The year we've had

As the end of 2023 approaches, I am incredibly proud of the Pennsylvania Optometric Association (POA) this year. We embarked on our journey with a goal of “breaking down the silos” and fostering increased lateral communication within our organization. What I have come to realize is, through our efforts, while those silos grew stronger, we developed better interconnectivity with sideward communication, effectively bridging the pillars of our organizational structure. We should take pride in the foundational work we have laid, and we will continue to build upon this spirit of collaboration. 

Let's delve into more of our collective achievements over the past months. We have actively contributed to Salus University's strategic efforts to attract more students to the profession of optometry. Our Proactive Optometry Initiative has gained significant momentum with pledges from many of our members. If you have not already pledged, please do so here. Our keyperson program has undergone thorough evaluation and is evolving into a more comprehensive strategy. This restructuring will provide a solid foundation for our grassroots efforts as we progress toward our legislative goals.

Additionally, we have successfully trained dozens of optometrists across our Commonwealth to perform advanced laser procedures, in partnership with and presented by Salus University on both the eastern and western sides of Pennsylvania. We are well-positioned to explore the modernization of our scope of practice in the near future. Our collaborative efforts with the Pennsylvania Academy of Ophthalmology have expanded, with their request for referral sources for scleral contact lenses and low vision services. We promptly answered this request for action. Please sign up here and here if you would like to be considered as an office providing these services and materials. Our initiative allows ODs, DOs, and MDs to refer through the POA to participating offices. 

In late September, the POA partnered with VSP and the Salvation Army to provide comprehensive eye exams and glasses to individuals in need in Harrisburg. Over two days, our doctors and supporting staff cared for over 220 people, making a substantial difference in their lives. Recently, the POA has enlisted new legal counsel from Tucker Arensberg, PC. They are a full-service law firm with over 80 attorneys who will specialize in addressing the diverse needs of the POA and its members. The POA is deeply grateful for the decades of service and expertise provided by our former counsel, Attorney Greg Knight. We wish him well in his future endeavors and will always consider him a friend of the POA. 

Our legislative affairs committee remains dedicated to advancing our children's vision bill. Once this law is codified, it will be crucial that our Children's Vision Care Alliance (CVCA) be prepared for action, so sign up here. This alliance is not exclusive to vision therapy or pediatric optometrists; it is open to all who work with children giving them access to a first line comprehensive eye exam. If you see kids in any capacity, please sign up. 

In closing the year, the POA will be involved in assisting the Governor’s Office with his executive order directing the Pennsylvania Department of Aging to develop its Master Plan for Older Adults. Identifying early and treating visual conditions in an aging population will be a prominent focus within this Master Plan. 

As we reflect on all we have accomplished this past year, I am filled with optimism for our future. Let's continue to move onwards and upwards, as 2024 is just around the corner! I look forward to seeing you there!

Jesse
Jesse Jones, O.D.
POA President

Your POA to do list

Happy New Year, everyone! I am honored, excited, and motivated to lead the POA for 2023. I’m looking forward to working with those I know well and getting to know new people, too. The POA Board of Directors is enthusiastic to meet those interested in contributing their skills in advocating for optometry. I hope everyone is refreshed and ready for an effective and efficient year. 

As we review our to do lists for this upcoming year, the following are some items you might add to yours:

First, open the POA Table of Organization. Examine the intricate structure of our organization and how it works for you, your colleagues, and, ultimately, your patients. It's impressive, isn’t it? 

Then, you can get more acquainted with the specific goals and action plans to be carried out within each committee. Consider if any of the committees are of particular interest to you and contact me, the POA office, or a POA Board member if you would like to serve. 

Next, check out the POA keyperson program. You can look up your current senators and representatives, and educate yourself with valuable keyperson training programs and materials. When contacting your legislators, inform them of your availability to discuss anything relating to eye care and our legislative efforts including our children’s vision initiative and scope modernization. 

Check out our Pennsylvania Diabetic Eye Health Alliance and Children’s Vision Care Alliance. When reviewing these important programs, assess if you are maximizing what these programs have to offer to you and your patients. Don’t forget to request the new near point card for school nurses in your area! Also, get two hours of TPA CE toward your license by registering for the “Innovations in Pharmaceuticals and Their Clinical Applications” webinar by Dr. Paul Karpecki on January 23. 

Additionally, get reacquainted with POPAC and consider committing to a monthly donation if you haven’t already. Learn how our organized political action has expanded to incorporate grassroots efforts lined out in the Proactive Optometry Initiative.

Finally, please mark your calendars for the POA Spring Congress in Gettysburg from March 30th to April 2nd along with our Fall Education Conference in Bedford Springs November 1st through 3rd. I am eager to see as many members as possible in person this year. We are developing creative new ways to expand and improve our efforts in welcoming and including all optometrists in Pennsylvania. The POA will also be enhancing communication in all aspects within the POA Board, POA staff, POA committee structure, general membership, and to non-members and the public. 

I anticipate a successful year, building on the hard work of the POA’s previous leadership and doing my best to direct and support current leadership. I will also strive to create new leadership for the future of our POA. See you soon!

Appreciatively,

Jesse Jones, O.D.

POA President

Access Low Vision in Pennsylvania

I am so proud of what we at the POA have achieved this year. The POA has provided leadership development for over 40 members and established a new Diversity, Equity and Inclusion (DEI) Committee. Additionally, we have developed a new POPAC Proactive Optometry Initiative. After advocacy efforts this year, we've seen the successful passage of the Early Eye Drop legislation. We have even supported Salus University’s Ophthalmic Lasers Procedures for Anterior Segment certification course. You can register here. 

In addition to our established initiatives with the Pennsylvania Diabetic Eye Health Alliance (PDEHA)  and Children’s Vision Care Alliance (CVCA), the POA has now formed a Low Vision Awareness Committee. The overall purpose of the Low Vision Awareness Committee is to promote Low Vision awareness to Optometrists, Ophthalmologists, other health care providers, and the general public.

We are reminding our members that the standard of care for a patient with low vision is to refer to one of the many Optometrists in Pennsylvania who provide Low Vision rehabilitation.

So, what constitutes a referral for Low Vision services? No longer is the trigger for a referral to Low Vision a certain visual acuity, visual field or diagnosis. The standard of care now is to refer any patient who is struggling with at least one activity of daily living due to their vision loss. Examples could be: difficulty reading mail or pill bottles; trouble keeping up in school (at any age); concerns about driving; difficulty performing work-related tasks; difficulty traveling through unfamiliar environments; trouble reading books, magazines, or computers; inability to see favorites hobbies or past-times; difficulty seeing to provide self-care such as shaving; or difficulty seeing to perform housekeeping such as cooking and laundry. 

If you have provided the best optical correction, but your patient is still struggling, please refer to a Low Vision Optometrist. They can tackle the problem, not only by traditional glasses or contact lenses, but also by use of lighting, contrast, prisms, modified working distances, eccentric fixation, various forms of optical and electronic magnification, training with these devices and techniques, and referrals as needed to other supportive professionals. The earlier the Low Vision Optometrist can become involved, the more successful your patients are likely to be.

Of course, at no time should Low Vision care replace proper medical or surgical intervention. But do remember, Low Vision is an essential treatment modality to those with visual impairments. Also, please do not prejudge a patient’s ability to adapt to Low Vision care or pay for the services. Low Vision consultations are generally covered under a patient’s medical insurance. If not, other funding sources are available such as the Pennsylvania Bureau of Blindness and Visual Services. Get to know your local Low Vision Optometrists. They can guide you. Consider the Low Vision Optometrist a part of your team. They do the rehabilitation and you continue to be the patient’s primary eye care Optometrist.

If you are a POA member who provides Low Vision Rehabilitation, please make sure your AOA profile indicates you have a special emphasis in Low Vision Rehabilitation. Also, join the AOA Vision Rehabilitation Advocacy Network by signing up on the AOA website under practice > specialties > Vision Rehabilitation. By identifying yourself as a Low Vision Provider with your professional association, your colleagues and the general public will be able to find you on the AOA and POA “doctor finder” under Low Vision Emphasis. If you are not a Low Vision provider, search on the AOA or POA websites for a Low Vision Optometrist in your area.

I want to thank the POA for all its support. I ask members to stay involved, join PDEHA, join CVCA, and join or refer to POA Low Vision Optometrists. Become a keyperson. Join the Proactive Optometry Initiative. We all know that Optometry is the premier eye care profession in Pennsylvania. Let’s keep it that way. Great things are being planned for 2023, and I look forward to continued success for Optometry in Pennsylvania. 

Tracy Carpenter Sepich, O.D., M.S.

Doctor of Optometry

Masters of Science in Low Vision Rehabilitation

A strong POA is a diverse and inclusive POA

The Pennsylvania Optometric Association has a long history of providing member benefits ranging from advocacy to education. The Association provides a voice for optometry in Harrisburg and Washington, D.C., offers problem-solving and maintains ongoing relationships with third-party payers on behalf of our members. POA membership opens the door to premium opportunities with buying groups, investment strategies with Fischer Financial, insurance, discounts with Element Risk Management, HIPAA compliance solutions with Abyde, and consultative services with POA legal counsel. Additionally, the POA Electronic Claims Service helps you submit claims to third-party payers while also generating income to reduce membership dues.

When the COVID shutdown hit, we devised quality online education, which has continued as an option in addition to our revived in-person educational offerings, and we will continue to provide cutting-edge education as we explore scope expansion.

Through the Children’s Vision Care Alliance, we form relationships with school nurses statewide, and provide members with no-cost posters, brochures, and presentations to educate local schools and families on the importance of eye examinations. We have similar materials available to promote the need and accessibility of diabetic eye examinations by optometrists through the Pennsylvania Diabetic Eye Health Alliance. These programs keep our member optometrists involved and relevant in these essential areas of vision and eye care. 

We partner with the Pennsylvania Paraoptometric Association which provides education as well as networking and professional development opportunities for your staff. The AOA Paraoptometric Resource Center also provides staff training and certification.

We support our fourteen local optometric societies so members can attend meetings, obtain CE, network, and advocate locally. We work closely with the Pennsylvania Student Optometric Association to recruit new members and keep our initiatives current and relevant.

We update our members through email and this bi-monthly newsletter, which includes a classified section to assist members with practice and equipment sales and job searches.

A new addition to our association structure is a Diversity, Equity, and Inclusion (DEI) task force. As a result of responses to our 2021 membership survey, our new strategic plan calls for the creation of this DEI task force. This initiative is important in making sure all optometrists in Pennsylvania have a home in the POA. We need to make sure all optometrists know they are valued and welcomed. We want optometrists with a variety of backgrounds to contribute to the volunteer structure of the POA. We will be stronger as an association if we have a diverse community of members involved.

In an effort to recognize the AOA’s dedication to all people, at the 2021 AOA House of Delegates, the following statements were added to the Optometric Oath: “I WILL provide professional care for the diverse populations who seek my services, with concern, with compassion and with due regard for their human rights and dignity.  I WILL work to expand access to quality care and improve health equity for all communities.”

Please recognize we all have biases. Please educate yourself. Please attend local conversations about diversity in your community. Simply saying we are welcoming is not enough. When you are at a conference, sit next to someone who does not look like you. Stop into local optometry practices in various settings and invite them to your local society meetings.

I hope to foster a POA in which optometrists of all backgrounds, lifestyles, and practice styles know they belong, are safe and valued, and work together for our common goals. My hope is by nurturing a diverse and inclusive association, we will become better providers and serve a greater community with more acceptance and positive results.

Little things matter. Respect, even in small ways, matters.

If you have an interest in strengthening the POA by participating in the new POA DEI task force, contact me at tsepich@restoreeyecare.com or the POA office at mail@poaeyes.org. Thank you.

Tracy Carpenter Sepich, O.D., MS

POA President

Why do children need the POA?

Did you know there are approximately 1,745,000 students enrolled in Pennsylvania schools? Studies estimate 33% of these students are at risk for vision problems. That is approximately 576,000 students. Did you know 40% of students with learning disabilities have vision issues that affect learning? Did you know Pennsylvania schools spend 9K-15K per student on an IEP (Individualized Education Program), which is required for all special education students? Recent studies have found that children who are spending increasing time on electronic devices have a higher incidence of vision deficits that impact learning. The negative impact of children’s vision problems is likely to get worse if nothing changes. 

Children need the POA because we can uniquely provide the vision and eye care children need to succeed.  The POA's Children’s Vision Care Alliance (CVCA) has been busy educating optometrists, school nurses, and legislators on the importance of proper eye care for our children’s success in and out of the classroom.

Representative David Zimmerman has introduced HB 1343, which would require children in Pennsylvania to have a comprehensive eye health exam when entering school, in 4th grade, in 8th grade, and before qualifying for special education services. This bill currently has 40 co-sponsors with bipartisan support. It is currently in the Education Committee. We feel confident this bill can pass once it is out of committee. 

So, how can you help?  Please attend our Optometry at the Capitol Day in Harrisburg on Monday, March 28, where we will be lobbying for important issues. You are all invited to this investment in the future of Optometry. Please register here: https://pennsylvania.aoa.org/education-and-events/poa-lobby-day. Learn more about POA's legislative efforts and send a letter to your legislator by visiting the Advocacy page here: https://pennsylvania.aoa.org/advocacy.

In addition to contacting your legislators, please consider joining the POA Keyperson Committee or POPAC Fundraising Committee. You don’t need experience. You only need a passion for Optometry and helping our patients.

Finally, keep your eyes open for the new POA Proactive Optometry Initiative to help advance current and future Optometry-friendly legislation, like HB 1343. More information will be available soon!

Let's get back to the children, though. One study showed that when students who were identified with visual deficiencies received proper treatment, their grades significantly improved, whereas without proper treatment, these students continued to underperform, leading to a 12% reduction in wages.  Don’t you want to be part of the solution? Educate yourself. Educate your patients. Educate your local schools. Educate your legislators. Join the CVCA. Become a Keyperson. Support POPAC. If you don’t know where to start, call the POA and we will help you. Your children, and your children’s children, will thank you. I thank you. 

(Citations for the facts included in this editorial can be found on the POA Advocacy webpage.)

Tracy Carpenter Sepich, O.D.
POA President

Why are you a member of the POA?

The beginning of a new year is a perfect time for introspection. What is important to me? Why do I volunteer? Why is the POA important to me? What is important to the POA and its members? 

I know why I volunteer. I want, in my own way and in my own capacity, to make the world a better place. This year, as POA president, I hope I can use my talents to lead the POA to a better place for its members, volunteers, staff, and, most importantly, our patients. 

The POA has just completed its 2022-2026 Strategic Plan, which you can find on the POA website here: https://pennsylvania.aoa.org/about/2022-2026-poa-strategic-plan. Please take the time to read it. This reflects our members’ priorities and provides our road map to achieve success as an association.

In our strategic plan, you will see four strategic priorities that will be addressed by our volunteers and committee structure. These four priorities include: legislative efforts, children’s vision promotions, third party relationships, and finally, building a strong and engaged membership. So, now I start at the end. Today, I want to concentrate on strategic priority number four: “Leverage unused talents among optometrists in Pennsylvania to support the POA’s vision and mission.” We plan to drive membership and engagement for all Pennsylvania optometrists to contribute their unique talents to the POA by: creating a Diversity, Equity, and Inclusion (DEI) task force; increasing the membership numbers of corporate and private equity optometrists; increasing the membership numbers of newly licensed optometrists; and increasing member participation in POA committees.

To that end, we are offering a free leadership development program. It starts with a live meeting on Saturday, February 12 from 1:00 p.m. - 4:00 p.m. at the Hyatt Place in State College and wraps up on Sunday, October 9 from 8:00 a.m. - noon at Seven Springs Mountain Resort in Champion. All intervening events will be via Zoom. We have invited Renee Brauns, a long-time executive at the American Optometric Association, to lead our in-person events and guide us through the year. There is no cost to you for the program and no obligation, but space is limited. You can apply online here: https://pennsylvania.aoa.org/education-and-events/poa-2022-leadership-development. 

The live meetings will include presentations, interactive discussions, and networking opportunities. We will help you understand your leadership style to apply it within your practice, the POA, and everyday life. Our goal is for you to gain leadership skills and a better understanding of the POA, our leadership structure, and volunteer opportunities. If you want to make a difference in your profession or if you want to learn how to become a more effective leader, please apply.

Now, I ask you to please take a moment to consider what is important to you. What are your priorities? What is your vision for 2022? If you would like to see the POA achieve its strategic goals and reach its vision of “creating access to high-quality eye health and vision care for all citizens of Pennsylvania,” please apply to our leadership program. Please volunteer to serve on a POA committee. If you don’t know how to do that, contact me or the POA office. 

I have a vision for the POA. I know we can achieve our goals. That vision includes you. Please help your association by taking a risk and volunteering. The beautiful thing is by helping the POA, you will help yourself and your patients. I will always take that type of risk; everyone wins. Happy New Year.

Tracy C. Sepich, O.D., M.S. (she/her)

POA President

tsepich@restoreeyecare.com

What a year!

 As I write my final President’s editorial, House Bill 2561, the Scope of Practice bill, sits on the Governor’s desk. By the time you read this column, he will have passed it or rejected it. All indications are that he will sign and pass this Modernization of the Optometric Practice Act. Through the incredible work by our Legislative Affairs Committee (LAC), lobby staff, executive director, and keypersons, we have finally passed both the House and the Senate and reached the Governor’s desk for his signature. I would be remiss to not recognize our LAC Chair, Dr. Bob Bittel. Bob and I joined the Committee close to 20 years ago. We worked with many dedicated committee members over those years whose goal was to play offense and pass legislation to advance our profession. Unfortunately, we often found ourselves playing defense and protecting our profession from harmful legislation like the “definition of ophthalmic surgery” our opponents have repeatedly introduced. We learned a lot through those years, cultivated relationships with legislators and gained respect as an organization. With Dr. Bittel’s leadership, countless hours of strategizing, difficult compromises and a pandemic that threatened to derail our efforts, we were successful in getting through both houses with one day to spare. Now we wait for the Governor.

I’d like to thank and recognize all the other committees that make up the POA. The word “unprecedented” is getting kind of old by now but they all faced challenges they never expected. All the committees adapted to the new “normal” and continued to function albeit in a totally different manner. We are a much stronger organization as a result of this pandemic.

The POA Board of Directors had many tough decisions to make this year: providing a forgiveness of two months dues, cancelling the in-person Spring Congress and House of Delegates, approving funds to purchase a platform to provide online CE for our members, planning and then having to cancel the fall meeting at Seven Springs, and modifying our bylaws to allow for a fall House of Delegates to elect our 2021 Board of Directors and approve the 2021 budget. 

The POA staff has been incredible through all of this. Their dedication to our profession is unparalleled. They participated in countless Zoom calls, many in the evening and often on a weekend when they should have been off duty. They found new ways to support the Board and the membership. I can’t thank them enough for their support this year.

Finally, I’d like to thank all of you for the opportunity to serve as President of the POA. It’s certainly not the year I expected. It’s been challenging and frustrating. I’ve had to make decisions to issues that had no clear answers. When I began my professional career, I couldn’t prescribe an antibiotic or bill Medicare. I owned a visual field instrument but couldn’t treat glaucoma. We are now the primary providers of eyecare due to the hard work of the leaders before me. I joined the Board of Directors because I felt the need to “give back” to a profession that had given so much to me over the years. I hope I have accomplished this and challenge all of you to do the same.

God bless and stay safe,

David Evans, O.D.

POA President

Going with the flow

Who is the Pennsylvania Optometric Association? We are a group of optometrists representing and protecting the interests of our profession for our members in Pennsylvania. We are a member-run organization supported by a staff and executive director in our office in Harrisburg. Our Board of Directors is elected by the membership and is responsible for providing leadership to the many committees that make up the POA and for making the decisions necessary to protect and promote our profession in Pennsylvania 

The POA welcomes all optometrists in the state to belong to our association. All modes of optometric practice are welcome and represented in the POA. You are reading this editorial because you are member of the POA. Imagine what we could accomplish if every optometrist in Pennsylvania was a member. Imagine what we could accomplish if every member was actively involved in the POA. 

The many committees within the POA are staffed by volunteer optometrists who contribute their time and skills to support their profession. Many members, who cannot dedicate time, provide support through POPAC donations and/or act as keypersons with their legislators. Many are available as individuals who are called upon for specific issues that the POA must address. 

We need strength in numbers and involvement by members, especially in these unprecedented times. Please consider getting involved and encourage your non-member peers to join us. Call the POA office and speak to our executive director, Joe Ricci, Esq., to discuss a committee you would like to participate in or a skillset you have that could benefit our efforts. We need members from all demographics to help address the needs of all optometrists in Pennsylvania.

As POA president, I’ve experienced more firsts than I ever imagined. On July 18th, we held the first POA Board of Directors meeting via Zoom. Every effort to replicate a face-to-face meeting was taken and I feel the meeting went well. The Board, local society presidents (or their representatives), POA staff, our executive director, our lobbyists, and our POA attorney were in attendance. At every Board meeting, the actions that the Board has taken since the last official Board meeting are voted on. Each Board member is a DEO (division executive officer) of one or more committees within the POA and is responsible for delivering a written report prior to the meeting for distribution to all parties in attendance. At the meeting, Board members present a verbal report highlighting each committee’s activities and questions from those in attendance are answered. Local society presidents are expected to relay the information in these reports to their respective membership so that our members are well informed. Copies of these reports are available through the POA office by emailing Ilene@poaeyes.org. 

Another first during my presidency will be a Virtual House of Delegates this fall. The Board rescheduled this event from our cancelled Spring Congress to the Fall Educational Conference at Seven Springs this fall. We recently were informed that Seven Springs will be unable to host our event due to COVID-19 limitations imposed on them with regard to group size. The House of Delegates can be attended by any member and I encourage you to join albeit virtually. Information with regard to date and time will be forthcoming.

The continuing education that was scheduled at Seven Springs will now be available via webinars. The schedule and registration are located on the POA website. If you still need the required Act 31 credits, this webinar is being held on September 13th from 7:00 to 9:00 p.m.

Stay well and stay safe! Stay informed. Things are constantly changing both locally and nationally. Get involved if you can. Help the POA and AOA protect your profession. If this pandemic has taught us anything, it’s that we need to be prepared for unexpected threats to our profession and livelihood.

Sincerely,

David Evans, O.D.

POA President

Unprecedented Times

I’ve got to be honest: when I figured out during the early years of my Board service that I would be president of the Pennsylvania Optometric Association in the year 2020, I thought “wow, how many ODs get to say that?” Both the POA and the AOA prepared for this unique year with big plans to promote our profession. None of us ever expected what we currently face both in our personal and professional lives. Like you, I am unsure of how long things will take to get back to normal and what the new normal will look like. The POA faces many of the same concerns and challenges as we wait to see what the future holds. However, as members of the POA, we are fortunate to have a strong professional organization that employs dedicated staff who truly care about us as individuals and as an organization. They are working from home to support and protect the POA in ways they never anticipated. As members of the POA, we are also fortunate to have a committee structure with volunteer ODs that are passionate about our profession.

Since the onset of COVID-19, the following optometry-centered events have been cancelled:

• Vision Expo East
• POA’s Lobby Day in Harrisburg
• POA/VSP eye exam clinic in Harrisburg
• POA’s Spring Congress in Gettysburg
• AOA’s Optometry’s meeting in Washington, D.C.
• POA’s CE in Italy trip

Keeping members updated during this time is the POA’s topmost priority. Here is an update on several of the committees and their current strategies:

THIRD PARTY COMMITTEE
This committee continues to work with the insurances we deal with every day. Their in-person meetings have been replaced with conference calls and Zoom events. They continue to advocate for us and work to resolve the ongoing issues between the insurance industry and optometrists as providers. Of utmost importance is their efforts to ensure that optometry is included in telehealth delivery of care to our patients.

LEGISLATIVE AFFAIRS COMMITTEE
The way the Pennsylvania Legislature functions during this pandemic has changed dramatically. There are no in-person meetings between our elected officials and constituents or lobbyists. Communication happens via email or phone calls. The LAC is working to update and modernize the optometric practice act as this pandemic has proven we are the primary eyecare profession and our diversity geographically increases patient access to urgent and emergency care.

Governor Tom Wolf has designated optometrists as life-sustaining providers. The Federal Government has recognized us similarly. We are on the frontline of urgent and emergency eye care statewide. The time is now to make your legislators aware of optometry’s expanded role during the pandemic and how we can continue to be a vital resource as we move out of this crisis.

CLINICAL EDUCATION COMMITTEE
The Clinical Education Committee has been working overtime to develop educational programs to assist members in renewing their licenses in 2020. The governor has allowed optometrists to obtain 100% of their credits for license renewal online for this renewal period only. The Committee sent out a survey to the membership and based on the responses have developed a series of webinars to include the core requirements for renewal and beyond. By now, you have hopefully participated in one or more of our web-based offerings. With the unexpected cancellation of our Spring Congress, the POA sustained a substantial loss of income. The Committee is doing what it can to give the membership what they need. Please support this endeavor when choosing the source of your online credits. Your financial support enables your professional organization to better support you!

As of now we are moving full steam ahead on our Fall Education Conference from October 23 to 24 at Seven Springs Mountain Resort. A few weeks ago, the POA emailed the membership a survey regarding continuing education this year and were encouraged by the number of members who still want to attend an in-person meeting this fall. Topics covering glaucoma, therapeutics, Act 31, and opioids for doctors still needing to meet the core requirements will be offered as well as additional educational topics.

I hope that you can appreciate all that the POA continues to do to support its membership. It is so very important to every Pennsylvania optometrist that the organization remains strong to support us in the coming weeks, months, and years. Your continued support of the POA and its programs is vital.

David Evans, O.D.

POA President

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:

HB 353 RE: Electronic Prescription Requirements for Controlled Substances
(by Rep. Tedd Nesbit, et al)

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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The 2015 Planning Session and Board of Directors Installation Dinner

For full size photos, please visit the POA on Facebook: www.facebook.com/PennsylvaniaOptometricAssociation. 

ICD-10: one month away!

The October 1st implementation date for ICD-10 is fast approaching. It is not too late to prepare. The AOA has available resources to assist our member doctors in preparing their practices for this major change. Don't be left behind; your claims will not be paid if you are not prepared!

Countdown to ICD-10 Implementation Date

Take these 10 steps to take to maximize the ICD-10 resources the AOA has available and prepare for ICD-10:

1. Order the Critical Resources You Need in Your Office - The AOA’s 2015 Coding Bundle, which includes the 2015 AOA ICD-10 Codes for Optometry Manual, the 2015 AMA Professional Edition CPT Manual and the AOA Express Mapping Card which provides ODs with a crosswalk from ICD-9 to ICD-10 for many commonly used diagnosis codes. Purchase the bundle here.

2. Review AOA’s 10 Part ICD-10 Webinar Series and 2 Hour ICD-10 Overview – This webinar series is available for review at any time. The series covers everything from how to prepare for the transition to ICD-10 to how to code for specific ocular conditions.

3. Check Your Progress – Many of the ICD-10 Webinars include brief quizzes so you can test your knowledge. Access the review material here.

4. Utilize AOA’s Coding Experts – AOA’s coding experts are available to answer your coding questions. Use the online form to contact AOA’s coding experts.

5. Review AOA Focus for ICD-10 FAQs - Each month AOA Focus includes a feature article on a timely coding topic written by AOA’s coding experts. Each article is accompanied by frequently asked questions. From May to October the FAQs are focusing specifically on common ICD-10 questions.

6. Utilize the AOA’s Online Coding Resource – AOACodingToday.com is a no cost, members only, online resource that houses ICD-10 and CPT information. The site allows you to browse ICD-10 codes and provides an ICD-10 crosswalk.

7. Watch for ICD-10 Articles in AOA Publications – Leading up to the implementation date, look for additional information and guidance in AOA’s publications such as AOA Focus, the AOA Alerts Page and the AOA News Page. 

8. Register for the Centers for Medicare & Medicaid Services (CMS) August 27 call “Countdown to ICD-10.” This call will be held five weeks prior to the ICD-10 implementation on October 1, 2015. A national implementation update will be provided along with coding guidance and tips, and updates from CMS.

9. Use AOA’s Website as a Gateway - AOA’s ICD-10 Resources Page includes links to ICD-10 tools and information from CMS, Medscape and other groups.

10. Contact AOA Staff – AOA’s Associate Director for Coding and Regulatory Policy is available for guidance on resource use and welcomes any suggestions for additional ICD-10 tools and resources doctors of optometry may need. Please contact Kara Webb at kcwebb@aoa.org.

Senator Kim Ward introduces Eye Care Freedom of Choice legislation

Senator Kim Ward (R-39) recently introduced SB978 in the Pennsylvania Senate. This bill would amend the Insurance Company Law of 1921 to ensure that competitive parity exists among eye care providers and that patient choice is protected by adding an article entitled “Quality Eye Care for Insured Pennsylvanians.”
This piece of legislation attempts to restore a “level playing field” in the eye care industry and ensure both patient freedom of choice when selecting a provider and providers’ freedom of choice to choose materials, fabrication and source of products and a uniform provider contract.
Recently, Senator Ward requested support for this bill from the Pennsylvania Optometric Association and the Pennsylvania Academy of Ophthalmology. Dr. Richard Christoph, POA president, responded to Senator Ward’s request offering POA’s support and assistance toward the passage of this piece of legislation.
We encourage POA members to familiarize themselves with this legislation by reviewing the information available on our website at www.poaeyes.org under Doctors, POA’s Legislative Priorities.

The POA honors Senator Don White with award

Each year, the POA honors a legislator who has proved him- or herself as a worthy friend of optometry. The POA's 2015 Distinguished Legislator Award was given to Senator Don White for his support and involvement with the introduction of important vision benefits bills, and advocacy efforts for patients and providers in the western Pennsylvania healthcare market.
Senator White had a previous engagement that prohibited his presence at the POA's annual Awards Ceremony during Congress. Members of the POA's staff and Third Party Center went to the Capitol and presented Senator White with his plaque.

PA optometrists now paid for additional procedure codes

In November of 2014, the POA sent a letter to the Department of Human Services requesting that optometrists get paid for ten Common Procedural Terminology (CPT) procedure codes. The POA is pleased to report that the department reviewed the optometrist’s Scope of Practice under the Pennsylvania State Board of Optometry and has determined that nine out of ten codes submitted for review will now be payable to optometrists.

For payment purposes, optometrists will be added to procedure codes 65778, 68761, 76510, 76511, 76512, 76516, 76519 and 92025, which already exist on the MA Program Fee Schedule. The department will issue a MA Bulletin to provide further payment information regarding these procedure codes to MA Program-enrolled optometrists. The department expects to issue the bulletin by the end of the first quarter of 2015.

The procedure code 83516, which was not added to the MA Program Fee Schedule, was left out because of the lack of specificity of the tested analyte. The department does not pay laboratories or physicians for this procedure code under the Fee-for-Service delivery system.

If the prescriber determines that the service reflected by procedure codes 65778, 68761, 76510, 76511, 76512, 76516, 76519 or 92025 is medically necessary, the prescriber may request a Program Exception through the 1150 Administrative Waiver Process, depending on the procedure specified in their MA Program Provider Handbook (Section 7.3), which is accessible by this URL: www.dhs.state.pa.us/cs/groups/webcontent/documents/form/s_001840.pdf.

Note: Optometrists rendering vision services under the managed care delivery system should address coding and payment questions to the appropriate managed care organization.

This is just another reminder of how the POA and its Third Party Center continually monitor payer issues and fights for you and your patients.

News You Can Use from the Third Party Center

By Dr. Mark Margolies
POA President-Elect

It was recently brought to the attention of the POA’s Third Party Center (TPC) that an in-office diagnostic test, InflammaDry, was being reimbursed by Medicare when performed by ophthalmologists, but not optometrists in Pennsylvania. Through a combined effort with our TPC colleagues in New Jersey, led by Dr. Charlie Fitzpatrick, we were able to get Novitas to correct this situation and now optometrists in Pennsylvania, as well as ten other states, are able to bill and get paid for this diagnostic test by Medicare.
Novitas administers the Medicare contract in eleven states and Washington, D.C. These states are Pennsylvania, New Jersey, Maryland, Delaware, Colorado, Oklahoma, New Mexico, Texas, Arkansas, Louisiana and Mississippi.
According to Rapid Pathogen Screening, Inc., InflammaDry is the first and only rapid, in-office test that detects MMP-9, an inflammatory marker that is consistently elevated in the tears of patients with dry eye disease. Using direct sampling microfiltration technology, InflammaDry accurately identifies elevated levels of MMP-9 protein in tear fluid samples taken from the inside lining of the lower eyelid, the palpebral conjunctiva.
In order to be able to perform and bill this test to Medicare, the first step is to apply for a CLIA certificate from CMS. The objective of the CLIA program is to ensure quality laboratory testing. The InflammaDry test is one of several that is exempt from the CLIA program, and therefore the next step is to obtain a CLIA Waiver to perform this test in your office. The needed forms can be found on the CMS.gov website. Click here for helpful information.
The InflammaDry test is billed with CPT code 83516QW. The code 83516 has historically been aligned with complex lab tests not used by eye care professionals. The new CPT code coupled with the QW modifier indicates that a CLIA certificate of waiver is required when used by eye care professionals.
If you are interested in adding this service to your practice, please contact Rapid Pathogen Screening at info@rpsdetectors.com or by calling (877) 921-0080.

ACA Resources for Optometrists

Need help navigating implementation of the ACA? Following are tools and resources to help Pennsylvania optometrists.

Guidance on employee health insurance marketplace notice requirements: federal government's FAQs or the Department of Labor's Technical Release 2013-02

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Tools and resources on the Health Insurance Marketplace enrollment process and coverage options in Pennsylvania

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Help for Pennsylvania small employers navigating the Health Insurance Marketplace

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Information on the Small Business Health Options Program (SHOP) and tax credits


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Access to Pennsylvania's Health Insurance Marketplace

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Information on new opportunities for optometrists to participate in insurance plans and treat new patients

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AOA Third Party Center resources and FAQs that explain the new marketplaces and assess participation in plans