What optometry’s advocates are championing at AOA on Capitol Hill

From health and vision plans to veterans’ care, contact lenses and Medicare pay reform, the list of federal priorities for AOA on Capitol Hill affects every doctor of optometry and student. But do you know the issues? 

As the foundation of the AOA’s federal advocacy efforts and the single-largest annual advocacy gathering, AOA on Capitol Hill, April 14-16, in Washington, D.C., connects our profession’s leaders to the nation’s policy leaders to advocate and support optometric eye health and vision care. This connection is what keeps the AOA recognized as one of the most effective and respected advocacy organizations in Washington. 

Robert Theaker, O.D., AOA Federal Relations Committee member, says building connections with members of Congress is critical not only for educating our nation’s leaders on the care that optometrists provide but also for when they consider impactful legislation—and that’s why AOA on Capitol Hill is so important. 

“At this meeting in April, hundreds of optometrists and optometry students will gather and meet with their legislators to educate them about our priority issues,” Dr. Theaker says.  

“The more optometrists and students we have there connecting with their representatives, the more impact we will have garnering support for our key policy issues and the more likely we get optometry-friendly issues to advance and bills to pass,” Dr. Theaker adds. 

Want to be more informed about the federal issues your AOA and affiliates are advocating for in Washington, D.C.? Review these four priority issues for AOA on Capitol Hill. 

Issue 1: Addressing anti-doctor, anti-patient vision plan abuses 

Abusive vision plan policies hurt patients and the doctors they rely on, fueling the AOA and affiliates’ years-long initiative to rebalance this equation. Even as a pair of open congressional inquiries probe vision benefit managers (VBMs) over their abusive marketplace power and tactics, heaping added scrutiny on plans, the AOA is growing support for federal legislation to combat these abuses. 

The Dental and Optometric Care (DOC) Access Act, H.R. 1385/S. 1424, would complement state-level vision and dental plan laws enacted in most states by disallowing detrimental policies by ERISA and other federally regulated plans. Specifically, the DOC Access would prohibit plans from: 

• Limiting patients’ and doctors’ choice of labs.
  
• Price fixing for noncovered services and materials. 

Jointly backed by the AOA and American Dental Association, the DOC Access Act wields the support of more than two dozen patient and consumer advocacy groups, including Patients Rising, the National Consumers League and dozens of others. 

📺 WATCH: Patients Rising video on stopping VBM abuses. 

Congress’ growing attention on Americans’ health care costs and transparency of their benefits makes this a critical opportunity for Optometry’s advocates on Capitol Hill as the AOA and affiliates continue their multi-pronged approach to achieving reimbursement and coverage fairness. Encourage your U.S. House members and senators to co-sponsor the DOC Access Act. 

Experiencing difficulties with a health or vision plan? Report these challenges to the AOA Third Party Center at stopplanabuses@aoa.org and view the AOA Health and Vision Plan Action Report. 

Issue 2: Stopping Medicare pay cuts and fixing the broken pay system 

Despite an eleventh-hour push by the AOA and other physician organizations, Congress failed to avert a 3.37% pay cut called for under the 2024 Medicare physician fee schedule (PFS). Consequently, such cut went into effect on Jan. 1, 2024, adding to a 2% sequester cut already in effect. 

On multiple occasions, Congress’ timely intervention following AOA advocacy has prevented Medicare pay cuts on a temporary basis yet even overall Medicare reimbursement levels have not kept up with inflation, with an estimated 26% decline in Medicare payments to optometrists and others, from 2001 to 2023, as compared to medical inflation.

The failure of Medicare reimbursement to keep pace with the true cost of providing care, combined with year-over-year cuts resulting from the application of budget neutrality and sequestration, clearly demonstrates that the Medicare payment system is broken. 

Optometry’s advocates will encourage their members of Congress to support and advance H.R. 2474, the Strengthening Medicare for Patients and Providers Act, to apply an inflationary update to help bring payment stability. AOA doctor and student voices are essential to pushing Congress to act this year to reverse the cuts, enact a lasting pay fix, and ensure continued patient access to essential optometrist-provided eye care.  

Issue 3: Stopping organized medicine’s turf-obsessed VA policy agenda 

While the U.S. Department of Veterans Affairs (VA) continues to assess access-to-care issues for America’s veterans, including further leveraging VA optometry’s widespread skills base and accessibility at 95% of VA sites with eye care services, elements of organized medicine have redoubled their turf protection in a naked campaign to boost medicine’s efforts opposing optometry’s scope expansion at the state level.  

AOA and veteran advocates have been notching policy wins at the VA, with the 2020 partial removal of the ban on optometric laser procedures within VA, as well as the 2021 reversal of a harmful access-to-care barrier preventing community care doctors from providing legally authorized scope procedures to veteran patients. However, medicine has been increasingly fighting back and the future of these wins are far from secure, potentially leaving veterans in the lurch and threatening our scope expansion efforts.  

Now, the AOA and the Armed Forces and Federal Optometric Services (AFOS) continue to fight for optometry’s full recognition in the VA’s national standards of practice, for VA optometrists to be recognized as physicians within the VA’s pay scale, and to protect the ability of optometrists in the community to continue to provide laser and other medical eye care, because optometry stands to be a significant benefit to veterans' care. 

• 70% of essential primary and medical eye care services are provided by VA doctors of optometry. 
   
• 73% of the 2.5 million selected ophthalmic procedures and nearly 99% of services in low-vision clinics and blind rehabilitation centers are provided by VA doctors of optometry. 
  
  
• 95% of VA sites where eye care is offered have a VA doctor of optometry practicing—and often they are the only independent licensed eye care practitioner at the facility. 

Issue 4: Making prescription verification simpler, safer for contact lens patients 

Commonsense changes are necessary for closing loopholes in the current contact lens prescription verification process, which is why the AOA, in partnership with the Health Care Alliance for Patient Safety, is building support for federal legislation. 

Introduced by Reps. Michael Burgess, M.D., R-Texas, and Lisa Blunt Rochester, D-Del., H.R. 2748, the Contact Lens Prescription Verification Modernization Act, would make the prescription verification process simpler and safer for the 45 million Americans who wear contact lenses by: 

• Requiring retailers to use direct communication to confirm prescription accuracy.
  
• Requiring retailers to offer a HIPAA-compliant method for allowing patients to upload a copy of their prescription directly. 

The AOA Health Policy Institute has previously reported that as many as 89% of optometrists providing contact lens services have received verification calls for invalid prescriptions and more than half have received calls for an altogether wrong patient. 

The AOA and Health Care Alliance for Patient Safety continue to speak out against patient safety problems precipitated by direct-to-consumer internet mass retailers, already resulting in major federal action against one such company.