Chief Resident Update: AAO Advocacy Day

aao-logoChief Resident Jeremy Lavine, MD, PhD, recently traveled to Washington, DC, where he represented the University of Wisconsin School of Medicine and Public Health’s Department of Ophthalmology and Visual Sciences at the American Academy of Ophthalmology’s (AAO) Midyear Forum and Congressional Advocacy Day. Dr. Lavine’s participation was part of the AAO’s Advocacy Ambassador Program, which provides individuals training in ophthalmology the opportunity to interact with the community of ophthalmologists from across the country and understand the legislative issues affecting their profession.

Dr. Lavine accompanied the delegation from the Wisconsin Academy of Ophthalmology (WAO). This statewide organization values the importance of advocating for the profession and hopes this experience will instill the desire to advocate in young ophthalmologists in the future.

The event’s itinerary included personal appointments with members of Congress, congressional hearings and lectures by national leaders in ophthalmology. Ambassadors also attended a LEAP forward program to teach Leadership, Engagement, Advocacy, and Practice.

According to Dr. Lavine, there are major issues facing ophthalmologists today. “We advocated with members of Congress on seven key points,” Dr. Lavine noted. “While I was already aware of a few of these current challenges, I learned a great deal about the legislative decision-making process and what the significance of those decisions will be in defining patient care and quality treatment.”

The key issues identified and explained by Dr. Lavine were:

  • Centers for Medicaid & Medicare Services is not following the Relative Value Scale Update Committee’s recommendations for adjustment to reimbursement for procedures. They cut reimbursement for trabeculectomy and pars plana vitrectomy by 25% based only on time changes. This goes against prior precedent which includes time, intensity of care, and liability.
  • Medicare Part B drug reimbursement demonstration is going into effect that cuts reimbursement from 6% over average sales price to 2.5% over average sales price. This will impact availability of ranibizumab and other anti-VEGF injectables nationwide.
  • The Food and Drug Administration has introduced a new policy to have compounded drugs used within 5 days of compounding. This would significantly limit usage of bevacizumab outside of major medical centers.
  • Truth in advertising legislation has been proposed so that patients seeking health care will clearly be able to understand the credentials of the health care providers that offer services.
  • Contact lens dispensing changes are being proposed. Currently, 1800Contacts can fax a contact lens prescription to a provider and if provider does not respond within 8 hours, they can then dispense the prescription. This bill would allow providers (OD and MD) to request a specific location and mode of contact (email, fax, phone call) to verify the prescription.
  • Increases in research funding for the National Eye Institute/National Institutes of Health and Department of Defense funding are essential.
  • We advocated for changing the meaningful use criteria for electronic health records so that factors outside the control of physicians are not used against physicians for reimbursement. For example, physicians are penalized if the patient chooses not to sign up for MyChart. In ophthalmology, we are definitely adversely affected by this issue since a majority of our patients are 70 years of age or older and typically not tech savvy.

“I am grateful for the opportunity that AAO, WAO and my residency program provided in supporting my participation at this important event,” Dr. Lavine remarked. “It was a valuable experience that will be beneficial not only to my future as a caring physician, but as a dedicated advocate for my profession.”