prospectus v38 n4
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Prospectus is the newsjournal of the New York State Optometric AssociationTRANSCRIPT
Volume 38Number 4
2012
Letter from the President .......................1
Register today for CE-NY...................2
Legal & Legislative Corner .................2A Letter to the NYS Health Benefits Exchange .............................................3
Classified Ads ........................................9
High-Tech Classroom Tips ..................... 7
SUNY Names New Associate Dean ...8
New Dept. Chair at SUNY .................8
CVC at The Great NYS Fair ...............9
2012 NYSOA PAC Supporters...........16
2011 CVC Contributors ......................18
Photos from Optometry’s Meeting .....20
Photos from Student Bowl ..................22
Welcome New Members .....................24
NYSOA Business Partners ..................24
Contact Information ............................24
Prospectus (ISSN 1055-7407) is published by the New York State Optometric Association, Inc., 119 Washington Avenue, 2nd Floor, Albany, NY 12210. Postage paid at Albany, New York. Yearly subscriptions $25.00, single copies $5.50. The views and opinions expressed are those of the signed author and in no way should be construed to reflect the opinions or position of the editorial staff of Prospectus, or the New York State Optometric Association, its officers, local affiliate societies, or administrative staff. All submissions are subject to editorial change with regard to clarity or length. Final decision regarding acceptance or rejection of any submission lies with the editor.
prospectusWhen somebody starts a conversation with the phrase “Can I ask you to do something for me?” how do you respond? Do you eagerly wait to hear the favor so you can help? Do you cringe inside while you silently
get ready to make an excuse to get out of it? Usually it would depend on the person asking for the favor. A friend or family member would probably be more likely to get your attention than a casual acquaintance or total stranger. Most of us are more likely to respond favorably to someone we have helped in the past or someone who has helped us. All of us like to help others or I assume we would not have joined the profession of Optometry. It is one of the top reasons that I chose this profession. We do a lot of things for a lot of people on a daily basis and even though we are compensated for many of these actions, we help others whenever we get the chance.
For many years, the AOA and the NYSOA have done things for us on a daily basis. They watch out for your rights as an Optometrist by communicating with our legislators and third-party interests. As I have become more involved with organized optometry, I am always impressed with our colleagues that give their time and energy to protecting our profession. However, periodically, the NYSOA has to ask a “favor” of its members. The AOA is currently in the process of updating the technology involved in maintaining its membership database. Part of this process may involve the collection of our
dues. You may be surprised to find out (as I was) that there are some state affiliates that do not forward AOA dues to the AOA in a timely manner. To help ensure this does not lead to a cash flow problem, the House of Delegates voted in the recent Chicago meeting to change the criteria for dropping a member when they are late in paying their dues. Effective next year, members who have not made any payment by the end of the first quarter (March 31st) will be considered late and may be dropped. The responsibility of collecting the late dues will fall onto the affiliates. SO, I am asking my considerate colleagues in New York to please pay your dues in the first quarter. This is not an issue for most of our members but there are some who consistently neglect to pay until well into the end of the year. You would also save your association some costs (mailing, office staff time, etc.) if you paid on time. As a reminder, there are numerous ways to pay, including post-dated checks and credit cards.
We are also hoping that the technology upgrades will make it much quicker and simpler to pay in the future. (Paying your dues and contributing to PAC with your cell phone?) We will keep you informed as things change. Any input from you is always welcome on these matters.
Oh… and one more favor for me?? Please invite/bring a non-member to your next society meeting. The benefits of being a member continue to grow. We all need to join together to keep our profession strong.
Thank you for your support!
We Need Our Members to Do Something For UsBy Thomas J. Landry, OD, President
INSIDE THIS ISSUE
Thomas Landry, OD
a2 Volume 38
Number 42012
Registration Now Open!Register Today at
www.nysoa.org
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angiogenic agents and genetic analysis. This course will provide the training
needed to understand and utilize these advantages in the management of
optometric patients.
Course Director: Sherry Bass, OD, FAAO
Instructors: Diana Schechtman, OD, FAAO & Jerry Sherman, OD, FAAO
On August 1, 2012, Governor Andrew Cuomo signed into law a bill drafted and advocated for by the NYSOA which authorizes Optometrists to certify a vision disability for purposes of a person obtaining handicapped person automobile registrations and license plates. The bill had previously passed unanimously in the State Senate and Assembly through the strong leadership of our bill sponsors Senator Martin Dilan and Assemblyman David Gantt, and Senator Charles Fuschillo, Chair of the Senate Transportation Committee. Under prior law, only physicians, osteopaths, physician assistants, nurse practitioners, and podiatrists (for podiatric conditions only) were allowed to certify disabilities for the issuance of a distinctive motor vehicle registrations and license plates.
This new law becomes effective on August 31, 2012. The Department of Motor Vehicles will update the relevant application form (MV 664.1) – with the on-line form expected to be updated in the next few weeks and the pre-printed forms to be available from local DMV and town clerk offices in the next few months. Optometrists may lawfully complete the practitioner portion (Part 2 Medical Certification) of
the form after August 31st even though Optometrists may not be listed among the professionals authorized to complete the certification until DMV completes its updates.
This law is part of the NYSOA’s continued effort to ensure that state law reflects Optometrists’ medical scope of practice, in particular, and we will continue to examine other areas of law where the law needs to be updated. If you have any questions regarding this new law, please contact Jim Lytle or Jim Walsh, the NYSOA’s legal and legislative counsel, at (518) 431-6700.
Legal & Legislative CornerOptometrists Authorized to Certify Vision
Disability for Handicapped Parking Privileges
3prospectusA Letter to the NYS Health Benefits ExchangeRegarding New York State’s Approach to the Provision of Vision Benefits in the Health Benefit Exchange.
This letter was sent on August 13, 2012
On behalf of the New York State Optometric Association (NYSOA), these comments are being submitted, as requested, to address the State’s selection of benchmark plans for the Health Benefit Exchange and, in particular, the design of an appropriate vision benefit for New Yorkers.
Optometrists serve patients in every corner of New York State and, in many rural, urban and suburban neighborhoods throughout the State, they are the only accessible eye doctors available. Doctors of optometry provide more than two-thirds of all primary eye and vision health care in the United States and are responsible for most eye care services provided to children, for whom optometrists have long advocated for comprehensive eye examinations. While optometrists provide comprehensive routine vision examinations for both adults and children, they also render a full range of health care services that are, as noted below, otherwise included within the Essential Health Benefits.
In summary, on behalf of the patients served by optometrists, NYSOA has three principal goals with respect to the definition of Essential Health Benefits:
1. The pediatric vision benefit offered in the Exchange should be robust enough to provide children the care they require;
2. The vision benefit should be fully integrated with the balance of the healthcare services offered by the plans in the Exchange;
3. The State’s and the ACA’s non-discrimination provisions, which guarantee that optometrists can fully participate in the delivery of covered services, should be fully enforced—not just to protect the interests of our members, but to ensure that patients continue to exercise choice in the selection of their eye doctor and are not forced to receive uncoordinated and duplicative services from multiple providers.
Introduction and Overview: As you know, the Affordable Care Act of 2010 (ACA) identified a set of “essential health benefits” that health plans in the exchange and certain plans outside the exchange must offer starting in 2014. The scope of practice of optometrists in New York1 includes—and optometrists routinely provide—services that fall within several of the essential health benefit categories, including:
1 Section 7101 of the Education Law defines the scope of optometry as including the “diagnosing and treating optical deficiency, optical deformity, visual anomaly, muscular anomaly or disease of the human eye and adjacent tissue by prescribing, providing, adapting or fitting lenses or by prescribing, providing, adapting or fitting non-corrective contact lenses, or by prescribing or providing orthoptics or vision training, or by prescribing and using drugs.
a) Ambulatory patient servicesb) Emergency Servicesc) Rehabilitative and habilitative services and devicesd) Preventive and wellness service and chronic disease
managemente) Pediatric services, including oral and vision care
In December 2011, the Department of Health and Human Services (HHS) announced that states would be allowed to determine the details of the essential benefits based on what is covered by so-called “benchmark” plans in the states. The first four of the optometric-related services listed above are typically included within the health benefit offered by health plans in New York, while the pediatric vision benefit is often offered through a separate vision benefit plan.
According to the federal guidance, if the pediatric vision care is not included in the plan chosen by the state, then the benefit would be a comprehensive vision examination, along with coverage of the cost of materials to correct any vision errors discovered.
The pediatric vision benefit: We would strongly recommend that New York select a benchmark plan that includes a robust pediatric vision benefit that adequately satisfies the mandate for the essential benefit. As such, we recommend the selection of a benchmark plan that at a minimum provides coverage of the following items and services for individuals under 22 years of age:
• One comprehensive vision and eye health examination by an optometrist or ophthalmologist during each year; and
• Diagnosis and treatment of diseases, refractive errors, binocular disorders and injuries of the eye, adnexa and visual system, with treatment to include, but not be limited to, the use of corrective devices and other therapeutic procedures.
In addition, we recommend integrating the pediatric vision benefit with the balance of the enrollee’s health coverage. HHS recognized that relying on stand-alone vision plans for essential health benefits can contribute to fragmented medical care and potentially costly duplicative coverage.
continues on page 4
4 Volume 38Number 4
2012
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Looking for Part-Time OptometristDr. Tom Kaminska is looking for someone for Tuesday evenings and every other Saturday for his office in Cheektowaga. He will also need more extensive coverage from mid October to mid November. Please call for information: 716-631-2020
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A Northtown optician has a need for an optometrist for Saturdays from 9:30am-1:30pm. Reply to [email protected]
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Doctor of Optometry w/TMOD certification, full-time/part-time or Per Diem position for Western New York offices. Contact LJ [email protected] 716-307-6374www.eyewearone.com
CLASSIFIED ADS
continued from page 3
Enrollees that access routine vision care through a stand-alone vision plan may be identified as needing medically necessary eye care services that are covered by their medical plan—and the State should ensure that optometrists should be permitted to provide care and services that are squarely within their scope of practice if they have not also been credentialed by the health plan. Integrating the pediatric vision benefit as a covered service in the medical plan ensures seamless coordinated care and is consistent with longstanding state statutory requirements of non-discrimination—which are now further strengthened by the ACA non-discriminatory provisions, discussed below.
Justification for comprehensive pediatric vision coverage: The ACA’s inclusion of pediatric vision care is well supported. Vision disorders, including amblyopia, strabismus, and significant refractive errors, are the most prevalent disabling childhood conditions in the United States, with one in four children having some form of vision problem, as recently noted by the American Public Health Association APHA).2 One study estimates that about one-quarter of children between 6 and 18 wear corrective lenses.3 Further, as also noted by the APHA, impaired vision can affect a child’s cognitive, emotional, neurological and physical development, and is associated with developmental delays, lower educational attainment, and the need for special education, vocational and social services, often into adulthood.
Moreover, the Centers for Disease Control and Prevention (CDC) emphasizes that treating vision problems early may protect a child’s sight, and teaching children with severe vision loss how to function as early as possible can help
2 American Public Health Association, Resolution A8, “Reducing Barriers and Increasing Access to Children’s Vision Care Services,” Adopted November 2011.3 “Prevalence and Distribution of Corrective Lenses among School-Age Children,” A.R. Kemper, D. Bruckman, and G.L. Freed. Optometry and Vision Science, 81(1):7-10, 2004.
them reach their full potential.4 The objectives of Healthy People 2020 include reducing blindness and visual impairment in children and adolescents.
We understand that the proposed coverage of pediatric vision care would be in addition to the proposed coverage for other medically necessary pediatric medical care and well child care. It is critically important that the vision benefit not be merely subsumed within a routine well child visit. The reference to comprehensive vision and eye health examinations should include at least the following services when provided by an optometrist or ophthalmologist:
• Comprehensive ophthalmological services (a general evaluation of the complete visual system, including clinically indicated history, general medical observation, external and ophthalmoscopic examinations, gross visual fields, basic sensorimotor examination, and initiation of diagnostic and treatment program), and
• Clinically indicated objective and subjective determination of the refractive state and initiation of diagnostic and treatment program.
While well child care may include vision screening, such screening is not a substitute for more comprehensive eye examinations and related diagnosis and treatment services, especially since a recent study suggests that much of what is recommended is not accomplished in well-child care visits where mere seconds are devoted to the visual system.5
continues on page 10
4 Centers for Disease Control and Prevention, Fact Sheet, “Vision Loss,” www.cdc.gov.ncbddd/actearly/pdf/parents_pdfs/VisionLossFact Sheet.pdf, accessed November 11, 2011.5 See “Delivery of Well-Child Care: A Look Inside the Door,” C. Norlin, M.A. Crawford, C.T. Bell, X. Sheng, and M.T. Stein. Academic Pediatrics, 11(1):18-26, 2011.
Letter to the NYS Health Benefits Exchange, continued
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How many hours a day do children spend on computers or other electronic devices? New data from the American Optometric Association’s (AOA) 2012 American Eye-Q® consumer survey indicates 60 percent of parents estimate their children spend up to four hours per day at home or in school looking at a computer or digital device screen. With smartboards, tablets and other digital tools being incorporated into daily school curriculums, the technology has students spending much of their time learning and socializing in front of a screen.
“While these high-tech classrooms can greatly enhance learning, they can pose a number of challenges to the visual system,” said Michele Lagana, OD, NYSOA’s technology and vision expert. “Many of these issues can be solved with frequent breaks, proper set up of computer screens and yearly, comprehensive eye exams by a doctor of optometry.”
Continuous or prolonged use of technology can lead to computer vision syndrome (CVS), which may include eyestrain, headaches, fatigue, burning or tired eyes, loss of focus, blurred vision, double vision or head and neck pain. Pre-existing, uncorrected vision problems like farsightedness and astigmatism, difficulty with focusing or eye coordination can also contribute to discomfort associated with computer vision syndrome.
Parents and teachers can help students avoid CVS by encouraging them to follow the 20-20-20 rule. When using technology or doing near work, take a 20-second break, every 20 minutes, and view something 20 feet away. Studies show that people need to rest their eyes to keep them moist. Plus, staring off into the distance helps the eyes from locking into a close-up position.
According to the most recent AOA American Eye-Q® survey, 79 percent of parents are concerned that their child may be damaging their eyes due to technology use. Dr. Lagana explains, “Since these new classroom devices are so compelling to students, they tend to stare at them and use them for hours at a time, which fatigues their visual system. So, in addition to breaks, holding screens at the right height and distance is extremely important.”
The following NYSOA guidelines can help prevent or reduce eye and vision problems associated with computer vision syndrome:
• Check the height and arrangement of the computer. According to optometrists, a computer screen should be 15 to 20 degrees below eye level (about 4 or 5 inches) as measured from the center of the screen and held 20 to 28 inches away from the eyes.
continues on page 9
Small Adjustments Can Make a Big Difference on the Visual Demands Students Face in the Classroom
New York State Optometric Association offers tips to help students make the most out of high-tech classrooms
8 Volume 38Number 4
2012
New Associate Dean Named at SUNY
OptometryStewart Bloomfield, Ph.D has been appointed Associate Dean of Graduate Programs and Research and will also serve Director of the Graduate Center for Vision Research beginning January 2013. Stewart brings more than 30 years of experience in research and graduate education to the college and an outstanding record of internationally recognized research on retinal neurophysiology.
He is a graduate of SUNY Stony Brook and received his Ph.D from Washington University in St. Louis. The NIH’s National Eye Institute, has funded his research on retinal amacrine cell function since 1988. He has had other grants from NIH and the National Science Foundation and consistently translates his research to address a variety of clinical applications, particularly those involving neuronal loss such as in Alzheimer’s and Huntington’s disease, diabetic retinopathy, ischemic retinopathy, retinitis pigmentosa, and glaucoma.
Stewart currently holds the rank of professor in the Department of Physiology & Neuroscience and the Department of Ophthalmology at New York University( NYU) Medical School where has been honored for excellence in medical education. He also served as director of the medical school’s Graduate Program in Neuroscience and Physiology since 1999 and he has coordinated the Integrated Program in Neuroscience since 2009. He was the Principal Investigator and ran the medical school’s institutional doctoral and post-doctoral training programs in neuroscience funded by NIH.
New Dept. Chair Named at SUNY
College of OptometryAfter an extensive national search, Suresh Viswanathan, BSc Optom, MS, PhD has been appointed Chair of the Department of Biological and Vision Sciences at the SUNY
College of Optometry. He will begin January, 2013.
Dr. Viswanathan is currently a tenured Associate Professor at the Indiana University School of Optometry. He received a BS degree in Optometry from the Elite School of Optometry in Madras, India; a MS degree from Pacific University College of Optometry and a PhD from the University of Houston.
His research uses electrophysiological in vivo imaging and histology to examine the events contributing to neuronal cell death in glaucoma.
“ Dr. Viswanathan has had extensive teaching and administrative experience in biomedical and vision sciences providing an outstanding frame of reference to oversee the department’s curriculum. His teaching experience includes anatomy, systems physiology, general pathology, neuroanatomy, and neurophysiology of the visual system, “said Dr. David Troilo, Vice President and Dean for Academic Affairs.
Suresh Viswanathan, BSc Optom, MS, PhD Stewart Bloomfield, Ph.D.
9
continued from page 7
• Check for glare on the computer screen. If possible, windows or other light sources should not be directly visible when sitting in front of the monitor. If this happens, turn the desk or computer to prevent glare on the screen.
• Reduce the amount of lighting in the room to match the computer screen. A lower-wattage light can be substituted for a bright overhead light or a dimmer switch may be installed to give flexible control of room lighting.
• Keep blinking. To minimize the chances of developing dry eye when using a computer or digital device, make an effort to blink frequently. Blinking keeps the front surface of the eye moist.
Most importantly, as part of the yearly, back-to-school checklist, students should see a doctor of optometry for a comprehensive eye examination to ensure their eyes are healthy and functioning properly. The American Eye-Q® survey revealed 51 percent of parents do not include a visit to the eye doctor as part of their child’s back-to-school routine. Doctors of optometry can conduct specific tests that address and diagnose CVS and other vision and eye health issues, which include:
• Measuring visual acuity (sharpness and clarity) to assess the extent to which vision may be impaired.
• Checking to detect and correct nearsightedness, farsightedness or astigmatism.
• Testing how the eyes focus, move and work together.
“Early detection and treatment are keys to correcting vision problems and helping students see clearly,” said Dr. Lagana.
To find an optometrist in your area, or for additional information on children’s vision and the importance of back-to-school eye exams, please visit www.nysoa.org.
For more information, download the American Optometric Association’s public health report See Well Learn Well: 3D in the Classroom.
About the American Eye-Q® survey:The seventh annual American Eye-Q® survey was created and commissioned in conjunction with Penn, Schoen & Berland Associates (PSB). From May 9 – 16, 2012, using an online methodology, PSB conducted 1,009 online interviews among Americans 18 years and older who embodied a nationally representative sample of U.S. general population. (Margin of error at 95 percent confidence level)
Small Adjustments Can Make a Big Difference on the Visual Demands Students Face in the Classroom, continued
For the third year, the Children’s Vision Coalition presented a booth at The Great New York State Fair in Syracuse, NY. During the twelve days of the fair, optometrists, students, optometric staff, industry representatives and others volunteered their time to promote comprehensive eye examinations for children in the beginning stages of their school years. Marc Rubinrott, from Advance Optical and Linda Pattington from Essilor (pictured above) donated their time to staff the booth too! Special thanks to all of our volunteers:
Gary Marrone, ODTara Vaz, OD
Gerry Cairns, ODChris Shimos, OD & Staff
Michele Lagana, OD & Ian CoxMaureen Wallen, ODJason Hochreiter, OD
Richard Frio, ODThomas Landry, ODKristen Taddie, OD
Pam Theriot, ODLinda Pattington, Essilor
Marc Rubinrott, Advance OpticalDave Girardi, ODBridget Frio, ODSteven Baker, OD
Ed Cordes, OD & Gail CordesStudents from SUNY Optometry:
Anthony ZarellaMartin Bucharowski
Tina BuiClarissa KumAllison Coffie
CVC at The Great NYS Fair
10 Volume 38Number 4
2012
continued from page 4
Further, a June 2009 report of the National Commission on Vision and Health found that evidence from past studies shows that comprehensive eye exams for children by an optometrist or ophthalmologist are highly effective in detecting vision conditions.6
Newly available data confirm that typical vision screening is insufficient to ensure optimal vision and eye health. According to the most recent prevalence study, 3.8 percent of preschoolers have significant myopia (nearsightedness), 20.9 percent have significant hyperopia (farsightedness), 10.1 percent have significant astigmatism (irregular curvature of the eye), and 2.4 percent have significant strabismus (eye turn) as assessed through eye examination.7 In contrast, when using “visual acuity” as sole criteria, the most common methodology used in vision screening, only 5.6 percent of all preschool children were identified as warranting any concern, undoubtedly due to the fact that the Snellen eye chart predominantly assesses reduced visual acuity associated with myopia. If children are only provided with vision screening and not with a comprehensive eye examination, significant eye problems (hyperopia, astigmatism, and strabismus) will be missed and these children will be at increased risk of visual impairment, which can become a permanent disability if not treated early. For all of these reasons, Congress included pediatric vision care within the essential health benefits specified in the ACA.
Benchmark Health Plans: Congress required that the scope of the essential health benefits be equal to the typical employer plan. To establish what a typical employer plan looks like, Congress charged the Department of Labor with providing a survey of employer plans to the Secretary of Health and Human Services. The Department of Labor’s survey data, provided to the Secretary of HHS in an April 2011 report, has helped to inform the Department’s knowledge of the benefit content and scope of private and public sector employer plans. 8
6 “Building a Comprehensive Child Vision Care System.” A report of the National Commission on Vision and Health, Prepared by Abt Associates, Inc., June 2009, p. 1.7 National Institutes of Health The Multi-Ethnic Pediatric Eye Disease and Baltimore Pediatric Eye Disease Studies (NEI.2011)8 See U.S. Department of Labor, Selected Medical Benefits: A Report from the Department of Labor to the Department of Health and Human Services, April 15, 2011.
Letter to the NYS Health Benefits Exchange, continuedHowever, there are significant gaps in the data, particularly with respect to benefits such as pediatric vision care. No information is provided on the nature or extent to which pediatric vision care is covered by employer plans. The only information relates to employer-sponsored vision care that is not specifically targeted to children. Although data are not provided on the percentage of employer health plans that offer vision care, it is notable that employees with vision care tend to have similar vision benefits regardless of firm size. Moreover, for those employees with a vision care benefit, the benefit almost always includes coverage for comprehensive eye exams (99%) and glasses (100%); coverage for contact lens is nearly as high (88%).9
continued on page 12
9 See U.S. Department of Labor, National Compensation Survey: Health Plan Provisions in Private Industry in the United States, 2008. Table 47, Vision care benefits: Extent of coverage for selected services, private industry workers, National Compensation Survey, 2008. July 2009, Bulletin 2719,www.bls.gov/ncs/ebs/detailedprovisions/2008/ebbl0042.pdf
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2012
Letter to the NYS Health Benefits Exchange, continuedcontinued from page 10
To assist in the implementation of the essential health benefits, the Secretary of HHS requested the Institute of Medicine (IOM) make recommendations on the methods for determining and updating the essential health benefits. In carrying out its charge, the IOM examined available evidence of benefit coverage in today’s health insurance market including pediatric vision care. To do this, it looked at the coverage provided by three private insurers in the small group market. It found that while full pediatric vision care has not been a standard benefit of smaller employer plans, it has been available as policy riders. Moreover, the IOM noted that a Mercer employer survey data found that 44 percent of all employers (large and small) offer plans that provide pediatric vision care coverage. Although information on the nature of those services was not specified, the IOM also reported that for larger employers, pediatric vision care benefits, if offered, are likely to be offered as supplements to their standard medical plans.
To the extent that the “benchmark” plans did not include a pediatric benefit, HHS urged consideration of health insurance options offered through the Federal Employees Health Benefits Program (FEHBP), where pediatric vision care is commonly a covered benefit and consists of comprehensive eye exams and vision services (including eyeglasses and sometimes contact lenses). The more detailed nature of available information on FEHBP plan options suggests that pediatric vision care may, in fact, be more typical of coverage offered in the private market than is evident from other survey data and that such coverage generally consists of periodic (e.g. annual) comprehensive eye exams and glasses.
Integrating the vision benefit with health plans: Even though dental and vision benefits are frequently discussed together, significant differences exist between the two categories of health benefits. Vision benefits and the balance of health benefits often are extremely closely related: members of NYSOA frequently identify significant eye health issues when undertaking what may have begun as a routine comprehensive vision examination. Optometrists also typically manage the eye health needs of patients undergoing treatment for diabetes, glaucoma and other diseases, closely integrated with the provision of other health care services to these patients. It is, therefore, extremely important that vision and other health benefits
be fully integrated to make certain that enrollees are provided seamless comprehensive care with as little disruption as possible.
Many optometrists participate in vision carve out plans that cover routine eye examinations and coverage of eyeglasses and contact lenses. Many optometrists also participate as fully credentialed providers in health plans for care within their scope of practice—providing “medically necessary eye care” for their patients. The disconnect between the vision carve out company and health plan can provide barriers to access, impose additional and unnecessary costs and deprive beneficiaries of their choice of provider.
continued on page 15
15
continued from page 12
In some cases, an optometrist that participates in vision carve out may not be credentialed by the health plan—and therefore unable to provide the medically necessary care that the patient requires, even when the care and treatment is squarely within the optometrist’s legally defined scope of practice and clinical competence. As a result, the patient has to endure the expense, delay and inconvenience of contacting, scheduling and being re-examined by someone else, who may not be their chosen eye care provider.
Accordingly, every effort should be undertaken to ensure that services provided through vision plans be as coordinated as possible with the health plan and, to the extent possible, the pediatric (as well as, where applicable, any adult) vision benefit should be fully integrated and embedded within the essential health benefits offered by the health plans participating in the exchange.
Freedom of choice and anti-discrimination: Thanks to provisions of both state and federal law, the ability for optometrists to participate in managed care and insurance plans has strong legal protection. Sections 4235(f)(C) and 4301(b)(1)(C) of the Insurance Law have long guaranteed health insurance subscribers “freedom of choice” of eye care practitioners when the requested service is within the scope of practice of a licensed optometrist. Section 4403(5) of the Public Health Law provides that managed care organizations may not exclude “any appropriately licensed type of provider as a class” from their managed care network Much more recently, section 2706 of the ACA (the so-called “Harkin Amendment”) precludes plans from discriminating “with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.”
Each of these provisions speak to the importance of permitting appropriately credentialed health care practitioners, including optometrists, to fully participate in health plans for the provision of both pediatric and adult services.
Notwithstanding these provisions, some plans believe they have discharged their obligations to optometric practitioners by allowing them to participate only in the vision plan—and some practitioners choose not to provide routine vision
examinations or to sell eyeglasses and are effectively unable to provide services to any of the health plan’s enrollees. While some health plans have allowed vision care carve-out entities to provide coverage for “medically necessary” eye care, they are not always ideally situated to do it and the provision of care through the separate plan runs the risk of being uncoordinated with the rest of the patient’s health care. In order to ensure continuity of care and broaden enrollee’s choice of health care providers, it is essential that these anti-discrimination provisions be observed by the plans that participate in the Health Benefit Exchange.
* * * * * * * * * * * * * * *
Accordingly, we recommend that the New York State Health Benefit Exchange define a comprehensive pediatric vision benefit that fulfills Congress’ intent to require that meaningful and effective vision coverage be offered to children whose families are accessing care through the Exchange. We strongly recommend that the vision benefit be fully integrated with the health coverage otherwise offered on the exchange to avoid uncoordinated, discontinuous care. We urge the State to enforce longstanding provisions of State law and recently enacted provisions of the ACA that guarantee the rights of enrollees to access care from the categories of practitioners of their choice.
We appreciate your consideration of our comments and look forward to working with you to ensure that the children of our state receive the high quality healthcare they need and deserve.
Sincerely,
NEW YORK STATE OPTOMETRIC ASSOCIATION
Letter to the NYS Health Benefits Exchange, continued
16 Volume 38Number 4
2012
Thank you to the following optometrists who have supported NYSOA PAC in 2012!*
Elias S. Abboud, ODMatthew C. Allen, OD
Kathy L. Allen-Aquilante, ODRobert J. Ancona, OD
Julia J. Appel, ODLori E. Arbital, ODSamuel Arbital, OD
Jacqueline Armani, ODBrent D. Arnold, ODRobert B. Austin, OD
Henry A. Azrikan, ODJerry L. Baker, OD
Stephen M. Baker, ODAlice W. Bade, OD
Alan M. Bagun, ODFrancesco J. Barbarossa, OD
Sherry J. Bass, ODJustin Bazan, OD
Robert E. Behan, ODViktorya Belenkova, OD
Michael J. Benyo, ODEdward Berger, OD
Brian K. Berliner, ODJonah B. Berman, OD
Andrea S. Bernstein, ODIra J. Bernstein, OD
Paul R. Bernstein, ODMonica Bhasin, OD
Andrew Bienstock, ODTeresa Blackstone, OD
Stuart H. Blankman, ODBrian E. Bleiler, OD
Casimir K. Bobowski, ODCarolee R. Boyd, ODPamela J. Brown, ODAnne Brunenavs, ODDaniel Brunenavs, OD
Theodore J. Calabrese Jr., ODJeffrey Calhoun, ODLaura A. Cantie, OD
Gina M. Cardone, ODEric R. Carson, OD
Stephen Chambers, ODThomas Chao, OD
Vicki L. Chenarides, ODLillian F. Chin, ODPaul M. China, OD
Dale Ching, ODDawn Chivers, OD
Ida Chung, ODDavid N. Ciccone, OD
Alan Cohen, ODAllen H. Cohen, ODEzra M. Cohen, ODRoy B. Cohen, OD
Jennifer J. Colavito, ODChristopher J. Colburn, ODJoseph D. Conigliaro, OD
Vanessa Conenna, ODJeffrey S. Cooper, OD
Edward V. Cordes, ODGail E. Correale, ODPaul R. Cosenza, ODJohn J. Costello, ODMario J. Craig, OD
Alexander R. Crinzi, ODErnest E. Czapla, ODErrol S. Daniels, ODAllan E. Davis, ODAsghar Dedhar, OD
Gregory Disanto, ODJack L. Devore, ODDavid J. Dexter, OD
Kenneth R. Dickerson, ODAnne Dodgen-Averitt, OD
Ann M. Downey, ODDavid P. Dozack, ODMitchell W. Dul, ODPaul R. Edelman, OD
Jack Eisner, OD
Burt S. Eschen, ODBarry J. Farkas, OD
Daniel T. Farkas, ODDoron Feder, OD
Harvey O. Feldman, ODBrian Fengel, ODJennifer Ferri, ODMichael Ferri, OD
Despina S. Fikaris, ODMurray Fingeret, ODSusan S. Fisher, OD
Jennifer P. Flynn, ODKirk C. Flynn, OD
Lawrence Forur, ODRobert S. Fox, OD
Howard S. Fried, ODJack Fried, OD
Stuart A. Friedman, ODRichard A. Frio, OD
Gregory Gaglioti, ODJoseph P. Gambacorta, OD
Steven J. Ganz, ODJerome M. Garber, ODAngela E. Gardner, OD
Dana L. Getz, OD
Valerie A. Giangrande, ODDavid M. Girardi, OD
Steven Givner, ODGwenda R. Gnadt, OD
Ronald S. Goldstein, ODTraci M. Goldstein, ODBrad C. Gollinger, OD
Steven I. Goodman, ODVincent B. Graniero, OD
Robert S. Greenbaum, ODMark L. Greenberg, OD
Israel Greenwald, ODAnne Griffin, OD
Shari L. Gustin, ODScott F. Hage, OD
Demetra Hamakiotes, ODBruce R. Hankin, ODGary L. Hanley, ODJoseph Hargrave, ODPaul E. Harvey, OD
Gary A. Holtzberg, ODNadine M. Jamal, ODArthur D. Jung, ODBarri J. Jones, OD
Thomas M. Kaminska, OD
*Contributions through August 31, 2012Original photo of New York State Capitol Building courtesy of the Albany County Convention & Visitors Bureau.
17Allen I. Kaplan, OD
Sanford J. Katims, ODRichard S. Kavner, OD
Yoon K. Kim, ODDaniel Kirchheimer, OD
Daniel P. Kirkpatrick, ODBarry T. Kissack, ODIvan M. Klayman, OD
Roy A. Kline, ODDonald B. Knapp, ODLeslie R. Kolker, ODMartin Kornblatt, ODRalph Kornblatt, OD
Martin A. Kusnetz, OD Ketan Kutlerywala, ODJerome M. Kramer, ODJeffrey Kraushaar, ODStuart L. Krieger, OD
David M. Krumholz, ODMichael S. Krzyzak, ODRichard B. Krzyzak, ODMichele A. Lagana, ODLori Marie Landrio, ODMichael V. Landy, ODThomas J. Landry, ODWilliam J. Lapple, OD
Eric W. Lau, ODAlan S. Lax, OD
William J. Leahey, ODLawrence Z. Levy, ODDavid L. Leibstein, ODPatti L. Leonard, OD
Betty Liao, ODRocco F. Loccisano, OD
Laurence Lonky, ODMartin S. Losito, ODStella S. Lou Lee, OD
Mary Ellen Loughrey, ODLawrence A. Lupo, OD
Todd H. Lustig, ODRichard J. Madonna, OD
Marilyn Mann, ODSergio Marano, OD
Gary F. Marrone, ODMarie A. Marrone, OD
Katherine M. Mastrota, ODGerald G. Mattison, OD
J. Kent Maurer, OD
John J. Maurillo, ODMark R. Maxon, OD
Robert P. McCormick, ODMichael J. McGovern, OD
Ronald A. Meeker, ODBradley R. Meltzer, OD
Hal R. Mendel, ODMaria A. Michalski, ODRichard H. Milan, OD
Bari Miller, ODLawrence D. Miller, OD
Arlene Minkoff, ODAnthony Modesto, ODHenry W. Mole, ODAnthony Mondo, ODScott I. Morrison, ODJames O. Morse, OD
Harvey G. Moscot, ODRena Moy-Chang, ODJoseph J. Mueller, OD
David L. Naparstek, ODCharles H. Neu, OD
Christine L. Ng-Yow, ODVaishali Nigam, ODAnn M. Nolan, ODDeanna M. Nus, OD
Maureen C. O’Dwyer, ODMary E. O’Hara, OD
Kristin E. Orabone, OD Eric Orava, OD
David S. Orenstein, ODEleonora Orloff, OD
Catherine Pace-Watson, ODBrett M. Paepke, OD
Charles W. Paepke, ODGina M. Parsloe, OD
John Richard Paskowski, ODNehal P. Patel, OD
Ralph Paternoster, ODBrian D. Peralta, OD
Todd Pereira, ODAlec J. Perlson, OD
Vernon A. Peryea, ODBenjamin P. Peters, OD Raymond Pirozzolo, OD
John P. Plow, ODStuart M. Podell, OD
Sebastian A. Polizzi, OD
Sophie Poselle, ODRonald H. Poulin, OD
Brian Powell, ODIra M. Price, OD
Richard S. Price, ODTodd D. Punim, ODAmi C. Ranani, OD
John Ray, ODTina M. Reeves, OD
Fran L. Reinstein, ODSusan A. Resnick, OD
Sheldon S. Retkinski, ODDebbie C. Roodner, OD
Kevin D. Rosin, ODJoseph A. Ross, OD
Bruce P. Rosenthal, ODJeffrey M. Roth, OD
Neil Rubin, ODSteve D. Rubinstein, OD
John Rundquist, ODDaniella Rutner, ODAndrew J. Sacco, OD
Nicolette Sacco-Brown, ODDenise D. Saunders, ODLeonard J. Savedoff, OD
Catherine C. Scandiffio, ODJill Schafer, OD
Terry R. Scheid, ODAlan B. Schlussel, OD
Timothy J. Schwach, ODElliot Schwartz, OD
Steven H. Schwartz, ODTerry R. Schultz, OD
Matthew E. Sendker, ODNazanin Shams, OD
Mary Rita Sheehy, ODChristopher W. Shiomos, OD
James Sickler, ODDavid A. Siegel, OD
Margaret M. Siegrist, ODMarc M. Silverman, ODShelly L. Skjolaas, OD
Joel F. Sklar, ODJennifer Small, OD
Andrew P. Smith, ODRichard M. Soden, ODMichael P. Spellicy, OD Laura C. Sperazza, OD
Mark R. Stadlen, ODJames E. Stafford, ODJoseph M. Stamm, OD
Libby Sukoff, ODCarissa L. Swanson, ODWayne Tabachnick, ODBarry M. Tannen, ODAndrea P. Thau, OD
Pamlea E. Theriot, ODRajiv Trivedi, ODSonia Valle, OD
Justin J. Verrone, ODRyan Vida, OD
David J. Vinci, ODRalph R. Vogel, ODKai Wing Wai, OD
Lawrence J. Waite, ODWilliam J. Waldron, OD
Larry B. Wallace, ODMaureen K. Wallen, OD
Michael R. Waterman, ODThomas P. Webb, OD
David L. Weinberger, ODGary M. Weiner, OD
Patricia E. Weisenreder, ODBernard H. Weitz, OD
Jan Weitz, ODVincent A. Wesolowski, OD
Kamaljit S. Westfall, ODPaul J. Westfall, OD
Denise M. Whittam, ODAleksandra Anna Wianecka, ODJeffrey S. Williams Jr., ODYvonne M. Williams, OD
Craig F. Willoth, ODReem K. Wlaschin, ODRussell M. Wohl, OD
Grace K. Woo, ODKevin B. Wynne, OD
Eva Yan, ODHeidi Ying, OD
Lori A. Youngman, ODShandor Zelenger, OD
Allen F. Zuck, ODJoseph Zupnick, OD
18 Volume 38Number 4
2012
prospectus
*Contributions through August 31, 2012
Thank you to our 2012 CVC Contributors!*
Kathy L. Allen-Aquilante, ODRobert J. Ancona, OD
Julia J. Appel, ODLori E. Arbital, ODSamuel Arbital, OD
Jacqueline Armani, ODBrent D. Arnold, OD
Henry A. Azrikan, ODAlice W. Bade, OD
Alan M. Bagun, ODJerry L. Baker, OD
Stephen M. Baker, ODFrancesco J. Barbarossa, OD
Jason Bart, ODSherry J. Bass, ODJustin Bazan, OD
Robert E. Behan, ODViktorya Belenkova, OD
Michael J. Benyo, ODEdward Berger, OD
Brian K. Berliner, ODAndrea S. Bernstein, OD
Ira J. Bernstein, ODPaul R. Bernstein, ODMonica Bhasin, OD
Andrew Bienstock, ODTeresa Blackstone, ODBrian E. Bleiler, ODCarolee R. Boyd, ODPamela J. Brown, OD
Nancy M. Bulas-Wadas, ODGrace Y. Burke, OD
Theodore J. Calabrese Jr., ODLaura A. Cantie, OD
Gina M. Cardone, ODStephen Chambers, OD
Thomas Chao, ODVicki L. Chenarides, OD
Lillian F. Chin, ODPaul M. China, ODDawn Chivers, OD
Ida Chung, ODDavid N. Ciccone, OD
Alan Cohen, ODAllen H. Cohen, ODEzra M. Cohen, OD
Roy B. Cohen, ODJennifer J. Colavito, OD
Christopher J. Colburn, ODJoseph D. Conigliaro, OD
Vanessa Conenna, ODJeffrey S. Cooper, OD
Edward V. Cordes, ODJohn J. Costello, OD
Alexander R. Crinzi, ODErnest E. Czapla, ODErrol S. Daniels, ODAsghar Dedhar, ODDavid J. Dexter, OD
Kenneth R. Dickerson, ODChristopher J. Digiorgio, OD
Gregory Disanto, ODAnne E. Dodgen-Averitt, OD
Anne M. Downey, ODDavid P. Dozack, ODMitchell W. Dul, ODPaul R. Edelman, OD
Jack Eisner, ODMarina Epelman Meyerowitz, OD
Burt S. Eschen, ODBarry J. Farkas, OD
Daniel T. Farkas, ODDoron Feder, OD
Harvey O. Feldman, ODBrian Fengel, ODJennifer Ferri, ODMichael Ferri, OD
Despina S. Fikaris, ODSusan S. Fisher, OD
Jennifer P. Flynn, ODKirk C. Flynn, OD
Howard S. Fried, ODJack Fried, OD
Stuart A. Friedman, ODRichard A. Frio, ODRobert S. Fox, OD
Gregory Gaglioti, ODSteven J. Ganz, OD
Angela E. Gardner, ODDana L. Getz, OD
Valerie A. Giangrande, ODSteven Givner, OD
Ronald S. Goldstein, ODTraci M. Goldstein, ODGwenda R. Gnadt, OD
Vincent B. Graniero, ODMark L. Greenberg, OD
Israel Greenwald, ODScott F. Hage, OD
Demetra Hamakiotes, ODGary L. Hanley, OD
Bruce R. Hankin, ODPaul E. Harvey, OD
Nadine M. Jamal, ODBarri J. Jones, OD
Arthur D. Jung, ODThomas M. Kaminska, OD
Allen I. Kaplan, ODSanford J. Katims, ODRichard S. Kavner, OD
Yoon K. Kim, ODDaniel Kirchheimer, OD
Barry T. Kissack, ODIvan M. Klayman, OD
Linda M. Kleinhenz, ODRoy A. Kline, OD
Martin Kornblatt, ODRalph Kornblatt, OD
Jerome M. Kramer, ODJeffrey Kraushaar, OD
David M. Krumholz, ODRichard B. Krzyzak, ODMartin A. Kusnetz, ODKetan Kutlerywala, ODMichele A. Lagana, ODLori Marie Landrio, ODThomas J. Landry, ODWilliam J. Lapple, OD
Eric W. Lau, OD
19
Alan S. Lax, ODWilliam J. Leahey, ODDavid L. Leibstein, ODPatti L. Leonard, OD
Lawrence Z. Levy, ODBetty Liao, OD
Laurence Lonky, ODMartin S. Losito, ODTodd H. Lustig, ODMarilyn Mann, ODSergio Marano, OD
Marie A. Marrone, ODKatherine M. Mastrota, OD
J. Kent Maurer, ODJohn J. Maurillo, ODMark R. Maxon, OD
Bradley R. Meltzer, ODMaria A. Michalski, OD
Bari Miller, ODDean M. Miller, OD
Lawrence D. Miller, ODArlene Minkoff, OD
Anthony Modesto, ODScott I. Morrison, ODJames O. Morse, OD
Rena Moy-Chang, ODDavid L. Naparstek, OD
Leroy D. Nelson, ODCharles H. Neu, OD
Christine L. Ng-Yow, ODVaishali Nigam, ODAnn M. Nolan, OD
Deanna M. Nus, ODMaureen C. O’Dwyer, OD
Mary E. O’Hara, ODKristin E. Orabone, OD
Eric Orava, ODDavid S. Orenstein, OD
Eleonora Orloff, ODCatherine A. Pace-Watson, OD
Gina M. Parsloe, ODJohn Richard Paskowski, OD
Ralph Paternoster, ODBrian D. Peralta, OD
Todd Pereira, ODAlec J. Perlson, OD
Vernon A. Peryea, ODBenjamin P. Peters, ODRaymond Pirozzolo, OD
John P. Plow, ODSebastian A. Polizzi, OD
Sophie Poselle, ODRonald .H Poulin, OD
Brian Powell, ODElizabeth H. Pradhan, OD
Ira M. Price, ODRichard S. Price, OD
John Ray, ODFran L. Reinstein, ODSusan A. Resnick, OD
Sheldon S. Retkinski, ODDebbie C. Roodner, OD
Deborah S. Rose, ODBruce P. Rosenthal, OD
Kevin D. Rosin, ODJoseph A. Ross, ODJeffrey M. Roth, OD
Neil Rubin, ODJohn Rundquist, ODDaniella Rutner, ODAndrew J. Sacco, OD
Denise D. Saunders, ODLeonard J. Savedoff, OD
Catherine C. Scandiffio, ODTerry R. Scheid, OD
Alan B. Schlussel, ODJanet R. Schmukler, OD
Elliot Schwartz, ODSteven H. Schwartz, ODMatthew E. Sendker, OD
Mary Rita Sheehy, ODChristopher W. Shiomos, OD
James Sickler, ODMargaret M. Siegrist, ODMarc M. Silverman, ODShelly L. Skjolaas, OD
Jennifer Small, ODRichard M. Soden, ODMichael P. Spellicy, OD Laura C. Sperazza, ODMark R. Stadlen, ODJames E. Stafford, OD
Libby Sukoff, ODCarissa L. Swanson, ODWayne Tabachnick, ODBarry M. Tannen, OD
Andrea P. Thau, ODPamlea E. Theriot, OD
Rajiv Trivedi, ODJustin J. Verrone, OD
Ryan Vida, ODDavid J. Vinci, OD
Ralph R. Vogel, ODKai Wing Wai, OD
Larry B. Wallace, ODMaureen K. Wallen, OD
Michael R. Waterman, ODDavid L. Weinberger, OD
Patricia E. Weisenreder, ODBernard H. Weitz, OD
Jan Weitz, ODVincent A. Wesolowski, OD
Kamaljit S. Westfall, ODPaul J. Westfall, OD
Denise M. Whittam, ODAleksandra Anna Wianecka, OD
Yvonne M. Williams, ODReem K. Wlaschin, ODRussell M. Wohl, OD
Grace K. Woo, ODKevin B. Wynne, OD
Eva Yan, ODLori A. Youngman, ODShandor Zelenger, OD
Allen F. Zuck, ODJoseph Zupnick, OD
20 Volume 38Number 4
2012
Photos from Optometry’s MeetingJune 27-July 1, 2012 · Chicago, Illinois
Ida Chung, OD carries the New York flag at Optometry’s Meeting
Susan Fisher, OD, NYSOA President-Elect with Ida Chung, OD, NYSOA Secretary/Treasurer
The AOA House of Delegates Meeting
Denise Whittam, OD represents NYSOA on the credentialing committee
Thomas Wong, OD at Optometry’s Meeting
Tom Landry, OD, NYSOA President
The Doctors Pirozzolo: NYSOA Past President, Frank and his son, Ray, NYSOA Young OD Chair
Andrea Thau, OD, AOA Trustee with Christopher Quinn, OD, AOA Trustee
Susan Fisher, OD, NYSOA President-Elect with her husband, David Tobias
21
Denise Whittam, OD, NYSOA Immediate Past President and CVC President with Andrea Thau, OD, AOA Trustee
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Ron Hopping, OD becomes the new AOA President
Ron Hopping, OD addresses the audience at the AOA House of Delegates Meeting
Richard Soden, NYSOA Third Party Consultant with Denise Whittam, OD, NYSOA Immediate Past President and CVC President
Ron Hopping, OD, AOA President and his wife, Desiree Hopping, OD
Photos courtesy Denise Whittam, OD
22 Volume 38Number 4
2012
Photos from the Varilux® Optometry Student Bowl™ XIX at Optometry’s Meeting
23
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NYSOA Elected OfficersPresident
Tom Landry, ODCorning, NY
Susan Fisher, ODN. Bellmore, [email protected]
Vice President Christopher Colburn, OD
Jamestown, NY [email protected]
Secretary/TreasurerIda Chung, ODNew York, NY
[email protected] Past-President
Denise Whittam, ODNew York, NY
Executive Director Jan S. Dorman
[email protected] Editor-in-Chief
Denise Whittam, [email protected]
Prospectus Managing Editor Jessica Stephenson
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Welcome New NYSOA Members!*
CENTRALAndrew Lindell, OD
Yaw Saarrah-Akyere, OD
EASTERNJudith Archibold, OD
HUDSON VALLEYJanessa Hartman, OD
NASSAUMarina Grapp, OD
OSCONYJaclyn Bruno, ODDavid Chau, OD
Marta Fabrykowski, ODLucienne Jacob, OD
Neil Satija, ODJolyn Tran, OD
ROCHESTERVadim Guy, OD
James Sementilli, OD
SOUTH CENTRALAngela Croteau, OD
Paul Russo, OD
SUFFOLKGrace Tan, OD
WEST-ROCK-PUTSijimol Sujoy, OD
WESTERNElizabeth Hetrick, OD
*June 15, 2012 through August 31, 2012