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AOA and State Affiliates Pressure Medicare Contractor to Withdraw Restrictive Policy

Facing intense pressure from AOA, state affiliates and pro-optometry leaders in Congress, a Medicare Administrative Contractor (MAC) reversed course on Monday and announced that it would withdraw a restrictive, anti-optometry coverage directive which wrongly sought to limit the scope of practice of optometrists in nine states.

Wisconsin Physician Services (WPS) — the MAC servicing Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska and Wisconsin — had issued an “optometry services” coverage determination whereby the contractor created a list of services it determined optometrists are allowed to provide based on its own flawed interpretation of state law. With backing from a Medicare regional office, WPS then utilized the directive to deny payment for services provided to Medicare beneficiaries which optometrists are legally authorized to perform.

Working closely with affected state affiliate volunteer leaders and staff, AOA appealed to pro-optometry lawmakers to help make clear to federal agency officials that states — not Medicare contactors —determine optometrists’ scope of practice. AOA and affiliates secured supportive letters from U.S. Senators Roberts (R-KS) and Moran (R-KS), and Reps. Braley (D-IA), Loebsack (D-IA), Boswell (D-IA), Latham (R-IA), King (R-IA), Huelskamp (R-KS), Jenkins (R-KS), Yoder (R-KS), Pompeo (R-KS), and Burgess, MD (R-TX).

After building support on Capitol Hill, AOA and affiliates then met with top Center for Medicare and Medicaid Services (CMS) officials at the agency’s headquarters in Washington, D.C. With pressure generated through lawmaker outreach and the productive meeting with CMS leaders, the Medicare contractor had to abandon its “optometry services” coverage determination, the precise action which AOA Federal Relations Committee chair, Roger Jordan, O.D., and state affiliate leaders had been seeking.

AOA and affiliates will remain vigilant to ensure that any future policy developed by the contractor respects optometry and the right of Medicare beneficiaries to receive eye care through their optometrist. To view the full report from AOA, please follow :http://newsfromaoa.org/2012/10/03/aoa-state-affiliates-pressure-medicare-contractor-to-withdraw-restrictive-policy/