Very busy time..

I realize it has been quite some time since I posted, I have been very busy . The good news is we passed a new law for Optometry that will make it illegal for Insurance companies to mandate a discount on non covered services, also they cannot mandate taking a vision plan to participate in medical eye care. The bill signing is May 16.

I spent four days in Las Vegas at the Vision Source Exchange meeting. It was wonderful getting out of the office and  into some warm weather. I wish I could say the same about my poker game.

Today I spent the morning doing eye examinations at Washington Jesuit Academy with Drs. Tom Wong, Doug Kiessling, Marty McGinn and Charles Mitchell. They students really enjoyed it.

This evening I am headed to dinner with the AOA Board, they are in Washington DC for a quarterly meeting.  Sunday I will be joining several past MOA presidents for a round of golf and lunch.  This job does have some perks.

In between all this I have enjoyed watching my boys lacrosse games and have been spending alot of time taking my kids to  orthodontist and dentist appointments.  ( I think I may have chosen the wrong profession).

 Enjoy the warm weather. Talk soon

John

Guest Blogger.. A Students View

Hi everyone! My name is Lindsey Parker and I am a third year student from the Pennsylvania College of Optometry.  I'm currently a student extern at Dr. John Burns' office in Clinton, MD.  I've taken over his blog this week to provide some insight into my first month here at Eye Design.  My first few days were all about learning the EHR software and dusting off my clinical skills after a two-month hiatus from patient care.  In addition to seeing patients, my extern experience has also included lobbying for an important optometric bill and becoming a patient myself.  

Stepping out of the office this past week, I had the opportunity to witness the legislative side of optometry by traveling with Dr. Burns to the Maryland House of Delegates in Annapolis to advocate for upcoming legislation, HB1160.  This bill prohibits insurance companies from requiring providers to discount services that they do not cover.  It also prevents insurance companies from requiring participation in an associated vision plan as a condition of participation in its medical plan.  It was a unique experience simply being in the House, watching the delegates, assistants, and staff bustling around (we even had an encounter with the lieutenant governor).  Dr. Burns and I had a brief meeting with Delegate Robert Costa, bringing the bill to his attention and discussing the effects the passage of the bill would have on our profession.  This experience has emphasized the importance of participation in state and national optometric organizations because, like it or not, optometry is a legislated profession.

One of the most exciting parts of my rotation so far has been my transition from extern to "guinea pig".  Dr. Burns introduced me to GVSS (orthokeratology), a vision-correcting procedure he has been offering patients for many years. I had learned a little about orthoK in school, but didn't know much about the fitting of the lenses or the management of GVSS patients.  While this technology was previously limited to mild myopic prescriptions, recent advancements in lens technology have allowed for correction of moderate myopia, astigmatism, hyperopia, and even presbyopia.  After wearing glasses since I was four years old, I was ready and willing to test one of the new lens designs on my moderate astigmatism. The first night was a little rough (needless to say, I was happy to shut my eyes and go to sleep after putting the lenses in).  But when I took the lenses out in the office that first morning, I could see 20/20. I had never before been able to accomplish that without glasses or soft contact lenses.  As I continue with the lenses, I'm starting to be able to go all day with clear vision. It's an exciting advancement that I'm grateful I've been able to try and something I hope more patients become aware of as an alternative to glasses and contact lenses.

I'm looking forward to many more unique experiences in the next few months of my rotation here in Clinton.  

EHR Victory, PCO Visit, A Bill Dropped

I know it has been awhile since I posted partly because I have been too busy too post. First I would like to let everyone know that we have been working feverishly since Legislative Session opened in early January.

A few months ago we asked the State to allow OD's to participate in the Medicaid EHR incentive program, the problem being we were not classified as "physicians" in the Medicaid program. We were met with a negative response we did not back down and used some political connections to garner a face to face meeting with the powers that be. I am happy to report the state has reversed their original decision and we can now participate in the program.

We have put a bill in Annapolis to prevent insurance companies from mandating a discount on non covered services. This bill mirrors one passed by dentistry three years ago.

I also had the pleasure of visiting PCO last thursday night with our new Young OD (Dean, Gayle, and Sunni) committee to talk to students about Maryland Optometry. It was a wonderful meeting and the student came prepared with all types of questions. We answered questions on everything from how to get a license, best place to find a job , scope issues and even board certification. It was wonderful mixture of students from first years to fourth.

I did encounter one embarrassing moment when asked why more students from Maryland attended the Federal Advocacy  Conference in Washington DC  last year than OD's?   All I could say was that I will try to not let that happen again.  This is the second time we have been out shined by students since I took office. We corrected the first one by increasing PAC donations so I challenge you again by attending  the conference in Washington  DC this April.

In my office I welcomed a new intern this week and personally have been coaching my youngest in basketball and watching lacrosse tryouts.

We have an executive board meeting Tuesday night so off to prepare.
Congrats to the Ravens.

Talk soon

John

My January Report

President's Message

It is hard to believe it is 2013 already. I hope everyone enjoyed the holiday season. It seems like yesterday we were all together at the 2012 Annual Convention. I would like to thank both Jen Levy and Jen Thornton for going above and beyond, helping to make the event such a success. I would also like to thank everyone who donated to the MOA and AOA PAC at the Convention, especially Drs. Tom and Irwin Azman, whose donations earned them each the prestigious AOA PAC "Visionary" status.

With so many opportunities on the horizon for 2013, there is no time to slow down. We'll kick off the new year with our first board meeting on Jan. 8, 2013. Typically this is the longest board meeting and our agenda is already packed with issues and questions that need to be addressed to secure our place in the ever changing landscape of Maryland healthcare reform. It's hard to imagine that seemingly simple things like finding a new Young O.D. Chair and increasing O.D. involvement in new committees and Federal and State Key Programs can really make a difference, but the past year has proved this emphatically true. The first year of my presidency was a humbling, learning experience. What I have taken away is this; the strength of the bridges we build and the quality of the roads we pave traveling toward success depend upon teamwork, collaboration and relationships developed along the way. 2013 has the promise of good things to come for optometry in Maryland, but not without your help.

This week, Dr. Bob Dobrusin and I attended a fundraiser for Delegate Sue Krebs. With the help of other Key ODs, optometry continues to be well-represented at important fundraisers, political events and meetings throughout the State. As a result, we have been able to engage key policymakers about vital issues to the profession and raise awareness about the importance of eye health as an integral part of healthcare reform. The dialogues we have initiated with legislators and policymakers over the past year have proved an invaluable asset to our profession politically. 2013 will be a pivotal year for State lawmakers as they gear up their re-election efforts after the Legislative Session to prepare for November elections. It is crucial that our Association, and our profession, take advantage of this time and make sure that candidates know who we are and where we stand. I want to thank all the ODs who served our profession in 2012 by attending fundraisers and meetings and those committed to doing so in 2013. Every relationship we develop and strengthen brings us closer to our goals and closer to "success."

This year, the MOA has added a new event to our annual CE program. Our first ever Winter CE program will be held on Jan. 27, 2013, just weeks away. The January event, which will undoubtedly be another successful MOA CE program, could not have been organized so quickly without the assistance of our new MOA Education Chair, Dr. Fran Burgos. Thank you Dr. Burgos. There are no NFL games on January 27, so come on out and enjoy the day.

I would be remiss if I did not mention the one statistic mentioned at the Convention that continues to haunt me. Referencing the decrease in MOA members over the past few years, AOA Board of Trustee member, Dr. Andrea Thau, matter-of-factly stated that the current composition of MOA membership represents less than 50% of practicing ODs in the State. The implications of this disturbing truth for the MOA, both financially and politically, are troubling at best.  At worst, this statistic has the potential to stymie our current political efforts and halt the progress we have seen over the past year. If the MOA cannot confidently state that as an association we represent the majority of our profession in Annapolis, political advocacy becomes very difficult. Given the importance of this year politically and our goals for 2014, we must work diligently NOW to begin reversing our declining membership trend.  There is strength and credence in numbers, which we cannot afford to lose. Our future successes require the 50% threshold not only been met, but exceeded, by the 2013 Annual Convention. Please help us get there by recruiting a colleague to join, or re-join, the MOA. Our "Be One Get One" campaign makes it easy. 

Like our first Board meeting, this first newsletter of the year is packed with detailed updates about past and present MOA and AOA efforts and news. It also includes a ton of useful information to assist you in the practice of optometry in Maryland. Please take the time to read through what follows and a happy and healthy New Year to all.      

IRS glasses and contacts

For those who ask  "What's in it for me"

IRS Confirms Eyeglasses and Contact Lenses Exempt from New Medical Device Tax

Affirming yet another AOA health reform victory, the federal government this month released final regulations confirming that eyeglasses and contact lenses will be exempt from the new 2.3 percent excise tax on most medical devices.

Set to take effect Jan. 1, 2013, the new tax will be imposed on most types of medical devices and was originally included in the 2010 health care overhaul as a means to help raise nearly $30 billion for the law’s expansion of health insurance coverage.

As supported by the AOA, section 4191(b)(2) of the Internal Revenue Code, as enacted in the Affordable Care Act, specifically provides that eyeglasses and contact lenses are not taxable medical devices under this provision.

As officials searched for mechanisms to help raise revenue for the bill and eventually settled on the medical device tax proposal, the AOA successfully convinced lawmakers to include a specific exemption for eyeglasses and contact lenses.

In promulgating the final rule, the Internal Revenue Service (IRS) explained that devices generally purchased by the general public at retail for individual use, such as eyeglasses and contact lenses, would be exempt from the tax. 

The IRS included a partial list of factors to consider, in their totality, whether other devices qualify for the exemption.  The IRS also outlined a safe harbor for categories of devices that automatically fall within the retail exemption, including prosthetics that do not require implantation or insertion, and certain over-the-counter items.

Importantly, the new excise tax is to be paid by manufacturers, importers, and producers of taxable medical devices, not the purchaser of such devices. Despite this arrangement, the AOA remains concerned that the price of ophthalmic and other equipment used in optometry practice settings may rise as a result.

Currently, there are bipartisan efforts underway to repeal or delay the new excise tax, particularly by lawmakers from states with a strong device manufacturer presence. Republicans and some Democrats in the U.S. House and Senate have launched multiple attempts to either repeal or delay the new tax.

While heartened that the federal government has affirmed one of optometry’s health reform victories, the AOA will continue to monitor efforts in Congress to address this issue and will continue to actively seek input from AOA members on the impact that the new tax might have on optometry practices. 

AOA members with questions or concerns should contact the AOA Washington office at 800-365-2219 or emailImpactWashingtonDC@aoa.org.

2012 Convention

As many of you know I like to use this blog to give the personal rather than the professional view of my Presidency. So here goes.

After being notified by the  Hyatt of the  double booking of our convention space just 10 days prior we had to change the itinerary quite a bit but we pulled it off. The Hyatt did a great job in the end and even comped me a room. Upon check in they upgraded me to a suite and took care of my parking... oh the benefits of being President.

My next surprise came during our Board meeting with AOA Trustee Dr. Andrea Thau, she brought us Black and White cookies from New York City.  Delicious.  After CE concluded Saturday we had a first ever member only legislative reception which was well attended and got rave reviews. (could have been the free food and drink).

Off to dinner,  I must say I learned a lot about Kosher food this weekend. Dr. Thau's  dedication to Optometry is only outdone by her dedication to her faith. We walked to Matsuri Japanese Restaurant in Federal Hill, I was just a bit apprehensive about this place (no forks) however I managed to survive with a quick lesson on chopstick use from Tracie King.  Broadening my horizons I ate Seaweed Salad, Edamame Beans and even a piece of seared Tuna for the first time.

Upon leaving the restaurant I noticed a bunch of Santa's walking around. Turns out it was Drunk Santa night in Federal Hill .. who knew.

 As most of the dinner party headed back to the Hyatt I joined Steve Flemke to find  Murphy's Law in Fell's Point. As you may recall I picked this place after watching the show Bar Rescue and seeing it transformed into a brand new place. Well much to my dismay it went out of business.  Fear not with Steve around , we enjoyed a Guinness and ended up at PBR in Power Plant Live watching many ladies (very few men tried) get thrown from a mechanical bull.

Midnight rang and back to the Hyatt as I had a 7 am wake up call. Sunday was filled with our CE and Annual Meeting.  I only had 2 hiccups during my Presidents Report  and it was a pleasure presenting our annual awards.

A quick exit  (avoiding Ravens traffic) to be home by 5 to coach my son's basketball practice , after which I enjoyed dinner with my family . Exhausted I fell asleep by 8:30pm.  



Talk soon 

John

Meaningful Use.. Glasses after Cataracts with Medicare

It has been awhile since I blogged , I was getting my office set for meaningful use. It was a bumpy, expensive and educational ride but we started our 90 days on October 2 in the cloud with Officemate and Examwriter. I also happy to report my office remodel is now complete. 

MOA news... Dr Fran Burgos has taken over as our Education Chair and we welcomed him to our last board meeting, also The Maryland Public Health association has approved our application for new Eye and Vision Care section in their association. 

Below is some interesting news from the AOA.  I find it interesting now that we have to pay over $500 for the privilege  of supplying glasses to our post cataract patient who have medicare. 

Talk soon 

John.

Reminder: Optometrists subject to $500+ fee for Medicare DMEPOS enrollment

Optometrists who wish to provide eyeglasses for cataract patients under Medicare are subject to a new durable medical equipment prosthetics, orthotics and supplies (DMEPOS) registration fee every three years, according to the AOA Advocacy Group.  As reported in AOA publications previously, the fee was put in place in March 2011 over the objections of AOA and other physician organizations when the Centers for Medicare & Medicaid Services (CMS) decided to treat all DMEPOS suppliers as institutional fraud risks.

Under a government initiative to screen out unscrupulous providers, all physicians who are now enrolled as health care practitioners or suppliers under Medicare will be required to re-enroll by March, 2015.   Optometrists should watch for letters to revalidate their Medicare enrollment, which verifies their enrollment records in the government health plan’s Provider Enrollment, Chain and Ownership System (PECOS).

Optometrists and other health care physicians who wish to provide only professional services are not subject to any Medicare registration fees, the AOA Advocacy Group notes. However, those who wish to provide health care products, including eyeglasses, are subject to a new $500+ fee ($523 this year, indexed to increase annually with inflation) as well as stringent new screening requirements including site visits by inspectors.

The Medicare DMEPOS registration fee is distinct from the health plan’s DMEPOS provider surely bond requirement, from which optometrists have been exempted unless they provide eyeglasses to the public without any sort of examination of the patient, and separate from the DMEPOS accreditation requirement, until the CMS decides to implement supplier standards for physicians.

The AOA Advocacy Group has been lobbying to win exemption for optometrists from the DMEPOS registration fee as well. However, at this time, the registration fee remains applicable to eyewear providers and other physicians who furnish DMEPOS to their patients, AOA Advocacy Group staff note.

Many optometrists have been receiving notifications to reenroll in Medicare over recent weeks, the AOA Advocacy Group reports.

For additional information, see “HHS anti-fraud program to mean new scrutiny, fees for physicians" on the AOA Newsblog or the Medicare Learning Network (MLN) article “Further Details on the Revalidation of Provider Enrollment Information."