Speak out on reimbursement and coverage fairness advocacy
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
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.
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 firstname.lastname@example.org.
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.
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.