Third Party
Talk of the townhall: Doctors view plan abuses as threat to doctor-patient relationship and quality care
Forum on reimbursement and coverage fairness advocacy produces fresh reports of plan-imposed barriers and support for mobilization for tough new laws, stronger enforcement and close government scrutiny of the vision plan industry.
Speak out on reimbursement and coverage fairness advocacy
Final hours to register for tonight’s virtual townhall Zoom session at 9 p.m. ET to speak out against vision plan abuses, assess 2023 legislative and regulatory gains, and help build support for policy change.
AOA, state affiliate tracking California lawsuit alleging VSP monopolistic practices
Mirroring some of the AOA’s longstanding agitation over vision plans’ abuses, the Sept. 26 lawsuit by Total Vision LLC (and Total Vision, P.C.) alleges unfair competition, monopolization, tying and intentional interference with prospective business relations. Total Vision LLC supports 59 independent practices in California.
When getting paid will cost you
Recent reports suggest over half of medical practices are compelled to pay fees for electronic payments—how the AOA’s Third Party Center advocates for fair payment practices and advises on these plan policies.
Overpower Payer Issues
The AOA's Third Party Center, working continuously to monitor plan policies and actions, is the profession's payer advocacy nerve center.
Optometry’s wins over abusive vision plans stacking up
The AOA and affiliates in Illinois and Georgia score wins against vision plan abuses in a year in which doctors of optometry are making inroads across the country. When all else failed, including talks with the plans and appeals to one state’s insurance commissioner, affiliates did the hard work of helping push through bills in their legislatures that address the abuses.
What defines the value of care we provide?
Health and vision plans have not adapted and grown with the care we deliver but hold back optometry’s momentum.
AOA survey finds discrimination by health and vision plans
The AOA has long championed nondiscrimination against doctors of optometry. The survey of doctors of optometry and AOA affiliates gathered responses from 47 of the 50 states plus the District of Columbia.
Aetna reverses AOA-opposed cataract surgery pre-approval policy
The prior-authorization requirement ended July 1, 2022, for all patients—except Medicare Advantage in Georgia and Florida—a year after the AOA and other groups decried Aetna’s decision.
AOA escalates concerns to DOJ over Medicare Advantage claim denials
Medicare Advantage Organizations’ denials of prior authorization requests raise flags in HHS report and prompt AOA’s third-party advocacy outreach on behalf of optometry practices.
AOA, affiliates prompt changes to MAC claims processing
Direct third-party advocacy remains a critical component of the AOA and affiliates’ mission, helping support practice success by ensuring patients can freely access the broadening scope of eye health and vision care delivered by optometry. But advocacy requires a team effort, and optometry’s advocates have an opportunity this spring to help bring about the payer changes the profession needs.