- Anthem Health fined for violations in Maine
- AOA, affiliates take on VBM lobby’s attacks on optometry
- Surveys say patient and doctor concerns about health industry middlemen on the rise
- Town hall draws hundreds as AOA and affiliate advocacy earns back millions
- AOA to update profession on health, vision plan advocacy efforts
- VSP warned on campus misinformation, efforts to divide the profession
- Talk of the townhall: Doctors view plan abuses as threat to doctor-patient relationship and quality care
- AOA, state affiliate tracking California lawsuit alleging VSP monopolistic practices
- When getting paid will cost you
- Optometry’s wins over abusive vision plans stacking up
- What defines the value of care we provide?
- AOA survey finds discrimination by health and vision plans
- Aetna Prior Authorization
- Medicare Advantage claim denials
- AOA, affiliates prompt changes to MAC claims processing
- Payer issues hot topic at AOA on Capitol Hill
- AOA and state associations target plan abuses
- Be a better negotiator on payer issues
- Anthem stops unilateral downcoding of eye codes
- Congress probes vision plan policies
- vision plan reimbursment
- aoa challenges VSP plan
- AOA fights back against discriminatory vision plans
- SGRC-TPC-Conference
- AOA affiliates assemble advocates to address evolving payer issues
- NAVCP Patients doctors come out ahead in states vision plan fights
- VSP spells doom gloom
- AOA never stronger takes issue with VSP practices
- Health plans changing tone vision plans not so much
- SGR TPC 2017 Conference
- Conference delivers vital advocacy tools knowledge
- Vision plan advocacy What doctors need to know
- State third party conference offers advocacy essentials
- AOA backed DOC Access Act targets health and vision plan abuses
- AOA secures important wins in historic SGR reform legislation
- AOA continues fight for permanent SGR fix advises members to hold claims
- House advances SGR fix AOA secures key role for ODs in sweeping Medicare changes
- AOA and Congress work toward permanent SGR fix
Speak out on reimbursement and coverage fairness advocacy
January 4, 2024
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.
Tag(s): Advocacy, Third Party
Update Jan. 5: The AOA Profession-wide Townhall on Reimbursement and Coverage Fairness has concluded.
Abusive, anti-competitive vision plan policies are harming optometry and its patients, yet the AOA and affiliates’ efforts to rebalance the equation are producing results.
In a virtual townhall on Thursday, Jan. 4, the AOA will provide the entire profession—members and non-members alike—the opportunity to speak out about plan-imposed barriers to patient care and receive updates about advocacy aimed at delivering relief to optometry practices. Such efforts by the AOA and affiliates achieved significant legislative and regulatory gains in 2023, while building support for greater policy change in the new year.
Hosted by AOA President Ronald L. Benner, O.D., and the AOA Board of Trustees, the townhall will address the national conversation surrounding optometry’s reimbursement and coverage fairness. While professional associations are strictly prohibited from coordinating the contracting decisions of their members, the event’s interactive format will help inform the AOA’s approach to constitutionally protected legislative and regulatory advocacy.
WHAT: AOA Profession-wide Townhall on Reimbursement and Coverage Fairness
WHEN: 9 p.m. ET, Thursday, Jan. 4
WHERE: Zoom
Register here to participate. Doctors are encouraged to share this information among colleagues; the session is open to all optometrists.
“The fight for reimbursement and coverage fairness for optometry is and will continue to be our highest advocacy priority,” Dr. Benner says. “With the AOA and our affiliates leading the charge for expanded enforcement and tough new laws to stop plan abuses, it’s essential for us to continue gathering reports from impacted doctors, share advocacy updates and, together, build support for policy change.”
Now is a pivotal moment in the advocacy fight for an equitable system that fairly values optometry’s essential and expanding health care role.
Making inroads
The AOA and affiliates have been long focused on advocating for an equitable system that fairly values optometric care, working at the local, state and federal levels to identify solutions. During the past year, there has been strong progress—accomplishments that the AOA will build on with an ever-greater advocacy push in 2024. Learn about AOA’s seven active advocacy initiatives to secure relief for optometry practices, including:
- Defeating a scheme by the vision plan industry’s lobbying group, the National Association of Vision Care Plans, to gain influence over state legislation and legislator organizations.
- Taking direct action to resolve doctor complaints against plan-imposed barriers to patient care. Just recently, the AOA identified an error in Elevance’s claim system that was disallowing doctors of optometry from billing for dry eye testing. Once flagged by the AOA, the plan reprocessed claims and paid doctors for their care.
- Launching its Health and Vision Plan Acton Report, a day-by-day advocacy tally focused on the work of resolving doctor complaints about plan abuses and errors.
- Forging advocacy alliances with the American Dental Association, Patients Rising and other groups supporting a crackdown on plan abuses.
- Working together with affiliates to update state laws, including 2023 legislation in Texas, Nevada, Georgia and Illinois, as well as seeking stepped-up legal enforcement.
- Pursuing a secondary high-level claims review process, which revealed that an Aetna downcoding system had incorrectly denied appropriately billed claims.
Looking for background? Check out these recommended advocacy reads
Learn more about the vision plan advocacy that the AOA and affiliates have accomplished throughout the past year, and access the reports that AOA will be referencing during the townhall, including:
- The AOA Health and Vision Plan Action Report, a day-to-day tally of member doctor complaints and the AOA’s actions.
- The AOA Health Policy Institute Reporton stagnation in vision plan fee schedules.
- The Avalon Health Economics Reporton how plan mandates result in higher costs, less convenience and worse health outcomes.
- The AOA’s advocacy reading listfor the top 15 advocacy-related stories in 2023.
Experiencing difficulties with a health or vision plan? Report these challenges to the AOA Third Party Center at stopplanabuses@aoa.org.