Friday, November 2, 2018

Legislative Update ~ October 2018

The House and Senate held what is believed to be the final voting session days of the 2017-18 session in October, passing a flurry of bills on a variety of subjects, seeing the Governor sign most but veto a few, and leaving a number of other issues unaddressed before departing for their districts and re-election campaigns.

In terms of legislation that the POA had been working hard to accomplish this session, one, the “Quality Eye Care for Insured Pennsylvanians Act,” earned the Governor’s signature on October 24. The bill, HB 1013, was amended to include the language the POA had negotiated with the insurers in SB 257. The Senate passed the House bill, sponsored by Rep. Steve Barrar (R-Delaware), and the House agreed with the addition of the vision plan language, and the Governor approved it. POA members are to be commended for their efforts over the past several years to get this bill done.

Unfortunately, the optometry scope bill didn’t fare as well. Despite overwhelmingly passing the Senate in September, SB 668 was not considered by the House Professional Licensure Committee. That clock will start over in January, as will the efforts by the POA to see the act updated for the first time in over 16 years. With the impending retirement of House Professional Licensure Committee Chairman Mark Mustio (R-Allegheny), along with dozens of his House and Senate colleagues, POA Keypersons will be counted on heavily, again, to education the new legislators about optometry, and to counter the misinformation spread this session by organized ophthalmology. A comprehensive post-election report will be distributed in mid-November.

The House and Senate will convene for perhaps one day each in November, for what is traditionally non-voting sessions, other than to elect temporary leaders to preside between the constitutional end of session on November 30 and the convening of the 2019-20 session in January, and to hold closed-door caucus elections for their respective leaders for next session. It is anticipated that no more votes on bills will be held after the November 6 election. POA members are reminded to VOTE on Election Day!

Last month, we reported that the General Assembly came close to passing legislation to create rules for PA to allow for the use of “telehealth” in the Commonwealth. Unfortunately, SB 780, sponsored by Sen. Elder Vogel (R-Beaver), got sidetracked by a host of amendments being offered, most lethal of which was a proposal by Rep. Kathy Rapp (R-Warren) to include language in the bill prohibiting the performance of “abortions” via telemedicine. Most of the other amendments were withdrawn, but Rapp held fast, and the vote on her amendment, and the bill itself, never was called. Although it appears to be dead for this session, Vogel and many in the provider community are committed to bringing the issue back in a new bill in 2019.


The Medical Assistance Advisory Committee (MAAC) held its regular monthly meeting on October 25. Some highlights of interest follow:

Patricia Allan, DHS CHIP director, provided an update on the Children’s Health Insurance Program (CHIP) and the State Health official letter, “Extending Federal Funding for Chip.” Congress reauthorized the program for 10 years. The letter outlines key impacts of the reauthorization legislation and was sent October 5, 2018. There are no direct impacts on optometric care. Any members wishing to know the details are encouraged to contact Dr. Rich Christoph.

Joseph Glinka of Gateway Health
 pointed to a declining enrollment in Medical Assistance (MA) and asked if the department is looking see where those people are going. Allan stated CHIP enrollment was climbing to almost 182,000 early this year, but then it dropped to 178,000 in May. She found that the drop was due in part to fears of the expiration of the program. Regarding the overall MA program, Kozak confirmed there have been some decreases in recent months, but she could not say if that is a trend yet. She said it is being monitored.

Managed Care Delivery System Subcommittee: The committee will prepare information to reduce confusion due to changes in the law that haven't been implemented by regulations. The also discussed Medicaid expansion numbers and quality measures. Questions were raised about how to keep individuals enrolled in Medicaid so they are not unnecessarily dis-enrolled. Glinka reported the new credentialing notice will be for all providers, not just dental providers. 



The following bills of interest to the POA were introduced or acted upon in the past month:

Amends the Controlled Substance, Drug, Device and Cosmetic Act further providing for definitions and for professional prescription, administration, and dispensing by requiring electronic prescriptions for Schedule II, III, and IV controlled substances, except in situations as prescribed by regulation. The bill allows exceptions for veterinarians, circumstances when an electronic prescription is not available due to temporary technological or electrical failure by providing a practitioner shall within 72 hours correct any cause for the failure, when dispensed by a pharmacy outside Pennsylvania, lack of internet access or an electronic health record system, where an electronic prescription would cause an untimely delay in an emergency department, patients enrolled in a hospice program or residing in a nursing home or residential health care facility, controlled substance compounded prescriptions and prescriptions containing certain elements required by the food and drug administration not able to be accomplished with electronic prescribing, a prescription issued pursuant to an established and valid collaborative practice agreement between a practitioner and a pharmacist, a standing order or a drug research protocol, a prescription issued in an emergency situation, circumstances where the pharmacy that receives the prescription is not set up to process electronic prescriptions, or controlled substances that are not required to be reported to the prescription drug monitoring program system. Establishes pharmacist responsibility if there is belief that a patient may be seeking a monitored prescription drug for a purpose other than the treatment of an existing medical condition.
Signed in the House and in the Senate, 10/17/2018
Approved by the Governor, 10/24/2018 G (Act No. 96 of 2018)

HB 1951 RE: Access to Dextromethorphan
(by Rep. Tarah Toohil, et al)
Amends Title 18 (Crimes and Offenses), in minors, establishing the offense of access of minors to dextromethorphan (known as DM or DXM) and imposing a penalty. A person commits a summary offense if he knowingly sells or purchases with the intent to sell a finished drug product containing any quantity of dextromethorphan to a person who is less than 18 years of age. Similarly, a person commits a summary offense if he falsely represents himself to be 18 years of age or older to another for the purpose of procuring a finished drug product containing any quantity of dextromethorphan.
Read third time, and passed Senate, 10-17-18 (49-0)
Approved by the Governor, 10/24/2018 (Act No. 116 of 2018)

SB 668 RE: Optometry Scope Modification
(by Sen. John Gordner, et al)
Amends the Optometric Practice and Licensure Act amending the definition of "practice of optometry" to include health care services related to the eye and vision care services including the supply and preparation of eyeglasses. Further provides the practice of optometry includes the administration and prescription of drugs approved by the Food and Drug Administration for the treatment of diseases and conditions of the eye. Allows an optometrist to order an imaging test appropriate for diagnosis and treatment of a disease or condition of the human visual system. Clarifies that optometrists may not perform surgery and that any insurance procedure and billing code may not be used to define surgery.
Received in the House and referred to House Professional Licensure Committee, 10/2/2018

HB 1884 RE: Patient Test Result Information Act
(by Rep. Marguerite Quinn, et al)
Provides for summaries or copies of patient test results to be sent directly to a patient or the patient's designee when there is a finding of a significant abnormality; and provides for duties of the Department of Health.
Signed in the House and in the Senate, 10/17/2018
Approved by the Governor, 10/24/2018 G (Act No. 112 of 2018)

HB 126 RE: Epinephrine Auto-injectors
(by Rep. Ryan Warner, et al)
Amends Title 35 (Health and Safety) providing for reimbursement of patient expenses associated with participation in cancer clinical trials and for duties of the Department of Health to define and establish a clear difference between what is considered inducement for a patient to participate in a clinical trial and direct reimbursement of patient-incurred expenses for participating in a cancer clinical trial, and establish all sponsors of cancer clinical trials shall inform potential patient-subjects at the time of the informed consent process; imposing a penalty; providing for the use of epinephrine auto-injectors by certain entities and organizations by establishing a health care practitioner with prescriptive authority may prescribe epinephrine autoinjectors in the name of an authorized entity for use; and conferring powers and imposing duties on the Department of Health.
Signed in the House, 10/9/2018 Signed in the Senate, 10/15/2018
Approved by the Governor, 10/24/2018
(Act No. 93 of 2018)

HB 1013 RE: Quality Eye Care for Insured Pennsylvanians Act
(by Rep. Stephen Barrar, et al)
Amends the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in quality health care accountability and protection, further providing for emergency services and providing for quality eye care for insured Pennsylvanians. As amended in the Senate, this bill now contained the agreed-to language that was in SB 257, before the House amended that bill.
Signed in the House and in the Senate, 10/17/2018
Approved by the Governor, 10/24/2018 (Act No. 103 of 2018)

SB 780 RE: Telemedicine Act
(by Sen. Elder Vogel, et al)
Provides for telemedicine; authorizes the regulation of telemedicine by professional licensing boards; and provides for insurance coverage of telemedicine. The bill authorizes the practice of telemedicine by health care providers. Requires each licensure board to promulgate regulations within 24 months of the effective date and provides for the publishing temporary regulations within 120 days. Further provides for evaluation and treatment; insurance coverage; and Medicaid program reimbursement. The provisions regarding insurance coverage and Medicaid program reimbursement shall take effect in 90 days and the remainder shall take effect immediately.
Amended on House floor, 10/11/2018

HB 1532 RE: Access to Prescription Information
(by Rep. Kristin Phillips Hill, et al)
Amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) Act further providing for access to prescription information adding that authorized users include a Medicaid managed care organization that is a party to a Medicaid managed care contract with the Department of Human Services. The Medicaid managed care organization may query the system to review the requested dispensing or prescribing of a controlled substance to an individual to whom the organization provides services under the State's plan for medical assistance under Title XIX of the Social Security Act. The Medicaid managed care organization shall notify the Department of Human Services and the Office of Attorney General if the organization has reason to believe that a controlled substance prescribed or dispensed to an enrollee under the State's plan for medical assistance under Title XIX of the Social Security Act is fraudulent.
Read second time, and rereferred to Senate Appropriations Committee, 10/1/2018

HB 1840 RE: Physical Examination or Expert Interview
(by Rep. Rob Kauffman, et al)
Amends the Workers' Compensation Act, in liability and compensation, further providing for schedule of compensation, for computation of benefits and for physical examination or expert interview. Allows employers to request an Impairment Rating Evaluation after an employee has received total disability compensation for a period of 104 weeks. Requires the employee to submit to a medical evaluation which shall be requested by the insurer within 60 days upon the expiration of the 104 weeks to determine the degree of impairment due to compensable injury. If such determination results in an impairment rating that meets a threshold impairment rating that is equal to or greater than 35 per centum impairment, the employee shall be presumed to be totally disabled and shall continue to receive total disability compensation benefits. If the determination is less than 35 percent, the employe shall then receive partial disability benefits provided that no reduction shall be made until sixty days' notice of modification is given. Further provides for physical examination or expert interview.
Signed in the House and Senate, 10/17/2018
Approved by the Governor, 10/24/2018 (Act No. 111 of 2018)

State Board of Optometry Board Meeting Schedule 
2019 meeting dates have not been announced yet

DHS Medical Assistance Advisory Committee (MAAC)
Remaining 2018 Meeting Dates: December 13
2019 dates have not yet been announced. For more information check the DHS MAAC website.

Copies of bills described above can be obtained online at:http://www.legis.state.pa.us/cfdocs/legis/home/session.cfm

Respectfully submitted,
Richard Christoph, O.D.
Chair, POA State and National Education Committee
doctorc@verizon.net

Special thanks to Ted Mowatt, POA Lobbyist, for preparing the content.
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Monday, May 15, 2017

A message from AOA President Andrea Thau, O.D.

Dear Colleague, 

As a practicing doctor myself, I know firsthand the challenges and frustrations that come with keeping up with ever-changing Medicare program requirements. As the Centers for Medicare & Medicaid Services (CMS) begins the new Quality Payment Program (QPP) this year, the AOA is working to support our doctors to protect future reimbursement and maximize incentives.

Just last month, CMS began sending out letters to all Medicare doctors to indicate whether the doctor has qualified for one of the exclusions under the Merit-Based Incentive Payment System (MIPS). CMS also developed an online NPI look up to check participation status. With this information, doctors can now best prepare themselves for MIPS participation. To equip doctors of optometry with the information needed to successfully participate in the program, we’ve developed a number of resources, including:


While these are all great resources, we know that many of our doctors are still unsure of the path forward when it comes to these program changes. The AOA wants to do more to support you. Please join us on June 12 at 9 p.m. Eastern time for a webinar that will offer the opportunity to ask your specific MIPS questions. The webinar will be presented by Dr. Zachary McCarty, chair of the AOA’s Quality Improvement and Registries Committee, and Dr. Jeff Michaels, immediate past chair of the AOA’s Quality Improvement and Registries Committee. Register here. If you have a specific question you would like addressed on the webinar, please email Kara Webb, the AOA’s associate director of coding & regulatory policy, at kcwebb@aoa.org.

If there are additional MIPS tools and resources that would be useful to you in your practice, please email me at president@aoa.org.

Sincerely, 
Andrea P. Thau, O.D.
AOA President

Tuesday, March 21, 2017

PCO Quiz Bowl 2017

The PCO Quiz Bowl was held Friday, March 17 at Salus University. Congratulations to PCO second-year (and my former employee) Celeste Gomez for winning the opportunity to represent the school in Denver next summer. Congratulations also to Colleen Gibson for winning the travel grant to Optometry's Meeting in D.C. this summer. Special thanks to Drs. Shana Barrett Zeitlin, Steve Hess and Ben Foreman for helping to represent the POA.
- Dr. Steven Eiss, POA President




Monday, October 31, 2016

IDENTITY THEFT: The Aftermath and Prevention

by Mark Dalton, O.D.

Over the past few months, many of us have either heard about, or have been directly affected by, the nationwide data breach affecting optometrists and optometry students throughout the country. This article serves as a brief summary of the breach, how to respond if you have already been victimized, as well as suggested ways to better protect yourself from becoming a victim of identity theft in the first place. 

At the end of July, reports began circulating of a possible data breach affecting the optometric community. The suspected breach was discovered when victims began receiving unsolicited, fraudulent applications for Chase Amazon cards. In some cases, the new account requests were denied, resulting in a letter being sent to the victim’s home. In other cases, the credit cards arrived in the unsuspecting victim’s mailboxes.

In early August, the AOA alerted its members, warning them about the breach and how best to respond. The AOA also contacted the FBI and the Federal Trade Commission to apprise investigators of the situation. In addition, the AOA immediately conducted its own internal investigation of its databases, reporting that it was not the source of the breach. Importantly, the AOA does not store social security numbers, which are needed to open the Chase Amazon accounts. In addition to the AOA, the AAO, NBEO, and ASCO all independently denied being the source of the breach. Although there is much speculation, as of this writing, the source of the data breach has not yet been confirmed. 

Since the initial discovery, it appears that more than 1,000 doctors and students have been victimized. While there appeared to be an initial wave of applications in early August, as well as a second one in late August, the reports of new accounts opening have continued to this day. Some victims have reported multiple attempts to open cards in their names, sometimes several weeks apart. In addition, recent reports have surfaced about other non-Chase credit card accounts being hacked with unauthorized charges being made. It is not known at this time if these are related.

So, what can you do? Since it appears all optometrists and students are at risk, the POA recommends everyone call Chase Bank at 1-888-247-4080 to see if an application using your social security number has been submitted. This is an automated system. You will initially be asked to enter your existing 16 digit card number. Ignore this. You will then be given the option to enter “1” to check on the status of your application. After selecting that option, you will be asked to press “3” to check the application status, then lastly, press “1” again. It will ask for your social security number. After entering it, if you are told they can’t find your application, then there is none pending. If you are told you have one pending or approved, hang up and follow these instructions:

1. Call the Chase fraud line at 1-877-470-9042
2. Have the application or card cancelled immediately and ask Chase to report it to the credit bureaus. Follow up with a certified letter mailed to the following address reporting the fraud and requesting that they report it to the credit bureaus to have it removed.
Chase Card Servicing
Attn: FACT Act Request
P.O. Box 15941
Wilmington, DE 19885
3. Obtain a copy of your credit report
4. Report to the FBI at www.ic3.gov
5. File a police report with your local police department. 
6. Visit identitytheft.gov, the federal government’s one-stop resource for identity theft victims. 
7. Request a credit freeze by contacting all three credit bureaus listed below. You can do this online, and there is typically a small fee. A credit freeze will restrict access to your credit report, which in turn will make it more difficult for identity thieves to open new accounts in your name. It is important to remember that any activity that may require legitimate access to your credit report, such as buying a house or car, will require you to lift the freeze temporarily, either for a specific time or a specific party. A freeze remains in place until you ask the credit reporting company to temporarily lift it or remove it altogether. The cost and lead times to lift a freeze vary, so it’s best to check with the credit reporting agency in advance. 
Equifax 1-800-349-9960
Experian 1-888 397 3742
TransUnion 1-888-909-8872
8. Submit an Identity Theft Affidavit (IRS form 14039) at
 www.irs.gov/pub/irs-pdf/f14039.pdf
9. Inform your personal bank and credit card companies of the breach. 
10. Change your passwords associated with your bank and email accounts. 

If you haven’t been victimized by this latest breach, it doesn’t mean that you are completely safe since reports of new fraudulent accounts are still appearing almost daily. Due to the current circumstances, you may want to consider a credit freeze, as described above, and/or a fraud alert. A fraud alert is a consumer statement added to your credit file. This statement alerts creditors that you may be a victim of fraud, including identity theft, as well as requests that they follow certain procedures to protect you in connection with requests for new credit accounts, increasing credit on an existing account, or issuance of a new card on an existing account. There are two types of fraud alerts: an initial fraud alert that lasts for 90 days, and an extended fraud alert that lasts for 7 years. An initial fraud alert is free, and will protect your credit from unverified access for 90 days. To initiate a fraud alert, you only have to ask one of the three credit reporting agencies to put a fraud alert on your credit report. They must tell the other two companies to do the same. Other ways to help protect yourself from identity theft include: 

1. Sign up for a credit monitoring service. Examples of these include LifeLock, Identity Guard, Identity Force, Experian and Transunion. There are many others as well. For a monthly fee, these companies offer a wide array of services. 
2. Check your credit reports regularly. 
3. Never give your social security number or other personal information to strangers who call, text, or email requests to you. 
4. Maintain anti-virus and anti-malware software.
5. Don’t open email attachments from senders you don’t trust. 
6. Handle financial documents with care. Shred documents with personal financial information on them. 
7. Create strong passwords. Use at least 7 characters of lower and upper case letters, numbers and symbols. The more complex, the better. In addition, do not use the same password for all of your accounts. 
8. Avoid entering passwords when using unsecured wi-fi.
9. Monitor credit card and bank accounts carefully.
10. Be careful of over-sharing online. Information like your exact birthday and your mother’s maiden name can be used to answer your security questions. 

It is recommended that each of you do your own due diligence, allowing you to choose the combination of actions and services that best fits your specific needs. 

In 2014, the most recent year in which government data is available, an estimated 17.6 million Americans aged 16 or older were victims of one or more incidents of identity theft. That’s up from 16.5 million in 2012. Also during 2014, 3% of persons experienced at least one incident of misuse of an existing credit card account. As many of you have already learned, responding to identity theft can be time consuming, stressful and expensive. For the rest of us, we can’t afford inaction. As more and more of our lives are stored online, it’s is imperative we be proactive and not reactive. As the old saying goes, the best offense is a good defense. 

Friday, July 8, 2016

Executive Director Search

The Pennsylvania Optometric Association (POA) is searching for an Executive Director who exhibits excellence in organizational management, strategic thinking, and relationship building. The POA represents the interests of over 1,200 optometrists across the state of Pennsylvania. Reporting to the Board of Directors, the Executive Director has overall responsibility for the execution of our strategic plan with emphasis on membership development and retention, legislation and insurance/third party related issues.

Candidates should possess proven leadership in some or all of the following areas: membership development, finance, legislation, third party and non-dues revenue income. The candidate should also possess the ability to manage staff, work with our volunteer structure, set and achieve strategic objectives, and manage a budget. Qualifications: Bachelor of Arts or Bachelor of Science degree with MPH, MBA, MPA, OD or JD preferred. Management experience in not-for-profit association administration, government relations, health services, public administration, or closely related area. Small business experience and/or experience in legislative and regulatory environment with emphasis on health policy and insurance issues is a plus. Availability for travel and required after-hours work including weekends. Salary and benefits will be commensurate with experience.


Please send cover letter, resume and references to Kelsey Rodkey at poaeyes@gmail.com by August 8, 2016.

Wednesday, March 30, 2016

Smart Talk with Scott LaMar on WITF

On Monday, March 28, Drs. Marianne Boltz and Gregory Caldwell joined radio host Scott LaMar for his show "Smart Talk." The doctors discussed Save Your Vision Month and the importance of yearly eye examinations, along with Kids Welcome Here and how to prevent digital eye strain. To listen to their interview online, visit
http://witf.vo.llnwd.net/o35/smarttalk/radiosmarttalk/RST_March282016.mp3.

Dr. Boltz explains the importance of the 20-20-20 rule on Smart Talk.

Dr. Caldwell smiles for the camera as Dr. Boltz discusses Kids Welcome Here.

Dr. Boltz and Dr. Caldwell have their photo taken by a WITF employee for their website.

Outside the green room, Dr. Boltz and Dr. Caldwell expressed their feelings about how the segment went.

Dr. Caldwell and Dr. Boltz with Scott LaMar after their segment.

Dr. Boltz and Dr. Caldwell pose for a photo outside the WITF building.