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It's Time to Opt Out

Posted By MOA Admin, Tuesday, August 4, 2020

It's Time to Opt Out

Dean Gogerdchi, O.D.
MOA President

Popular vision insurance carrier Vision Service Plan (VSP) recently announced a differentiated reimbursement policy for certain lens products and anti-reflective coatings. VSP’s new ophthalmic product formulary will include two new categories (preferred and non-preferred) for AR coatings, progressive lenses and digital single vision lenses.

To the disappointment of many local and nationwide optometrists, the announcement made it clear that doctor service fees will be reduced by approximately 50% for all non-preferred brands but unaffected for preferred brands. VSP is following in the footsteps of Davis Vision, Spectera, and other vision plans by restricting doctor choice when it comes to ophthalmic materials and labs.

As we look beyond the recent scope expansion legislation victory and set our sights on the 2021 General Session, we have polled our membership regarding future legislative initiatives. “Allow providers to make the best choice for patients when it comes to materials and lab,” is a common refrain I hear from members. The difficulty is that vision plans are not regulated like other health insurers. A lack of competition in the market means plans can dictate how doctors furnish services, thereby limiting patient choice. We must resist these aggressive policies.


THE TIME IS NOW to protect our patients, and fight back against current & future vision carrier abuses:

  • On the federal level - We have to finally pass H.R. 3762, the Dental and Optometric Care Access Act (DOC Access Act). This is a bipartisan bill that prevents federally regulated vision and health plans from placing limits on a doctor's choice of labs and lenses, and prohibits unfair mandated discounts on noncovered services and materials.
  • On the local level - Maryland must become an “Opt Out State.” There are fifteen as of August 2020: Arkansas, Georgia, Florida, Virginia, Missouri, Texas, Alabama, Vermont, West Virginia, Maine, Kansas, Oregon, New Jersey, Ohio, and Pennsylvania. “Opt Out" contracts are unique and can be variable between states and within the plans themselves. “Opt Out” contracts allow for more flexibility on exam and frame reimbursements, allowing increased patient choice as well as the ability to recoup additional revenue.  

If you want to make a direct impact on decisions like these, become a member of the MOA Legislative Committee. Our group meets virtually every other week when the General Assembly is not in session, and on a weekly basis during session. Thanks to our top notch lobbying team at Venable in Annapolis, we are continually updated on legislative matters relevant to optometry. Please send me an email at gogerdchi@gmali.com if you’d like to learn more.

More news to come on this and other third party topics. Be sure to check out the “TPC Tidbits” section of our Tuesday Talk Blog for weekly updates on this evolving story.

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Scope Expansion New Authorities Refresher

Posted By MOA Admin, Tuesday, July 28, 2020

Scope Expansion New Authorities Refresher

Kevin Johnson, O.D.
MOA Immediate President

Most of you are now practicing full scope optometry under Maryland’s new law. In fact, the State Board of Examiners reports that over 90% of all Maryland TPA licensed ODs have met the requirements to practice with new scope expansion authorities. Since the law’s effective date (March 1, 2020), MOA has received several questions about what is and is not permitted. As a quick refresher, below you’ll find a summary list of new authorities based on member inquiries. For a more detailed summary of the law, click HERE or read the new law text.

New authorities allowed include the following:
1. Rx of any topical except anti-metabolites
2. Rx of any oral except anti-metabolites, controlled dangerous substances, anti-fungal, immuno-modulatory and suppressive agents (
carve out for 1 month dose of steroids w/physician consult)
3. Independent treatment of Open Angle Glaucoma. Referral is only required under two conditions:
     ● 
IOP can’t be reduced within 3 months or
     ● 
Condition remains unstable after 1 year
4. Performing/Ordering tests includes cultures and swabs (no genetic testing), imaging (no radiographic testing) and bloodwork (w/physician consult and report back to M.D.)

***LIPIFLOW and IPL permitted!***
5. Foreign Body Removal w/any tool except a scalpel (may not perforate Bowman’s in central axis or mid-stroma in peripheral areas)

A few prohibitions to remember include:
     ● Tx of glaucoma to patients under 18 yrs
     ● Rx of orals to patients under 16 yrs

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Optometry’s Role in Emergency Eye Care

Posted By MOA Admin, Tuesday, July 21, 2020

Optometry’s Role in Emergency Eye Care 
 
Corinne Casey OD, FAAO
PR Committee Co-Chair
 
Approximately 1% of Emergency Department (ED) visits are attributed to eye-related visits, most of which are for conditions that are best treated by an eye care provider in an office setting. Diversion of non-urgent ocular concerns to an office-based eye care provider could yield considerable cost savings, prevent delays in treatment, and reduce unnecessary visits to urgent or emergency care centers. With the COVID-19 pandemic, it is more important now than ever to minimize unnecessary ED visits. 
 
National data from ED coding suggests that one in four eye-related emergency visits are for conjunctivitis, blepharitis, or chalazion. Despite having health insurance, younger patients, racial minorities, and patients with lower income are more likely to visit an ED for non-urgent eye conditions. Conversely, individuals who already have an established relationship with an eye care provider are less likely to visit an urgent or emergency care facility. Considering this disparity, we should proactively educate patients about local availability for urgent and after-hour eye concerns. The MOA has compiled this list of local providers with on-call services to better coordinate urgent referrals. 
 
During the stay-at-home period, many individuals turned to home improvement projects and the use of abrasive cleaning agents, which corresponded to a high rate of corneal abrasions, chemical injuries, and foreign bodies that were reported during this time. A recent survey  by the AOA Health Policy Institute (HPI) questioned if optometry emergency services contributed to a drop in ED visits during the height of the COVID-19 pandemic. Indeed there was a reduced number of ED visits for non-infectious concerns this spring, and surveyed optometrists estimated that 60% of patients treated during this time would have otherwise sought care at an urgent or emergency care facility. Unfortunately, 13% of surveyed optometrists across the country were forced to refer patients to an emergency care facility due to restricted scope in their state. It appears that Maryland achieved scope expansion just in time for our optometrists to contribute essential services during this public health crisis! 

As we cautiously expand our availability and resume routine care, we must also prepare for a possible resurgence and consider the impact of our role in the emergency healthcare workforce. The MOA is a great resource for practice preparedness and to connect with local colleagues in an effort to better serve our community during this challenging time. Stay connected with the AOA  and MOA  for up-to-date resources related to the COVID-19 pandemic.


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COVID Stress Test

Posted By MOA Admin, Wednesday, July 15, 2020

COVID Stress Test 
MOA Admin

During this unprecedented time of uncertainty, everyone is feeling stressed out. After all, each and every day-to-day action we take has the potential to impact not only our own safety and well-being but that of our family and friends. The seven degrees of COVID separation just adds more fuel to the pandemic pressure cooker we are all experiencing. It’s no wonder that “nearly 1 in 4 employees report feeling down, depressed or hopeless often, and 41% feel burnt out, drained or exhausted from their work.” Recognizing and acknowledging the source(s) of our stress, and taking action to alleviate those within our control, is essential to healthy living in today’s new world. With that in mind, we all need to reevaluate our stress level using a COVID Mental Health Checklist, like the one provided below. If you feel unduly stressed, talk to someone, your employer, your family, your friend, your therapist/counselor – anyone. Under OSHA workplace standards, the Anti-Retaliation Rule ensures that employees have the right to express any safety concerns in the workplace. And for employers, there is guidance on what to do if an employee tests positive for COVID. Ironically, now more than ever, we need to support one another in all relationships -- not only with our family and friends but with neighbors and as employers and employees. 

 

After all, we are all seeking the same outcome – mental and physical health and well-being! Employers, please take a moment to learn about some positive HR actions that may help your employees during this difficult time. Remember, a happy workplace is a productive workplace, and we are all in this together! 


If you feel uncomfortable seeking help through conventional avenues, visit the National Alliance on Mental Illness website for a list of resources, or text HOME to 741741 to connect with Crisis Text Line’s counselors.

 

COVID Mental Health Test

Checklist:

(Select 0 if No, 1 if Yes)

1. I am an extrovert.

0 or 1

2. I personally know someone who has COVID-19.

0 or 1

3. I personally know someone who died or is in critical condition from COVID-19.

0 or 1

4. A major life event occurred since the coronavirus outbreak (someone I know died, I moved or was unable to move, became homeless, etc. )

0 or 1

5. I am pregnant.

0 or 1

6. I have an immunocompromised or at-risk family member living with me.

0 or 1

7. I do not have access to outdoor space (live in an apartment).

0 or 1

8. I have children.

0 or 1

9. My life was majorly changed as a result from working from home. 

0 or 1

10. I personally or my partner lost his/her job as a result from the coronavirus.

0 or 1

11. I was a working parent prior to this outbreak.

0 or 1

12. My sleep has been disrupted in the last two weeks.

0 or 1

13. My eating has been changed (eating more or less than usual in the last two weeks).

0 or 1

14. I have been diagnosed with COVID-19.

0 or 1

15.  I am concerned I have it or frequently concerned about my health.

0 or 1

 

Add up the numbers on the right to view your total.

 

Mild Impact 0-5

Functioning and life are largely uninterrupted. The global impact is still ever present but life in many ways still may resemble normalcy. Consider ways you may be able to lend a hand to someone in need. 

Moderate impact 6-10

Life has been disrupted but to a manageable degree. Efforts are made to safeguard but there’s an expectation that after this passes, there may be a return to normal baseline of functioning. You need to make sure your taking care of your basic needs and set up infrastructure in your life to handle the changes that are occurring. 

Severe Impact 11-15

There are current disruptions that are changing nearly every aspect of life. There are concerns about when or if this will ever be resolved. There is a great deal of stress that life as you currently know it may never be the same. Consider increasing self care activities and interests to give yourself added support.

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Red, white, and blue...light?

Posted By MOA Admin, Wednesday, July 8, 2020

Red, white, and blue....light?

Howai "Jenny" Chan, O.D.
MOA GBOS President

 

You may have heard the buzz on blue light over the past few years, but have you heard the latest news on RED light?

Red Light Glasses

The Journals of Gerontology published a new study on June 29th, titled:Optically improved mitochondrial function redeems aged human visual decline. In it, the researchers recommend viewing "deep red light" for 3 minutes to improve eyesight. The story was quickly picked up by national news syndicates, but is it fact or fiction?

 

The researchers reported that the retina, which ages more quickly than other parts of the body, experience a decline in adenosine triphosphate (ATP) and a subsequent decrease in photoreceptor function. They found that mitochondria can experience increased activity when exposed to light between 650nm and 1000nm (for reference, the limit of human vision lies between 380-740nm). When exposed to 3 minutes of red light (at 670nm) every morning, "older patients" (38 years old and up) experienced some improvement in color contract sensitivity (CCS) and scotopic/rod sensitivity.

 

However, there were significant limitations, the study contained only 24 participants, and there was a wide age range (between 28 and 72 years of age). The researchers concede that they are unsure of the precise metabolic pathway of the red light, and are not sure about the downstream effects of this light therapy on the other structures of the eye. Furthermore, the study does not indicate how long its effects last. There is still much to explore in this new wavelength, and as always, we will keep you updated on any news and updates in our field of Optometry!


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Be Color Aware: Not Color Blind

Posted By MOA Admin, Wednesday, July 8, 2020

                                

"Be Color Aware; Not Color Blind"

Eleanor Siri, O.D.
MOA Eastern Shore Society President

Following the undeniable inhumane execution of George Floyd in front of the entire world, we must stop for a moment and address some very important issues in our communities and our nation as a whole.

Firstly, we must treat all humans equally as indicated in last week’s segment on gender equality. This equal treatment must exist irrespective of race, sexual orientation, descend, age, etc.

We must come together and have tough and uncomfortable conversations about race and race relations in our homes, practices and optometry communities as a whole.

We must be willing to listen, learn and acknowledge one another’s plight for change and humanity.

During this article, I’ll focus on African American and not POC in general. Why?

Statistically according to Black Eyecare Perspectives’ website;

- 3.2% of students in optometry school are African Americans

- 1.8% of practicing optometrist are African Americans

- 3.8% of faculty in colleges of optometry are African Americans

Honest questions we must ask ourselves to start the conversation.

Color Awareness towards African American Optometrists;

- How many times have you seen another optometrist at a meeting and looked twice or immediately stipulated they were event staffers and not optometrists?

- How many times have you eliminated an OD candidate looking for work after realizing they were of a certain race?

- How many times have you used, made or contributed to comments that demean or support stereotypes of your fellow colleagues?

Color Awareness towards African American employees

- How many times have you not hired an office associate or consider them as a candidate after seeing their first names?

- In your offices, how many times have you favored an employee over the other based on race?

- How diverse is your employee pool?

Color Awareness towards our African American patients

- Do you question your safety in the exam room if your patient is an African American man vs another race?

- Have you treated the concerns &/or pain of one race differently than the other consciously or unconsciously?

-Do you find yourself suspecting a certain race of people as frame thieves when they enter your office?

How can we make a deliberate, intentional and conscious difference in our industry?

● Mentor more diverse pre and post Optometry individuals

● Hire more diversity

● Encourage and include more diversity on our boards

● Treat all patients equally without stereotypes

● Join other optometrists making a difference like theBlack Eyecare Perspective by created by Dr. Darryl Glover and Dr. Adam Ramsey.

I’m not insinuating that Optometry schools/ practices and industries should hire solely based on

diversity and not skill and character. But we must be more conscious, intentional and aware of our racial biases and stereotypes while doing so.

This awareness should enable us to create diversity, and be part of the solution.

On the same note, I’m encouraging all African American/ Black colleagues to also make themselves available and get involved in different areas of our profession; starting with the MOA and your local optometric society.

Diversity & its acceptance makes our world more suitable for everyone’s existence.

Listen to this amazing piece by a Black American executive Color blind or color brave by Mellody Hobson.


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Pride - How Your Practice Can Be an Ally

Posted By MOA Admin, Wednesday, June 24, 2020

Pride
How Your Practice Can Be an Ally

Rich Miller, O.D.
MOA AACOS President

Pride Flag

As June is Pride Month in the LGBTQ+ community, it is pertinent to understand some of the issues that can directly affect members of the community and how we as optometrists can be of service. Many studies have shown that individuals who identify as being part of the LGBTQ spectrum suffer from a higher percentage of systemic conditions such as STDs, certain cancers, cardiovascular disease, obesity, as well as depression, anxiety, and suicide. There is also some evidence that indicates that transgender individuals who are receiving hormone therapy are at higher risk for idiopathic intracranial hypertension and more severe dry eye disease. Furthermore, due to perceived stigma and discrimination, those on the spectrum are less likely to seek out healthcare services.

As healthcare providers, we strive to treat all our patients equally, however, many of us are unaware of this additional hurdle that LGBTQ individuals face, so we should make special efforts to be inclusive. Some of these efforts include registering your office with provider directories that target the LGBTQ community such as the GLMA, include alternate gender identity options on your intake forms, displaying a PRIDE sticker on your website, and having a non-discriminatory statement. Just as we reach out to PCPs to educate them about our excellent pediatric skills or the importance of diabetic eye exams, we can also reach out to other doctors who serve the LGBTQ+ community. We can let them know the importance of eye exams, and that your office is also a safe space for their patients to receive care.


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1 or 2?

Posted By MOA Admin, Thursday, June 18, 2020

1 or 2?

Barbra Johnson, O.D.,
MOA CMOS President 

Doesn't it seem like we get asked the same questions over and over agin? Sometimes I feel like I have a sixth sense and know what a patient will ask before they even open their mouth. While I was stuck at home over the past few months I thought it would be fun to list some of the most frequently asked questions I get on a daily basis. What are some of the most frequently asked questions that you get?

Here is my list. I even included a few short answers!

1)  If I Wear Glasses, Will My Eyes Get Weaker? 
Click here for the answer

2)  What is Astigmatism?
Click here for the answer
 

3)  What Can I Do to Keep My Eyes Healthy?
Click here for the answer
 

4) Other than a Refractive Error, what is the Most Common Eye Problem?
Click here for the answer

5)  Do You Have to Dilate My Eyes?
Click here for the answer

6)  Why Do My Eyes Get Dry While Working on My Computer?
Click here for the answer
 

7)  How Often Do I Need an Eye Exam?
Click here for the answer

8) My Mom Always Said That Reading in Dim Light Causes Vision Loss. Is That True?
Click here for the answer
 

9) Do They Make Bifocal Contacts and How Do they Work?
Click here for the answer

 10) I See Lots of Black Spots in Front of My Eyes - Should I Be Worried?
Click here for the answer

And the Most Frequent Question That I Ask My Patients Is,

Which is better, #1 or #2?

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The "Patient Experience"

Posted By MOA Admin, Thursday, June 18, 2020

The "Patient Experience"

 

Natalie Sukontasup, O.D.,
MOA 2nd Vice President


Staff Welcome

Optometrists are caring, empathetic, and one of the more well-liked health professionals in all of healthcare. Some of us have seen generations of families walk through our offices, and we pride ourselves on the personal relationships we have developed over the years. For this very reason, one could infer that we have one of the most loyal patient bases in all of the health care. Over the last few weeks, our offices have spent the larger part of our time installing barriers, stockpiling PPE, and enhancing protocols in preparation for patient care amidst the pandemic. While the safety measures are necessary to protect our patients and our team, one question has arisen. What will the “Patient Experience” look like post-COVID? Our doctors and team are now donned with masks to hide our welcoming smiles and physical barriers put up to separate us from the traditional hug or handshake we all have become accustomed to while greeting our patients. Although I do not have all the answers, I hope this blog will help us share ideas and spark new ideas that will help you elevate your patient experience within your practices.

Drive-up Sign

1.Masks.Consider creating picture ID cards on lanyards to help patients identify your team.

2.Fear of the unknown.Create an office video explaining your new office protocol to help reduce patient anxiety and reassure them that your office is a safe environment to visit. 30 minutes of YouTube; and you too can create your own office video. No high-cost production needed! Here’s an example of mine: https://youtu.be/MoTgNw-f_q0.

3.Digital Forms.Help expedite the check-in process by having patients fill out forms from home. Patient management services that allow text features allow patients to send images of their insurance cards to your team ahead of time. Not only explain new protocols with digital forms but also have patients acknowledge (initial) new procedures like temperature measurements and face-mask requirements. This will help avoid uncomfortable staff-patient confrontations.

Hand Sanitizer

4.Marketing.1 oz hand sanitizer with your office logo may be appreciated now more than ever.

5.Patient Education.Whilepatient education brochures have been removed, consider adding patient education videos to your exam rooms while patients wait for the doctor.

6.Virtual Waiting Room.Patients arriving at the office can wait in their cars and bypass check-in altogether.

7.Telemedicine.Great way to follow up with patients that don’t necessarily need to be seen in the office. Now you can have a conversation without a mask!

8.Virtual Frame-Styling.Offer an online frame gallery and help pre-select styles for your patients to reduce in-office selection time.

9.Curb-Side Pick-up.Deliver eyewear and contact lenses to the patient's car or institute direct shipping to the patient's home.


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The Homeschooling Shuffle

Posted By MOA Admin, Thursday, June 18, 2020

The Homeschooling Shuffle

Jennifer Kungle, O.D., FCOVD
MOA Secretary/Treasurer

If you have school-aged children, I'm sure you are just as happy as I am that the school year is coming to an end. Over the last 3 months, my husband J and I have been propelled into the homeschooling realm. I feel that I got the better end of the deal having to only spend 2 days teaching, while he ended up with 3 days. While I feel super comfortable teaching and educating people about vision and neurological vision disorders, teaching my Kindergartener and 2nd grader has been a completely different story. On top of organizing numerous Zoom meetings for myself, I have had to contend with a new and crazy schedule for my children. Additional Zoom meetings, science experiments, writing projects, strange ways of doing "math," flashcards, and reading...lots and lots of reading! Of course, all of this has been on top of trying to navigate the alphabet soup world of PPP, EIDL, PPE, manage a full staff while trying to work remotely, plus a few telehealth sessions sprinkled here and there.

As I enter my final week of schooling my children, my daughter brought me one of her final worksheets...to my delight it was on VISION!!! It was fun to be able to help her learn the parts of the eye, and gave me a chance to pull out my old anatomy books! If it could have all been this easy!! This week also wraps up with speech writing for my Kindergartener's 'Flying Up' Zoom ceremony to elementary, and a drive-through farewell parade in the school parking lot. We are all very excited about the start of summer vacation, and I am so thankful for the teachers and all the hard work they do every day!
              


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