Volume 9, Issue 44 │November 21, 2025

Editor's Note: The IOA office will be closed Thursday November 27th through Friday November 28th observance of Thanksgiving.

License renewals are just around the corner, attend the IOA Winter CE Series! Each session offers 6 tested hours, registration is now OPEN!

The IOA is gathering insights to strengthen optometry across Illinois. Please fill out the anonymous survey & upon completion you will receive a link for your chance to win a $100 gift card!

2026 membership dues invoices have been sent! 🎉

This year, the 2026 dues contest will be related to making your dues payment via Zelle. Zelle is a direct and fast way to send and receive money that will reduce transaction costs to the Association. Details on making your dues payment via Zelle will be located in your invoice mailing and emails.

If you are planning on retiring before the end of 2025 or in 2026, please reach out to discuss membership options.

Attention Controlled Substance License Holders: Overview of Illinois E-Prescription Mandate and Waiver Options (P.A. 103-0425)



Effective January 1, 2024, Illinois requires prescribers to issue electronic prescriptions for controlled substances. However, two waiver options are available through the Illinois Department of Financial and Professional Regulation (IDFPR):

1. Economic Hardship Waiver:

• Available until January 1, 2026, for prescribers who can demonstrate financial difficulty in obtaining or managing an e-prescribing system.
• Starting January 1, 2026, only those who have received a federal CMS waiver for economic hardship under the Electronic Prescribing for Controlled Substances (EPCS) program may qualify.
• Requires documentation of annual income and two cost quotes for e-prescribing setup (kept by licensee, submitted upon request).

1. Low-Volume Waiver:

• Applies to prescribers who issue 150 or fewer prescriptions in a 12-month period.
• Starting January 1, 2029, this threshold drops to 50 prescriptions per year.
• Certification is made via an attestation question on license renewal; no documentation required initially.

Additional Details:

• Waivers can be reapplied for during renewal cycles.
• There is no set deadline for requesting waivers, but starting in 2026, hardship waivers require federal CMS proof of hardship from the prior compliance year.

This week IOA's Chicago North Side Society President Dr. Justin Kwan & IOA Public Health Director Dr. Caitlyn McHugh-Glab joined fellow Change Agents in D.C. to spotlight the myopia crisis and advocate for solutions.

MEMBER BENEFIT: FREE On-Demand CE!

Don't forget! The IOA offers FREE On-Demand CE, as part of your membership you gain access to a variety of free continuing education courses. Courses for the 2024-2026 licensing cycle are now available on the On-Demand CE platform. ODs can take all 18 regular hours of CE online through the On-Demand CE Series.

As an Illinois licensed CE provider, all courses taken through IOA will count for an Illinois license renewal. 

The Eyes on Tomorrow Fund, previously known as the Legislative Equity Fund, is a dedicated resource created by and for optometrists to support the Illinois Optometric Association’s (IOA) state-level advocacy efforts. This fund directly empowers optometry’s fight for scope expansion, the regulation of Vision Benefits Managers (VBMs), and other legislative battles crucial to protecting the profession and ensuring patient care. Unlike political action committees (PACs), this fund is not used to support candidates but instead provides critical resources for advancing optometry in Illinois.

The PAC (Political Action Committee) is a group organized to promote its members' views on selected issues, usually through raising money that is contributed to the campaign funds of candidates who support the group's position to keep our friends in office. Now more than ever, we need strong, principled leaders who will fight for equal rights, and access to essential services —Will you pitch in today to help us protect our profession and the patients we serve?

Contributions to the IOA PAC can be made as a One-Time Donation or as Recurring Monthly Donation and deducted automatically from donor's bank account or charged to their credit card. Selecting to contribute a set amount on a monthly basis is a painless and effortless way to contribute to and support the IOA PAC. Contributions to the IOA PAC fund are not deductible for federal income tax purposes.

Eye care practitioners should report all violations of the FCLCA, including instances in which contact lens sellers fail to comply with the prescription verification provisions of the law.

Filing a complaint? Use the resources below to get started.

If you believe a health insurance company is violating the Vision Care Plan Regulation Act, please file a complaint with the Illinois Department of Insurance by following the link below. If appropriate, please also encourage your patients to file a complaint. Doing so is what drives the Department of Insurance to take action against insurance companies who aren’t following the law. File a complaint with the Department of Insurance at the link below. 

Vision Plans & Insurance Companies:

Dept of Insurance Complaint Submission - How to File a Complaint

Office of the Illinois Attorney General - File a Complaint

Report illegal and unsafe contact lens sales to the FDA & FTC:

Fairness to Contact Lens Consumers Act compliance and safety | AOA

IDFPR:

IDFPR | File a Complaint

Medicaid Managed Care Complaint Portal:

Managed Care Provider Resolution Portal | HFS

1/25: IOA Winter CE Series | Effingham, IL

2/22: IOA Winter CE Series | Itasca, IL

3/1: IOA Winter CE Series | Tinley Park, IL

2026 Medicare Physician Fee Schedule: What to Know About the Rule

AOA | Staff

November 11, 2025

Key Takeaways

• The qualifying APM conversion factor increased by 3.77% while the nonqualifying APM conversion factor increased by 3.26% with the final rule.
• CMS reduced indirect practice expense RVUs for services delivered in the facility setting, impacting reimbursement for care provided in these settings. 
• CMS removed the distinction between provisional and permanent telehealth services, and all Medicare Telehealth Services List are now considered included on a permanent basis.
• CMS considered AOA feedback in several additional updates, ranging from code valuations to MIPS QPP and more.

Most doctors of optometry will see a slight pay increase under the 2026 Medicare Physician Fee Schedule (PFS) as the AOA continues to stress a stable pay structure from the nation’s largest health insurer. 

Published by the Centers for Medicare & Medicaid Services (CMS) on Oct. 31, the Medicare PFS Final Rule announced a slew of changes taking effect on Jan. 1, 2026, to not only the Medicare conversion factor but also telehealth services, facility setting practice expenses, code valuations, quality payment program (QPP) measures and thresholds, and more.  

Last-minute advocacy by the AOA and other physician organizations ensured the 2.5% pay increase was included as part of H.R. 1, reversing an anticipated statutory cut for 2026. These efforts are the groundwork for long-term reforms that would mandate annual positive pay updates consistent with inflation. This legislation is reflected in the final rule.   

In addition, CMS finalized other provisions that also impact Medicare pay and made several other policy changes outlined by Medicare’s final rule. Below is a roundup of pertinent 2026 PFS changes and the AOA’s advocacy: 

Facility setting practice expense reduction 

CMS opted to reduce physician pay rates for services performed in facilities, e.g., hospitals or ambulatory surgical centers. Beginning in 2026, CMS will reduce the portion of the facility practice expense (PE) relative value units (RVUs) allocated based on work RVUs to half the amount allocated to non-facility PE RVUs. The AOA and other physician groups raised concerns with CMS’ proposed rule, yet the agency finalized the reduction. 

Telehealth services 

CMS streamlined the review process for adding services to the Medicare Telehealth Services List by removing the distinction between “provisional” and “permanent” services, making all services included on a permanent basis. The AOA has supported this proposal. 



Efficiency adjustment 

CMS will apply a 2.5% decrease to the work RVUs and physician intra-service time for nearly 9,000 physician services expected to see efficiency gains from technology and practice changes. As stated in its final rule, CMS believes time assumptions built into the valuation of many services are inflated and, therefore, finalized an “efficiency adjustment” that applies to all codes with a few exemptions: 

• Standalone evaluation and management (E/M) services are exempt regardless of whether the E/M visit is billed based on time or medical decision-making.
• Eye exam codes are exempt to this adjustment.
• Time-based codes, services on the Medicare Telehealth Services List and new codes for 2026 are exempt. 

The CMS will apply this efficiency adjustment to the intraservice portion of physician time and work RVUs every three years. The adjustment will impact most surgical specialties, radiology and pathology by reducing their overall payments. 

Code valuations 

CMS will use their proposed work RVU of 0.29 for CPT code 92284, as opposed to the RUC-recommended crosswalk to CPT 92282 with a work value of 0.32 RVU. The AOA supported the CMS proposal to accept the RUC-recommended direct PE inputs for CPT code 92284 but opposed the CMS proposed work RVU of 0.29 for CPT code 92284. 

QPP updates and MIPS 

CMS will maintain the Merit-based Incentive Payment System (MIPS) performance threshold to avoid a 9% penalty at 75 points for the CY 2026 performance period (2028 MIPS payment year) through the CY 2028 performance period (2030 MIPS payment year). 

CMS also adopted a two-year informational-only feedback period for newly implemented MIPS cost measures.  

Lastly, MIPS-eligible clinicians must adhere to updated cybersecurity requirements, including maintaining an inventory of connected devices and performing a security risk assessment.  

Primary open-angle glaucoma (POAG): Optic nerve evaluation 

CMS finalized an AOA-supported revision that would clarify that evaluations must occur during the measurement period, rather than “within 12 months.” 

Diabetes eye exam 

CMS will not remove the MIPS CQM collection type for this measure in order to support MIPS reporting for smaller and rural practices, in alignment with the AOA’s concerns over revision language. 

POAG reduction of IOP 

CMS finalized changes to measure Q141 with a 1-year delay in implementation. The change will be included in the measure specification for the CY 2027 performance period (2029 MIPS payment year). The AOA will provide additional information to affected physicians. 

10 Big Themes for AI in Healthcare Heading Into 2026

Beckers Hospital Review | By Laura Dyrda

November 18, 2025

Artificial intelligence has evolved from experimental pilots to a foundational part of healthcare strategy.

Across eight sessions at the Becker’s CEO + CFO Roundtable AI Summit, hospital and health system leaders described how they are moving beyond hype to build governance, data discipline, and measurable impact. Ten key themes emerged that define where AI in healthcare stands today — and where it’s headed next.

Join us at the next AI Summit during the 16th Annual Meeting on April 14! Learn more and register here.

1. ROI encompasses people as much as profit. Health system leaders are redefining return on investment to include time savings, workforce satisfaction, and patient experience, not just financial returns. Many organizations are measuring success by reduced clinician burnout, improved documentation accuracy, and better care coordination alongside cost savings.

2. Data quality is the cornerstone of AI success. Every discussion reinforced that reliable data is the true infrastructure for AI. Without standardized, interoperable, and well-governed data, predictive tools fail to deliver consistent results. Health systems are investing heavily in cleansing data pipelines, strengthening interoperability, and building enterprise-level analytics teams to support trustworthy insights.

3. Governance defines responsible innovation. Formal AI governance frameworks are now essential. Hospitals are establishing multidisciplinary committees that include clinical, operational, cybersecurity, and ethics leaders to review algorithms before deployment. This structure helps balance innovation with safety, transparency, and compliance.

4. Transparency and trust drive adoption. Executives emphasized that successful AI depends on transparency — how models are trained, monitored, and updated. Hospitals expect vendors to provide explainability, audit trails, and ongoing validation. Building trust requires consistent communication about model performance and safety, not just accuracy claims.

5. Predictive AI Is delivering measurable impact. AI is beginning to fulfill its promise in clinical settings. Predictive models for patient deterioration, chronic disease management, and readmission prevention are producing tangible results, improving outcomes while reducing mortality and length of stay. Hospitals that pair these tools with strong workflows and human oversight are seeing the biggest gains.

6. Ambient and agentic AI are transforming clinical workflows. AI-driven documentation tools are freeing clinicians from administrative burden and improving engagement. Many systems have reported substantial reductions in after-hours charting and significant increases in physician satisfaction. A new wave of agentic AI tools — automated voice and text agents — are extending this value to scheduling, patient outreach, and care coordination.

7. Ethical data sharing and consent are emerging priorities. Health systems are embracing privacy-preserving methods that allow data collaboration without compromising patient privacy. At the same time, leaders are calling for clear standards on patient-level consent and data provenance. Ethics, fairness, and accountability are becoming central to AI strategy discussions.

8. Long-term partnerships matter more than point solutions. Hospitals are increasingly cautious about one-off pilots and unproven startups. They are prioritizing vendors with financial stability, proven integration capabilities, and long-term support plans. Sustainable partnerships — those built around shared outcomes and governance — are replacing transactional contracts.

9. Regulation and standards are on the horizon. The industry expects stronger oversight and standardization in the near future. Health systems and coalitions are already developing frameworks for testing, validation, and assurance modeled after regulated industries. Early adopters view this as an opportunity to establish credibility and consistency across AI deployments.

10. AI’s true value lies in empowering people. Across all sessions, leaders agreed that AI’s greatest potential lies in amplifying — not replacing — human expertise. Whether reducing burnout, improving accuracy, or giving clinicians more time for patient care, the technology’s success will ultimately be measured by how well it enhances human performance and connection.

Meibomian Gland Features ‘Directly Related’ to Tear Lipid Film Thickness

Healio | By Justin Cooper

November 17, 2025

BOSTON — A thicker tear lipid layer results from having a greater number of thicker, longer and more tortuous meibomian glands, with greater density and less atrophy, in both the upper and lower eyelids, according to a study presented here.

“Meibomian glands show a lot of different characteristic features. However, in clinical settings and a lot of research, we still only focus on meibomian gland atrophy assessment,” Meng Lin, OD, PhD, director of the UC Berkeley Clinical Research Center, said at Academy 2025. “We would like to develop a tool to quantify more characteristic features of these glands other than atrophy.”

A thicker tear lipid layer results from having a greater number of thicker, longer and more tortuous meibomian glands, with greater density and less atrophy, in both the upper and lower eyelids. 

Lin and colleagues used a deep learning model to analyze 2,233 meibography images from 560 subjects, captured using the Oculus Keratograph 5M. Linear mixed effects models were used to assess associations between lipid thickness, tear film stability and meibomian gland features, including gland quantity, density, length, width, tortuosity and local contrast.

“We used a convolutional neural network to train a supervised machine learning model to rapidly quantify features,” Lin said. “We used human-annotated images as a ground truth for training and also testing. Then we also validated our model with a novel set of images that our AI has never previously seen.”

According to the results, in the upper eyelid, meibomian gland features, except contrast and the number of glands, had significant relationships with lipid thickness (P < .05), with the lower eyelid demonstrating similar trends.

“Longer, wider, more tortuous glands with greater density but less atrophy will lead to clinically significant difference in tear lipid thickness,” Lin said.

Fewer features had links to tear film stability.

A longer noninvasive breakup time was linked to greater contrast (P = .001) in the lower eyelid. In the upper eyelid, shorter breakup time was significantly associated with greater meibomian gland atrophy (P = .029) and higher quantity of glands (P = .042), the latter of which Lin described as “kind of counterintuitive.”

“We did some post hoc analysis, and we realized ... there are many, many skinny and thin meibomian glands in those images,” she said. “We know from our previous work that thin glands actually reflect poor quality of meibum, so it’s very possible that they are driving this finding.”

Overall, the results show that “meibomian gland morphology does encode information directly related to tear lipid thickness,” Lin said.

“Not so much for the tear film stability,” she added. “Tear film stability is more downstream, so many other factors may also affect the tear film stability.”

401(k) Limit Increases to $24,500 for 2026, IRA Limit Increases to $7,500

IRS | Press Release

November 13, 2025

WASHINGTON — The Internal Revenue Service announced today that the amount individuals can contribute to their 401(k) plans in 2026 has increased to $24,500, up from $23,500 for 2025.

The IRS today also issued technical guidance regarding all cost‑of‑living adjustments affecting dollar limitations for pension plans and other retirement-related items for tax year 2026 in Notice 2025-67 PDF, posted today on IRS.gov.

Highlights of changes for 2026

The annual contribution limit for employees who participate in 401(k), 403(b), governmental 457 plans, and the federal government’s Thrift Savings Plan is increased to $24,500, up from $23,500 for 2025.

The limit on annual contributions to an IRA is increased to $7,500 from $7,000. The IRA catch‑up contribution limit for individuals aged 50 and over was amended under the SECURE 2.0 Act of 2022 (SECURE 2.0) to include an annual cost‑of‑living adjustment is increased to $1,100, up from $1,000 for 2025.

The catch-up contribution limit that generally applies for employees aged 50 and over who participate in most 401(k), 403(b), governmental 457 plans, and the federal government’s Thrift Savings Plan is increased to $8,000, up from $7,500 for 2025. Therefore, participants in most 401(k), 403(b), governmental 457 plans and the federal government’s Thrift Savings Plan who are 50 and older generally can contribute up to $32,500 each year, starting in 2026. Under a change made in SECURE 2.0, a higher catch-up contribution limit applies for employees aged 60, 61, 62 and 63 who participate in these plans. For 2026, this higher catch-up contribution limit remains $11,250 instead of the $8,000 noted above.

The income ranges for determining eligibility to make deductible contributions to traditional Individual Retirement Arrangements (IRAs), to contribute to Roth IRAs and to claim the Saver’s Credit all increased for 2026.

Taxpayers can deduct contributions to a traditional IRA if they meet certain conditions. If during the year either the taxpayer or the taxpayer’s spouse was covered by a retirement plan at work, the deduction may be reduced, or phased out, until it is eliminated, depending on filing status and income. (If neither the taxpayer nor the spouse is covered by a retirement plan at work, the phase-outs of the deduction do not apply.) Here are the phase‑out ranges for 2026:

• For single taxpayers covered by a workplace retirement plan, the phase-out range is increased to between $81,000 and $91,000, up from between $79,000 and $89,000 for 2025.
• For married couples filing jointly, if the spouse making the IRA contribution is covered by a workplace retirement plan, the phase-out range is increased to between $129,000 and $149,000, up from between $126,000 and $146,000 for 2025.
• For an IRA contributor who is not covered by a workplace retirement plan and is married to someone who is covered, the phase-out range is increased to between $242,000 and $252,000, up from between $236,000 and $246,000 for 2025.
• For a married individual filing a separate return who is covered by a workplace retirement plan, the phase-out range is not subject to an annual cost-of-living adjustment and remains between $0 and $10,000.

Other phase-out ranges and limitations

The notice also provides limitations for 2026 for Roth IRAs, the Saver’s Credit and SIMPLE retirement accounts.

• The income phase-out range for taxpayers making contributions to a Roth IRA is increased to between $153,000 and $168,000 for singles and heads of household, up from between $150,000 and $165,000 for 2025. For married couples filing jointly, the income phase-out range is increased to between $242,000 and $252,000, up from between $236,000 and $246,000 for 2025. The phase-out range for a married individual filing a separate return who makes contributions to a Roth IRA is not subject to an annual cost-of-living adjustment and remains between $0 and $10,000.
• The income limit for the Saver’s Credit (also known as the Retirement Savings Contributions Credit) for low- and moderate-income workers is $80,500 for married couples filing jointly, up from $79,000 for 2025; $60,375 for heads of household, up from $59,250 for 2025; and $40,250 for singles and married individuals filing separately, up from $39,500 for 2025.
• The amount individuals can generally contribute to their SIMPLE retirement accounts is increased to $17,000, up from $16,500 for 2025. Pursuant to a change made in SECURE 2.0, individuals can contribute a higher amount to certain applicable SIMPLE retirement accounts. For 2026, this higher amount is increased to $18,100, up from $17,600 for 2025.
• The catch-up contribution limit that generally applies for employees aged 50 and over who participate in most SIMPLE plans is increased to $4,000, up from $3,500 for 2025. Under a change made in SECURE 2.0, a different catch-up limit applies for employees aged 50 and over who participate in certain applicable SIMPLE plans, which remains $3,850. Under a change made in SECURE 2.0, a higher catch-up contribution limit applies for employees aged 60, 61, 62 and 63 who participate in SIMPLE plans, which remains $5,250.

Details on these and other retirement-related cost-of-living adjustments for 2026 are in Notice 2025-67, available on IRS.gov.

Check out the newest IOA classifieds here!

Northern IL:

Excellent Opportunity for Optometrist, Bloomington IL (Read more)

Chicago Suburbs:

Optometrist Needed in Western Suburbs (Read more)

Full-Time Optometrist Needed at Geneva Eye Clinic in Geneva, IL (Read more)

On-Site OD Needed with Illinois Department of Corrections (Read more)

Optometrist Opportunity in Riverwoods, IL (Read more)

OD Needed PT at Community Family Wellness Center (Read more)

Looking for an Optometrist to Join Team Full or Part-Time (Read more)

Optometrist Wanted at Trusted Practice (Read more)

Part-Time Opportunity at Low Vision Rehab Non-Profit (Read more)

Central IL:

On-Site Opportunity with IL Dept of Corrections (Read more)

Excellent Opportunity for Optometrist, Central IL (Read more)

Optometrist Opportunity – Advanced Medical Eye Care Practice (Read more)

Southern IL:

OD Needed in Greater STL Area & Throughout Southern IL (Read more)

On-Site Opportunity with IL Dept of Corrections (Read more)

Join our Team and be Part of 100 Years of Optometry Excellence (Read more)

Out of State:

OD Needed in Waukesha, WI (Read more)

Pediatric Optometrist Needed in West Des Moines, Iowa (Read more)



OD Needed in Jackson Michigan (Read more)

Join Our Dynamic and Growing Practice in Beautiful Door County, WI (Read more)

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