TOA Update: May 1, 2008

Table of Contents

• President's Message
• Membership Critical to Survival of Associations AND Profession
• TOA Members Work For Parity and OptometricRepresentation in Washington
• UV Protection Sells and Saves Eyesight
• Optometry Must Play Active Role in Efforts to Build National Health Information Network
• 2008 Election Dates to Remember
• Find Your Legislator: http://www.fyi.legis.state.tx.us/

President's Message

It was truly impressive for TOA Secretary-Treasurer Stan Woo, OD, MS, FAAO and I to see the cross section of people that the Golden brothers, Dixon and Dennis, gathered to contribute to Gov. Rick Perry's re-election campaign in Center, TX this week. They brought in checks from a multitude of sources, for a total of more than $80,000. We also had a private audience with the governor that topped off an excellent evening with two of optometry's most politically connected optometrists

Once again, optometrists have proven their dedication to their community, their state, their education, and, of course, our profession. It is 'grassroots' at its best.

Thanks, Dixon and Dennis, from the TOA

Your friend,
Brian Blount, OD, President, TOA

[back to top]

Membership Critical to Survival of Associations AND Profession

By Steven Ezzell, OD, FAAO
Beverly Newhouse, OD
TOA Memership Co-Chairs

TOA's Membership Committee Chairs attended AOA's first annual Membership Rally in Washington DC last month.. Executive directors and membership chairs from all over the United States, along with AOA representatives, met to share information about the opportunities and challenges of recruiting and retaining new members. Spoken loud and clear were two messages that we all need to hear.

First, membership is essential to the strength of the AOA and TOA. Put another way, we need more members! Organized optometry represents our profession in every way. Attacks from medicine, defense against contact lens distributors,insurance discriminationand protection of our current optometry law are just a few examples of how the AOA and TOA represent our best interest as optometrists. Lack of membership causes a significant problem for organized optometry fighting on our behalf. It is hard to have much influence when our association only represents 50% of the optometrists in the state, especially, when the other side has greater representation or money. Surely,more than 50% of the optometrists in Texas care about the future of our profession. We need to work hard to increase our membership insuring that our voice has more volume and power.

Second, to successfully add new members there is no substitute for personal contact. Our legislativegrass roots efforts have shown this to be true and TOA membership is no different. The TOA can explain membership benefits again and again but nothing is more effective in recruiting a new member than a personal invitation from a friend and colleague. Other states proved that this works with membership of 80% and higher! Call a non-member colleague today and invite him/her to join us in our efforts to strive for excellence in optometry.

[back to top]

TOA Members Work For Parity and Optometric Representation in Washington

Jon Hymes, director of the AOA Washington office(left), Bill Elizondo, OD, Maria Elizondo present award honoring Rep. Ciro Rodriguez (right) for his work on Optometry's behalf.

TOA optometrists were part of a large contingent that blanketed Capitol Hill in April. Several legislators were honored by AOA, including Reps. Gene Green of Houston, Ciro Rodriguez of San Antonio, Joe Barton of Arlington and Ralph Hall of Rockwall. The issues that ODs took to Congress include:

• The National Health Service Corps Improvement Act (HR 1884) — an AOA-backed bill designed to expand access to eye and vision care by ending the exclusion of ODs from the National Health Service Corps student loan repayment and scholarship programs, key Federal incentives for health care providers to serve in medically underserved communities around the country
  
  
• The Optometric Equity in Medicaid Act (HR 1983) — an AOA-backed bill to provide full recognition to ODs physicians and providers of medical eye care through the Medicaid program and eliminate a loophole in Federal law that can be used by state bureaucrats and Medicaid third-party payers to restrict patient access.
  
  
• The Vision Care for Kids Act (S. 1117 / HR 507) — an AOA-backed bill designed to make funding for children's vision treatment programs a Federal government priority. S. 1117 / HR 507 recognize the link between healthy vision and learning and would establish a federal grant program to bolster children's vision initiatives in the states. HR 507 passed the U.S. House of Representatives in October 2007.
  
  
• The Contact Lens Consumer Health Protection Act (HR 2012) — introduced during the conference, this is an AOA-backed bill to provide for a Federal crackdown on prescription verification abuses by unscrupulous Internet and mail order contact lens sellers.

AOA touted a list of congressional successes that TOA optometrists helped pass including averting Medicare paycuts, securing federal funding for InfantSEE®, a bill to better care for wounded service personnel suffering from eye conditions and extending SCHIP.

[back to top]

UV Protection Sells and Saves Eyesight

Get Your Patients Ready for Summer

As summer approaches and more time is spent out in the sun, people start thinking more about UV protection. According to the AOA's 2007 American Eye-Q® survey, most people think about protecting their skin, but not their eyes. In fact, the survey found that 40 percent of Americans do not think UV protection is an important factor to consider when purchasing sunglasses. In light of this, the AOA is dedicating the month of May to educating consumers on the importance of UV protection and eye safety.

Beginning May 5, you can go to the TOA website for a press release to send to your local newspapers, plus important facts for your patients.

[back to top]

Billing, Coding and More

Optometry Must Play Active Role in Efforts to Build National Health Information Network

By Tony Tran, OD, MBA, FAAO

Federal and state health care officials met in Houston on April 15 - 16 at the National Health Information Technology Summit: a Washington-Texas Dialogue to discuss an initiative to build a National Health Information Network (NHIN), which would improve the quality of patient care and ultimately reduce health care costs. In 2004, President Bush set a goal for most Americans to have access to an interoperable electronic medical record by 2014. It has become clear that in order for this vision to be achieved, a consensus among stakeholders must be achieved.

In the first such conference of its kind in the country, the April 2008 Summit brought regional healthcare stakeholders together to facilitate consensus and provide input to local, state and federal government representatives, including the National Coordinator for Health Information Technology, Robert Kolodner, MD. It was a successful meeting with well over 100 in attendance-the exchange of ideas and information was clearly a step in the right direction.

Where does optometry fit in? AOA has encouraged optometrists to play an active role in shaping the Regional Health Information Organizations (RHIOs) that are established across the nation. RHIOs provide the basic building blocks for NHIN, under which all Americans are to have electronic health records (EHRs) that can be transferred among health care providers, making critical health information available whenever or wherever it may be needed. RHIOs, developing at the state and regional levels, provide the basic infrastructure through which these health records are transferred. In Texas, lawmakers have created the Texas Health Services Authority, a non-profit, public-private collaborative to foster regional collaboration and have directed state agencies to develop a system for sharing client data.

Electronic health records and the NHIN will reshape American health care. For that reason, it is imperative that optometrists play a very active part in developing the network and the standardized EHR that will be used for patients. Otherwise, there is a risk that the nation will adopt electronic health records that will not adequately meet the needs of eye care patients or practitioners. Moreover, there is the risk that optometry, as a profession, could be shut out of the network or relegated to second-class provider status.

Optometrists who join RHIO boards, become participating providers, or have information regarding their area RHIO should inform the TOA. Email Bj Avery at the TOA office at texop@aol.com.

Important Information for Medicare FFS Providers

May 7 is "Legacy Free" Day - An opportunity to check your NPI readiness!

CMS, in collaboration with the Healthcare Information and Management Systems Society (HIMSS), has requested clearinghouses that submit claims to FFS Medicare to participate in a one day NPI preparation exercise. Specifically, on Wednesday, May 7, 2008, participating clearinghouses should submit Medicare claims with NPI-only in all provider identifier fields for which a provider uses NPI/legacy pairs. On May 8th, participating clearinghouses will revert back to sending Medicare NPI/legacy pairs as received from the providers.

Through its monthly NPI messages, CMS has been requesting providers to begin testing NPI-only by sending a group of claims with NPI alone in primary provider fields. This "exercise" will result in feedback from your Medicare contractor on your readiness as it pertains to your National Provider Identifiers.

On May 7, 2008, participating clearinghouses will send Medicare claims with NPI-only in provider fields which originally contain NPI/legacy pairs from the provider. In other words, clearinghouses will strip the legacy identifiers when they are submitted as part of an NPI/legacy pair. Of course, fields already containing NPI-only will be sent to Medicare, as usual, and secondary provider identifier fields containing legacy-only will be sent to Medicare, as usual.

This exercise will help Medicare providers evaluate their NPI readiness prior to the May 23, 2008 deadline.

The outcomes of this exercise are described below:

• Claims are processed and paid by Medicare. Under this scenario, the provider can feel confident that their cash flow will not be affected by the May 23rd implementation date.

Or

• Claims are rejected or suspended. Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23rd. Resolution might include changes to the NPESS data or to the 855 enrollment record.

Again, on May 8, 2008, participating clearinghouses will revert back to sending Medicare NPI/legacy pairs, if sent to them by the provider.

Participating clearinghouses will be soon notifying provider clients about details so pay close attention to Clearinghouse communications.

Need More Information?

Still not sure what an NPI is and how you can get it, share it and use it? As always, more information and education on the NPI can be found through the CMS NPI page https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.

Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.

[back to top]

2008 ELECTION DATES TO REMEMBER

Voter Information Available:

June 6-7 — Democrats hold their state convention in Austin

June 12-14 — Republicans hold their state convention in Houston

June 14 — Green Party holds its state convention; location TBA

July 10-13 — Green Party holds its national convention in Chicago

August 25 — Democratic National Convention opens in Denver

September 1 — Republican National Convention opens in Minneapolis

November 4 — General election for all national, state, and county offices

[back to top]