ with VBMs; Texas testifies at health insurance hearing
Doctors of optometry in Texas continue serving as a voice on behalf of patients and the profession when it comes to health and vision plans. In May 2024, the Texas Senate Health and Human Services Committee held an interim hearing to examine the Texas health insurance market, and to identify barriers to accessing care that Texans face when navigating a complex health insurance market. The committee also examined the current state of access to primary health care and ways to improve that access.
2)'All the advocacy firepower’ called up at AOA on Capitol Hill
Over 500 AOA doctors and optometry students championed the profession’s priority issues in Washington, D.C., including a growing Congressional focus on vision plan abuses.
3)Lawmakers host AOA, patient and consumer advocates for VBM abuse briefing as Congress expands probes
VBM abuses are increasingly under fire on Capitol Hill as Congress ramps up bipartisan and bicameral probes into costly, controlling and care-limiting practices. At the request of a key U.S. House committee, members of Congress and staffers heard firsthand accounts of VBMs’ anticompetitive, costly and controlling policies from patient and consumer advocates alike as the AOA and anti-abuses lawmakers urge greater federal action.
4) AOA joins other groups seeking Supreme Court reversal of decision favoring ERISA authority
The AOA is siding with the state of Oklahoma and other health care organizations who seek a reversal of a lower court decision allowing federal Employee Retirement Income Security Act (ERISA) rules to supersede state regulation of insurance plans.
Your AOA Town Hall checklist
How you can help stop VBM abuses
If you experience challenges with a health or vision plan, please report this to stopplanabuses@aoa.org.
You can also text DOC (D – O – C) to 855.465.5124 to learn more, including how you can join us in the fight to put a stop to VBM abuses.
🏛️️Learn more about advocating on behalf of the profession.
Breaking news: VA OD physician-level recognition legislation signed into law
Roughly 70% of primary and medical eye care services are provided by VA Optometry, and the new law will help the VA better recruit and retain doctors of optometry to help preserve that level of care.
Citing array of concerns and complaints, Congress ramps up scrutiny of vision benefit manager (VBM) industry
With a direct message to the U.S. Attorney General, the Oversight Committee set an accelerating pace for a growing number of Capitol Hill and agency inquiries focused on plan abuses.
AOA-PAC election report: Optometry has outsized impact on 2024 elections
Tap into the AOA’s interactive 2024 elections map to see how hundreds of pro-optometry U.S. House and Senate candidates fared and learn how advocates can get more involved in the fight in our nation’s capital for patients and the future of the profession.