AOA News Volume 43 Number 13 January 17 2005

32.9 MB·English

by  American Optometric Association

Volume 43
No. 13
January 17, 2005
Panel stalemate ends OD laser use in VA facilities
The U.S. performed by ophthal- Procedures in Veterans is a reluctant one,” said istrative tie-up and
Department of mologists with the req- Health Administration Secretary of Veterans maneuvering by med-
Veterans’ Affairs uisite training and Facilities,” issued Dec. Affairs Anthony J. ical groups.
(VA) has rescinded a expertise,” reads VHA 17. Principi. “Since experts “We are deeply dis-
five-month-old policy appointed in the VA’s
“This troubling action is unprecedented and
that permitted properly decision to restrict
trained and licensed optometrists’ laser privi-
not based on any evidence of quality of care
optometrists to perform leges in the VAsystem,”
therapeutic laser eye concerns. In fact, the VA reviewed the cases of Dr. Pittman said. “This
procedures at its health troubling action is
care facilities under the laser therapy performed by VA optometrists and unprecedented and not
supervision of ophthal- based on any evidence
found the outcomes met VA standards of care.”
mologists. of quality of care con-
The action came cerns. In fact, the VA
after a multidisciplinary Directive 2004-070, “The decision I could not come up with reviewed the cases of
panel was unable to “Performance of made to rescind an implementation plan laser therapy performed
agree on exactly how Therapeutic Laser Eye optometrists’ privileges agreeable to both spe- by VAoptometrists and
that supervision should cialties, I chose this path found the outcomes met
be handled. to protect the interest of VAstandards of care.
“It is VHApolicy veterans.” We regret the VA’s
that therapeutic laser The American action to limit the clini-
eye procedures only be Academy of cal privileges of those
Ophthalmology Web appropriately trained
site hailed the new and licensed VA
Inside directive as a “victory optometrists who were
for patient safety at the providing laser therapy
AOA News
VA.” for patient conven-
However, AOA ience.”
launching online
President Wesley In August, the VA
Pittman, O.D., said there issued a policy that, had
With news that affects optometrists occurring is no evidence of safety it been implemented,
faster than ever, and most ODs using the Internet problems related to would have permitted
frequently, AOA has launched a Web-based version laser procedures previ- optometrists who hold
of AOA News to keep AOA members well ously performed by licenses authorizing
Eye on Washington,
informed. optometrists in VAfacil- laser eye surgery to per-
Page 7
All visitors to www.AOANews.org will be able ities. form those procedures
to read headlines and abstracts of the latest news Dr. Pittman attrib- when supervised by an
affecting the profession. To get full stories, access uted the abrupt VApoli-
archived articles and access links to AOA member cy change to an admin- see VA, page 4
benefits, ODs will need to log on with their member
number and password, just as on AOA’s main site.
Essilor gets Seal,
(Members can find their member number on each
Page 11
printed issue of the News, on the address label).
The AOA News Online will be completely new
each month, reflecting what is in the print version,
but also featuring Web-only stories and updates as
often as news happens, so check in often.
We’ll be reporting immediately from optometric
meetings, be able to conduct polls and surveys,
Industry News
and continually update breaking stories.
Page 14
The print version will continue of course, in the
familiar format you enjoy now. Because we have a
new avenue for communication, we will now pub-
lish 18 printed issues in 2005, (instead of 24) plus
12 monthly editions of AOA News Online as well
as continuing updates.
As always, we want to hear from you! Send
comments, story ideas, and queries to
Calendar,
[email protected].
Page 16
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launch Optometry’s Meeting
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St. Louis MO63141
800 365-2219
www.aoa.org
Coming on the ongoing and incredibly 1984, to serve as nation-
AOA Board heels of the hotly important lobbying al voter contact director
contested 2004 efforts,” Dr. Hudson for the Reagan/Bush
Wesley E. Pittman, O.D.
PRESIDENT presidential election, the said. “The Opening Campaign. She held
Richard L. Wallingford, Jr., O.D. AOA— thanks to the General Session is the senior positions in the
PRESIDENT-ELECT generous support of highlight of George H. W. Bush 1988
C. Thomas Crooks, III, O.D. Essilor —will welcome Optometry’s Meeting™ campaign and, upon
VICEPRESIDENT
both sides of the politi- , so I encourage all to President Bush’s elec-
Kevin L. Alexander, O.D., Ph.D.
SECRETARY-TREASURER cal spectrum, and both attend. ” tion, was appointed
sides of a marriage, at Before joining the chief of staff for the
Victor J. Connors, O.D.
IMMEDIATEPASTPRESIDENT the 2005 Optometry’s Bush/Cheney White RNC.
TRUSTEES Meeting™ , June 22-26. House, Matalin hosted In 1992, President
Mary Matalin, for- CNN’s critically Bush named her the
Randolph E. Brooks, O.D.
J. Wayne Buck, O.D. mer assistant to acclaimed debate show, deputy campaign man-
Dori M. Carlson, O.D. President George W. Crossfire. Mary Matalin ager for political opera-
Joe E. Ellis, O.D.
Peter H. Kehoe, O.D. Bush and counselor to is the former founding tions. As deputy cam- Mary Matalin
Carol D. Record, O.D. Vice President Dick co-host of the paign manager, she was
Cheney, and James Washington-based polit- responsible for the
AOA News Staff
Carville, one of ical weeknight talk overview and organiza-
www.aoanews.org
America’s best-known show, Equal Time, which tion of all 50 state oper-
Bob Foster premiered in May ations.
EDITOR-IN-CHIEF
[email protected] 1993 on CNBC. As the on-board
Bob Pieper Matalin has planner who traveled
SENIOREDITOR
[email protected] made frequent tele- with President Bush
Sean Hixson vision appearances throughout the 1992
ASSOCIATEEDITOR
[email protected] as a political com- campaign, she emerged
Kim Stuckmeyer mentator, and has as the vocal, and occa-
ARTDIRECTION
written for various sionally controversial,
Stephen M. Wasserman periodicals includ- defender of the presi-
DIRECTOR, COMMUNICATIONSGROUP ing Newsweekand dent and his policies.
[email protected]
The Los Angeles Carville’s political
Andrew Miller
ASSOCIATEDIRECTOR-PUBLICATIONS Times. Matalin also consulting winning
AOAPUBLICATIONS
[email protected] co-authored the streak began in 1986, James Carville
best-selling politi- when he managed the
Advertising
cal campaign book gubernatorial victory of
Fox Associates
All’s Fair: Love, War Robert Casey in
Email:
political consultants, and Running for President Pennsylvania. In 1987,
[email protected]
will keynote the with her husband, Carville helped Wallace
Opening General James Carville, who was Wilkinson win a hard
ATLANTA, GA 30342
Session on Thursday, the chief campaign fought gubernatorial
1070 ONEPREMIERPLAZA
5605 GLENRIDGEDRIVE. June 23rd. strategist for campaign in Kentucky.
404-497-7690 “We’re extremely Clinton/Gore in 1992. The following year
CHICAGO, IL 60610 excited to have such Her newest book, Letters brought Carville to New
116 WESTKINZIESTREET. high quality speakers to My Daughters, was Jersey, where he guided
312-644-3888
addressing Optometry’s released in April and Frank Lautenberg’s
ROYALOAK, MI 48067
Meeting™ ,” said AOA has already been named campaign for United
WASHINGTONSQUAREPLAZA
306 S. WASHINGTON, STE. 222. Congress Executive a Book of the Month States Senate to victory,
248-543-0068 Committee Chair Allan Club selection as well as defeating Rhodes
LOSANGELES, CA 90079 Hudson, O.D. a New York Timesand Scholar and Heisman
110 EAST9THSTREET, SUITEA1173 “People are very Washington Post Trophy winner Pete
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familiar with Mr. Bestseller. Dawkins. Carville next
NEWYORK, NY 10016
347 FIFTHAVENUE, STE1110. Carville and his intelli- After a hiatus from managed the successful
212-725-2106 gence and humor. Ms. Washington to attend 1990 gubernatorial cam-
Matalin is equally, if not Hofstra Law School, paign of Georgia’s Lt.
Change of address:Notify pub- more, sharp. Their Matalin returned to the Governor Zell Miller,
lisher at least six weeks in advance,
including both mailing label from the insight into politics is Republican National
most recent issue and the new invaluable to AOA’s Committee (RNC) in see Power Couple, page 4
address with proper ZIP code. Accep-
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Printed in the USA.
JANUARY 17, 2005 • 3
VA, from page 1
ophthalmologist. lobbied for legislation to appeared to end the VAophthalmologists,
In VAfacilities, restrict laser use by controversy, according proved equally fruitless.
health professionals optometrists in VAmed- to the AOAAdvocacy Details regarding the
“This issue is
may request clinical ical centers. Group. panel discussions are
not, and never privileges for services The Veterans Eye The directive specif- unobtainable.
they are licensed to pro- Treatment Safety (VETS) ically stipulated that Acting VAUnder
has been, about vide under state law. Act, (H. R. 3473) was optometrists could per- Secretary Perlin, who
Oklahoma licenses introduced in form therapeutic laser had formally issued the
quality of care
properly trained November, 2003 by Rep. eye procedures under VAdirective authorizing
optometrists to perform John Sullivan (R-OK), to the supervision of an laser procedures by
concerns.
laser procedures. amend Title 38 of the ophthalmologist as long optometrists, subse-
Instead, it is As a result, at least United States Code to as those optometrists quently issued a second
one VAMedical Center stipulate that only have been properly directive rescinding it.
about ophthal- had been employing an licensed medical doctors trained to perform such “This issue is not,
Oklahoma-licensed and licensed doctors of procedures and appro- and never has been,
mology and
optometrist to provide osteopathy could per- priately licensed by a about quality of care
YAG capsulotomies form eye surgery at VA state regulatory agency. concerns. Instead, it is
organized
since 2003. facilities or under con- However, the six- about ophthalmology
medicine’s The therapeutic tract with the depart- member VApanel, and organized medi-
laser privileges granted ment. appointed to determine cine’s desire to control
desire to to that optometrist The bill would have the terms of that super- optometry and prevent
sparked a complaint also restricted vision, was unable to expansion in our profes-
control
from the American optometrists from per- agree on even basic con- sional responsibilities.
Academy of forming many minor cepts during its only It is regrettable the
optometry and
Ophthalmology to VA surgical procedures face-to-face meeting in Department (of
prevent administrators in such as punctal dilation, September. Subsequent Veterans’ Affairs) caved
Washington, DC. epilation of lashes, and teleconferences, involv- in to those self-serving
expansion in However, the VAinves- insertion of punctal ing the panel’s three VA motives,” Dr. Pittman
tigated and found that plugs (see AOANews, optometrists and three said.
our professional
department policy Dec. 1, 2003). However,
assuring patient safety the legislation died in Power Couple, from page 3
responsibilities.”
was being followed and the House without a
that the clinical privi- hearing. including a tough pri- focus on foreign consult-
leges were being grant- Aformal directive, mary win over Atlanta ing.
ed appropriately. issued by Jonathan mayor Andrew Young. James Carville is
Unsatisfied with the Perlin, M.D., the VA’s In 1991, Carville— also an author, actor,
VAadministrator’s Acting Under Secretary who had already become talk-show host, speaker
response, the AAO and for Health, on July 30 of prominent in political and restaurateur. In
other medical groups last year initially circles — drew national addition to All’s Fair:
attention when he man- Love, War, and Running
WWoorrkk HHaarrdd,, PPllaayy HHaarrdd aged Senator Harris for President, Carville’s
Wofford from 40 points books include: We’re
behind in the polls to an Right, They’re Wrong: A
You work hard providing the best possible eye care to upset landslide over for- Handbook for Spirited
patients who depend on you. You need the latest mer Pennsylvania Progressives; And the
up-to-date information. Get it from the most Governor and U.S. Horse He Rode In On: The
knowledgeable, experienced optometrists as they share
Attorney General People vs. Kenneth Starr;
their extensive clinical expertise with you. And after 4 hours a day of the finest
Richard Thornburgh. Stickin’; Buck Up, Suck
education available, play just as hard, as you enjoy the best beaches, the finest
With the startling Up… and Come Back
fare, the most luxurious resorts and the release you deserve for working so hard.
and unpredicted When You Foul Up; Had
Wofford win, Carville Enough? AHandbook for
had exposed the political Fighting Back; and his lat-
Keynote speakers vulnerability of George est and first children’s
Bush, who had been book, Lu and the Swamp
Chris Snyder, OD, MS, FAAO
GGrraanndd CCaayymmaann 22000055 enjoying 91 percent Ghost, an adventurous
Anthony Cavallerano, OD, FAAO
February 16-22, 2005 Rob Prouty, OD, FAAO approval ratings during tale of his mother’s
KKeeyy WWeesstt 22000055 Eric Schmidt, OD the Gulf War. childhood, set in the
March 16-22, 2005 David Bright, OD, FAAO Carville finished the Louisiana bayous.
CCoossttaa RRiiccaa 22000055 John McGreal, OD job the following year, Talk show host
April 20-26, 2005 Art Epstein, OD, FAAO
when he guided Bill Carville can be seen reg-
Paul Ajamian, OD, FAAO
Clinton to the presiden- ularly co-hosting CNN’S
cy in 1992. Crossfire with hosts Paul
In 1993, Carville was Begala, Tucker Carlson,
honored as Campaign and Bob Novak.
Register on the web or just call Kathie today.
Manager of the Year by Matalin and Carville
[phone] • [email protected] the Ameri-can reside in Virginia with
www.tropicalseae.com Association of Political their daughters, Matalin
Consultants. “Matty” Carville and
20 hours of continuing education APPROVED After the Clinton Emerson “Emma”
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4 • AOA NEWS
FDA approves new drug treatment for
age-related macular degeneration
The Food and Drug Two-year clinical processes responsible for drug makers, “Macugen
Administration data from the studies the vision loss associated was well-tolerated and
(FDA) announced demonstrated a contin- with neovascular AMD. the patients who entered
Dec. 20 the approval of ued treatment benefit Macugen is adminis- the second year on the
pegaptanib sodium injec- with Macugen. tered in a 0.3 mg dose same therapy received
tion (Macugen), a new over 90 percent of possi-
“Macugen provides a needed
therapy to slow vision ble treatments over the
loss in people with the addition to the treatment of two years of the study.
eye disease neovascular This indicates strong
(wet) age-related macu- patients with this disease.” compliance and accept-
lar degeneration (AMD). ance to therapy. Most of
Pegaptanib is a selective Serious adverse once every six weeks by the adverse events report-
vascular endothelial events related to the intravitreal injection. ed over the two years
growth factor (VEGF) injection procedure Eyetech and Pfizer plan were mild in severity,
antagonist. included infections, reti- to make the treatment transient and attributed
“Macugen is among nal detachment, and available in the first by investigators to the
the first treatments to tar- traumatic cataract. Other quarter of 2005. injection procedure rather
get the underlying biolo- frequently reported According to the than the study drug.”
gy of wet age-related adverse events in
macular degeneration,” patients treated with
said Lester M. Crawford, Macugen were eye irrita- Firm’s latest products aid
D.V.M., Ph.D., acting tion, eye pain, hemor-
commissioner of the rhage under the conjunc- AMD detection, treatment
Food and Drug tiva, and blurred vision.
Administra-tion. The New Drug Carl Zeiss Meditec is touting a three-pronged pro-
“Macugen provides a Application for Macugen gram for combatting Age-related Macular
needed addition to the was received and Degeneration, which includes early detection, effec-
treatment of patients approved in six months tive monitoring, and innovative treatment.
with this disease.” according to the FDA. To monitor AMD-related structural changes, Carl
The FDAapproval Macugen therapy is Zeiss Meditec offers digital imaging devices such as
was based on findings being co-developed by the FF 450 Plus to perform fluorescein angiography to
from two pivotal Phase Eyetech Pharmaceuticals, detect if newly formed or abnormal blood vessels
2/3 randomized, multi- Inc. and Pfizer Inc. found in advanced AMD patients would benefit from
center, double-masked Eyetech and Pfizer will treatment. The company’s Stratus OCT technology
clinical trials involving co-market the product in provides cross-sectional imaging of the back of the
approximately 1,200 the United States. eye, allowing practitioners to view and precisely
patients with all sub- According to the quantify the degree of fluid accumulation or retinal
types of neovascular drug makers, “Macugen thickening associated with advanced AMD.
AMD. meets a major urgent For treatment of patients already diagnosed with
The primary efficacy unmet medical need and advanced AMD, Carl Zeiss Meditec’s VISULAS 690s
endpoint was the pro- is the first therapy indi- Laser activates a photosensitizing drug for
portion of patients pro- cated for the treatment of Photodynamic Therapy (PDT), which may stop or slow
tected from three-line all types of neovascular vision loss from advanced AMD.
loss of visual acuity on AMD, regardless of As a visual field analyzer, the PreView PHP bases
the eye chart by week 54. lesion subtype or size.” its diagnostic capability on “hyperacuity,” the inherent
Results showed that Until now, the only human ability to visually detect the misalignment of
among patients receiving FDA-approved treatment objects relative to other objects in space. According
0.3 mg of Macugen, 70 was limited to the pre- to Carl Zeiss Meditec, the PreView PHP bypasses sev-
percent lost less than dominantly classic sub- eral of the limitations of the Amsler Grid by:
three lines of vision on type of neovascular (cid:2) Randomly projecting an image on the touch-
the eye chart, compared AMD, which accounts screen, eliminating the possibility of patient memoriza-
with 55 percent of for up to 25 percent of tion.
patients receiving control the neovascular AMD (cid:2) Eliminating “lateral inhibition” by flashing one
treatment. patient population. line at a time, allowing the patient to detect distortions
The results demon- Macugen is a pegy- with greater accuracy.
strated a 27 percent rela- lated anti-VEGF aptamer, (cid:2) Eliminating the possibility for visual compensation
tive treatment effect for a single strand of nucleic by flashing images for just 160 milliseconds.
Macugen treated patients acid that binds with (cid:2) Providing a normative database and objective
compared to controls specificity to a particular means for evaluating whether a change in the visual
with respect to three-line target. Macugen specifi- field is actually sight-threatening.
loss. Macugen also cally binds to VEGF 165, (cid:2) Providing monitoring in a clinical environment,
helped limit progression a protein that plays a ensuring correct and scheduled use, which is difficult
to legal blindness, by 50 critical role in angiogene- with take-home tests.
percent compared to sis and increased perme- For information, visit www.meditec.zeiss.com.
controls, in the study ability, two of the pri-
eye. mary pathological
JANUARY 17, 2005 • 5
108th Congress leaves profession
altered, sets stage for new laws
Last year, with the more than $21 million despite the best efforts recommendations that
adjournment of over 2004. of Rep. Boozman, that were issued in May by
the 108th While this falls refinement proved to be the Senate Republican
Congress, optometry short of the vision com- elusive and an agree- Task Force on Health
saw action and inaction munity’s request of $711 ment could not be Care Costs and the
on many issues, meas- million, it represents reached to satisfy the Uninsured,” said Dr.
ures, and legislation progress in reaching an chairman’s concerns Williamson.
related to the profes- equitable funding level and clear the way for The AOAand other
sion. for NEI, the FRC said. final passage. critics contend that the
Two optometry- For details about the Senator Gregg gave bill would undercut
related bills concerning NEIfunding, see the up chairmanship of the state insurance regula-
vision benefits for feder- story on the next page. HELPCommittee to tion and open the door
al employees and Decorative take the gavel in the to fraud. Nearly every
retirees, and the Senate Budget organization represent-
contact lens
Individuals with Committee. Senator ing state officials has
regulation
Disabilities Education Mike Enzi (R-WY) takes come out against AHPs,
Act, were highlighted in Last November, the over as chairman of the including the National
the Dec. 27 AOANews. House of HELPCommittee. Governors Association
Now for AOANews, Representatives “He has close ties to (NGA), the National
the AOAFederal approved H.R. 2218 by Wyoming’s optometric Association of Insurance
unanimous consent. community and we Commissioners (NAIC)
This legislation, have a very strong and the National
introduced by keyperson relationship Conference of State
Representative John with him,” Dr. Legislatures (NCSL).
Boozman (R-AR), would Williamson said. “We “President Bush
clarify that decorative believe that Sen. Enzi was an enthusiastic
contact lenses should be will be receptive to the AHPsupporter on the
regulated as medical Boozman legislation.” campaign trail this fall
devices under the and additional AHP
Federal Food, Drug and Association supporters will be join-
Cosmetic Act. ing the Senate next
health plans
This measure was month, so we will have
Relations Committee introduced in response On two different our work cut out for us
(FRC) summarized what to a Food and Drug occasions, the House on this issue,” Dr.
happened to the major Administration (FDA) approved legislation to Williamson said.
measures related to notice outlining plans to allow small employers The AOAand other
optometry, as well as regulate these lenses as to form regional and AHPopponents are
what happened to cosmetics because their national association reviewing alternatives
potential legislation regulation as a medical health plans (AHPs) that would enable small
you’ve been reading device was not support- that would be exempt businesses to enjoy the
about throughout the ed by statute. from state benefit and benefits of larger risk
last two years. See page Rep. Boozman is an regulatory require- pools without gutting
one for full story on the optometrist and an ments. state regulatory protec-
latest details of the AOAmember. He is H.R. 660 was tions.
VETS bill. serving his third term approved in June 2003
representing the Third by a vote of 262 to 162 Children’s
National Eye Congressional District and H.R. 4281 was
eye exams
in Arkansas. approved in May by a
Institute
“We had hoped that vote of 252 to 162. A Congressman Bill
During the recently the Senate would give companion bill, S. 545, Pascrell (D-NJ) intro-
completed lame duck swift approval to this was introduced in the duced legislation last
session, the president important legislation,” Senate, but no action year to address the issue
signed the massive said Dr. Williamson. was taken. of eye examinations for
omnibus spending bill “Senator Judd The AOAFRC told school-age children.
into law. Included in the Gregg (R-NH), chair- AOANewsthat the The bill, H.R. 2173,
law is funding for most man of the Senate Senate has traditionally was largely initiated by
health programs, Health, Education Labor looked on AHPs with the Vision Council of
including the National and Pension Committee less favor than the America (VCA), which
Eye Institute (NEI). NEI at the time, worked to House of consulted with the AOA
will receive $674.58 mil- refine of the bill’s lan- Representatives. as the bill was being
lion in funding for fiscal guage,” he said. “In fact, AHPs were
year 2005, an increase of Unfortunately, not even included in the seeLegislation, next page
6 • AOA NEWS
EEyyee oonn WWaasshhiinnggttoonn
NEI wins 2.5% funding increase
Despite an overall this year. AOANews, April 26).
spending freeze, Funding was allo- Eye researchers
a “zero percent cated under terms of the have been among the $28.6 billion—a $800
growth” policy and federal government’s most effective in produc- million increase over
across-the-board cuts in annual Omnibus ing breakthrough treat- 2004.
non-defense-related dis- Spending bill, signed ments for serious health Before the 0.83 per-
cretionary spending, the Dec. 8 by President conditions, according to cent cut, the appropriat-
federal government is George W. Bush. James F. Jorkasky, the ed amount for 2005 the
allocating a record Increased NEI fund- alliance’s executive NEI stood at $674.6 mil-
$669.5 in funding for the ing is among the AOA director and a former lion—which would have
National Eye Institute Advocacy Group’s top research scientist. For represented a $21.5 mil-
(NEI) in the 2005 budg- federal legislative priori- example, recent studies lion, or 3.3 percent,
et—up $16.5 million ties for this year. have led to improved increase over the $653
from 2004. AOAis among the treatment for glaucoma. million the institute
The allocation rep- members of the National The increase also received for the 2004 fis-
resents a 2.5 percent Alliance for Eye and comes as optometrists cal year—again more
increase for the entity Vision Research are playing a growing than the 2.9 percent
which sponsors much of (NAEVR), a coalition role in eye research. sought by the adminis-
the nation’s eye formed to coordinate Optometrists played an tration and the House
research, as well as one Washington lobbying on important role in a but less than the 4.4 per-
of the few times the NEI behalf of eye research recent glaucoma study cent increase initially
has won a greater per- funding. and other major approved by the Senate.
centage budget increase NEI’s above-average research, notes AOA Applying the 0.83
than its parent agency, funding comes in the Washington staff person percent cut to the NEI
the National Institutes wake of a federally John Whitener, O.D. appropriated amount,
of Health (NIH). sponsored study show- Approved Nov. 20 the NEI appropriation
NIH, the nation’s ing the number of by both the House (on a was reduced to $669.5
largest sponsor of health Americans with major 344-51 vote) and the million, reflecting a net
research, is allocated a eye diseases is increas- Senate (on a 65-30 vote) 2.5 percent increase over
total of $28.4 billion for ing, and vision loss is the federal govern- fiscal year 2004.
2005, up $560 million, or becoming a major public ment’s fiscal year 2005 Those funding lev-
about 2 percent, from health problem (see omnibus spending bill els could still be subject
actually encompasses a to some reduction as the
series of nine appropria- result of “program
Legislation, from page 6 tions bills consolidated transfers,” Jorkasky
under the Foreign notes.
Operations appropria- The House-Senate
prepared. licensed health care tions bill (H.R. 4818). Conference Committee
The bill would have provider or certified The final spending which developed the
made grants available to vision screener as need- package totals $821.9 bil- final spending package
states for providing ing such services.” lion and reflects a is allowing the director
comprehensive eye No legislative action spending freeze or “zero of NIH to direct up to
examinations to school- occurred on either bill. percent growth” policy 1 percent of appropria-
age children and to for all non-defense dis- tions to designated
develop and dissemi- Medicare cretionary spending, activities such as the
nate educational materi- implemented to meet ongoing development of
Modernization
als on the benefits of spending targets agreed an NIH “research
Act
such examinations. to by Congress and the roadmap.”
The bill would After passing the administration. Despite the increase,
require an optometrist milestone Medicare Total discretionary NEI’s fiscal year 2005
or ophthalmologist to Prescription Drug, spending in the bill is funding still falls short
provide these compre- Improvement, and $388.4 billion; any addi- of the $711 million
hensive eye examina- Modernization Act of tional spending is paid sought by AOAand
tions. 2003 (MMA), Congress for by an across-the- NAEVR as part of a
Rep. Vito Fossella took a breather from board 0.83 percent cut in long-term plan to dou-
(R-NY) introduced a Medicare issues last all non-defense, non- ble NEI’s funding from
competing version of year. However, AOA homeland security its 1998 level.
this legislation. His bill, expects to see a “techni- spending and cancella- Both the AOA
H.R. 3602, would have cal corrections” bill. tion of other funding. Advocacy Group and
provided support for The AOAFRC will be Prior to the 0.83 per- NAEVR promise further
eye examinations for closely monitoring cent cut, the appropriat- NEI funding increases
children who “have developments on the ed amount for the NIH will be back on the leg-
been identified by a technical bill. for fiscal year 2005 was islative agenda for 2005.
JANUARY 17, 2005 • 7
CMS announces changes to
Medicare managed care program
The U.S. maintain viable PPOs, age plans or, where pos- an expanded geographic
Department of expand the managed sible, PPOs that provide area. That alone could
Health and care program to rural both health care and bring 1.6 million
Human Services (HHS) areas, and thereby drug coverage. Medicare beneficiaries
is hoping prescription attract potentially mil- The old into the managed care
drug benefits and pre- lions of new beneficiar- Medicare+Choice pro- program, they say.
ferred provider organi- ies as Medicare admin- gram provided coverage But whether plans
zations will bring new istrators hope. through HMOs. choose to stay with the
life to Medicare’s man- The AOAFederal Although the program may ultimately
aged care program. Government Relations Medicare Advantage depend on reimburse-
However, some Committee and AOA name is already in use, ment rates which,
insurance company Eye Care Benefits the new coverage sys- although now based on
executives—whom the Center (AOA-ECBC) are tem is to begin in 2006. Medicare fee-for-service
U.S. Centers for studying the Medicare Key to the new pro- rates and subsidized out
Medicare and Medicaid Advantage program as gram is a system of of a special fund, are
Services (CMS) are ulti- well as possible strate- regional administration, expected to come down
mately relying on to gies optometrists might announced Dec. 8 and next year as the result of
provide managed care use in approaching designed to make sure competitive bidding,
services under Medicare potential bidders in coverage is available even with a planned
Advantage on a contract each region. virtually everywhere retention bonus.
basis—wonder if the Revamped and across the U.S. Meanwhile, many
program will be able to renamed under the The health care side insurance industry exec-
retain participating Medicare Moderniza- of the program is to be utives wonder if health
plans or attract patients tion Act of 2003, the administered through 26 care practitioners, par-
any better than it did Medicare managed care designated managed ticularly in rural areas
when it was known as program is to begin care regions, most with a limited number
Medicare+Choice. offering a combination encompassing one or of care providers, will
Moreover, they of comprehensive health two states. Pharmaceu- be anxious to join PPOs
wonder if Advantage care and prescription tical coverage similarly and accept lower reim-
will be able to attract coverage through either will be administered bursements to see the
the health care combinations of PPOs through 34 service same Medicare patients
providers necessary to and prescription cover- regions. they might see anyway
In order to become under the Medicare fee-
Medicare’s PPO for-service program.
provider for any given “We often struggle
region, a health plan to recruit Medicare ben-
will have to demon- eficiaries that have been
strate that it can provide in Medicare plans for
access to care in every many, many years or
part of that region. were disillusioned when
Under Medicare+ many plans left the mar-
Choice, HMOs have ketplace,” said Keith
often offered care on a Dines, president and
county-by-county basis. chief operating officer of
As a result, coverage the Arizona-based
has been unavailable in regional insurance com-
many areas, particularly pany, Sun Health. “We
rural localities, and it also struggle with
has often been difficult billing provider net-
for beneficiaries to tell works in rural areas.
what plan was provid- There are many, many
ing their coverage. plans and many
In addition, a num- instances where you
ber of important HMOs, have had difficulties
Regional Medicare PPOs, Prescription Drug Plans
reportedly unhappy contracting with
The Medicare Modernization Act requires a number of changes to with reimbursement lev- providers.”
the Medicare program, including the addition of Medicare prescrip- els or CMS administra- CMS plans to pub-
tion drug plans (PDPs), as well as the addition of regional Medicare tion of the plan, lish regulations for the
Advantage (MA) plans under the new Medicare Advantage program. dropped out of new Medicare
To implement both new programs, the Centers for Medicare and Medicare+Choice, mak- Advantage plans this
Medicaid Services has defined the regions for MA regional plans and ing coverage even spot- month in the Federal
PDPs. An MA region is one color. A difference in shading indicates tier. Register.
that there are multiple PDP regions nested within the MA region No CMS say 35 new The agency plans to
change indicates that the MA and PDP regions are the same. For plans have already have the new managed
example, Wisconsin and Illinois are in one MA region; they are each applied to participate in care programs organ-
a separate PDP region. Each territory is its own PDP region. Advantage in 2005 and ized and ready to offer
22 have applied to serve the public by June 6.
8 • AOA NEWS
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Apply online. application at AOAInsurance.com. may vary or be unavailable in some states. requested by March 31,
601-03 ADR 851-2003
2005 and should include
PPlleeaassee sseenndd mmee iinnffoorrmmaattiioonn oonn tthhee ffoolllloowwiinngg 13331
a narrative statement of
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with a copy of paper/
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Log on at www.AOAInsurance.com & apply for:
Nominations should
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Name: Verma, Chair, VCS
Awards Committee
Address:
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Daytime Phone#: ( ) Date of Birth: / /
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To receive the facts* about these plans,just fill out this form and send it in a stamped envelope to: 1345, fax: (215) 780-
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OR call 1-800-245-4454,and use promo code 3279 and a Benefit Representative will assist you. ©2003 AGIA
601-03
Promo Code 3279 *Including costs,exclusions,limitations and terms ofcoverage. ADR 851-2003
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