Volume 9, Issue 8│February 28, 2025 | |
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2025 Winter CE Series
There is still time to register for Winter CE! Please note: All registrations that were received after Wednesday, February 26 are considered on-site and will incur a $25 on-site registration fee.
On-site registration will be available Sunday morning. Registration will open at 8am. Please arrive early to register on-site.
Courses run from 9am - 4pm CT.
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Corporate Transparency Act Reporting Requirements Back in Effect 📢
On Feb. 18, the U.S. District Court for the Eastern District of Texas ruled in favor of the U.S. Department of the Treasury, effectively putting beneficial ownership information (BOI) reporting requirements under the Corporate Transparency Act (CTA) back into effect. For the vast majority of small businesses, including independent optometry practices, the new deadline to file a BOI report is March 21, 2025.
Congress enacted the CTA, which originally took effect in 2024, to make it easier for the federal government to crack down on shell companies used for illegal activities. Although optometry practices are not involved in such activities, many would be required to report information about their ownership to the Financial Crimes Enforcement Network (FinCEN), a Treasury Department agency, or face penalties.
The AOA continues to advocate for relief from this administrative burden. Meanwhile, the AOA will continue to provide CTA updates and resources, including a FAQ, compliance guide and informational webinar available on AOA EyeLearn.
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The East Central Optometric Society held a meet up for society members this week where they had dinner and discussed optometry updates!
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We want to hear from YOU!
Do you have a business question or a dilemma we can answer for you? Others may have the same inquiry. Ask away! We will answer your question in an upcoming issue.
(Don't worry, we won't include your name.)
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Report illegal and unsafe contact lens sales to the FDA & FTC
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Eyes on Tomorrow Fund
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.
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MEMBER BENEFIT: Free On-Demand CE!
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.
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Report Vision Plan Abuses to the IOA
The IOA recognizes that Vision Care Plan Regulation Act constitutes a significant stride forward for optometry. However, it doesn't signal the conclusion of our efforts to champion fair contracting with vision plans. In the next few years, our members will be renewing and amending their contracts to reflect the changes in the new law. Throughout this process, we will gain valuable insight directly from our members regarding instances of vision plan abuses.
If you encounter vision plan abuses, we ask that you fill out the form below to report abuse. The IOA will collect this information to prevent further vision plan abuses on behalf of our members.
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AOA Independent Practice Institute — New in 2025!
The AOA CIP Independent Practice Institute is a 10-month member benefit program designed to engage and equip the upcoming generation of doctors with the business basics of running an independent practice. Through a combination of virtual and in-person training, focus groups, and networking opportunities, participants will obtain the skillset and confidence necessary to start or step in to an independent practice leadership role.
Developed by the AOA Center for Independent Practice, the AOA CIP Independent Practice Institute is open to active AOA member students and doctors of optometry, particularly those who are early in their careers. Participants get free registration—a combined value of more than $750—to Optometry’s Meeting®, June 25-28, 2025, and AOA on Capitol Hill on March 15-17, 2026. Applications are due by Friday, February 28.
Learn more and apply now for the inaugural 2025-26 Independent Practice Institute here.
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Texas Optometrists Mount Defense in Court and Legislature of Landmark Law on Vision Plan Abuses
— The Texas Optometric Association delivers a strong retort to attempts by vision benefits managers to circumvent the state’s landmark 2023 law curbing abuses.
AOA | By Staff
February 27, 2025
Two years after celebrating passage of its first-in-the-nation law curbing anti-competitive practices by vision benefits managers (VBMs), optometry’s advocates in Texas are back in the legislature.
H.B. 3211 was filed Feb. 24 to improve access to vision care, counteracting VBM aim to limit optometrists’ participation as in-network providers.
“This bill is a continuation of efforts by the Texas legislature, which passed H.B. 1696 in 2023 to address anti-competitive practices in the vision benefits market,” says Tommy Lucas, O.D., director of advocacy for the Texas Optometric Association (TOA).
“They’re trying to tilt the playing field in their favor,” Dr. Lucas adds. “Basically, they’re thumbing their noses at the state legislature.”
What did the landmark H.B. 1696 do?
H.B. 1696 broke new ground for Texas optometrists—and potentially for doctors of optometry across the country in their fights to end abuses by VBMs. Signed by Texas Gov. Greg Abbott in June 2023, the law’s passage reflected a decade of planning, pushing and persevering by the TOA.
Specifically, it will prevent grievous abuses by vision benefit plans, such as:
- Patient steering. Plans cannot encourage or incentivize patients to seek services at any particular in-network provider, or at locations, retailers or e-commerce sites that the plan owns or affiliates with.
- Doctor tiering. Plans cannot tier in-network providers based on noncovered service discounts, amount doctors spend on products or brands, etc.
- Practice control. Plans cannot offer different fee schedules based on doctors’ practice or business decisions, such as lab or supplier choice or affiliations.
- Chargebacks. Plans cannot utilize chargebacks when the plan is not paying for the cost of goods to be delivered.
- Covered services. Plans cannot call a product or service “covered” when there is no reimbursement from the plan to the doctor nor can plans require doctors to provide a covered service or product at a loss.
- Requiring unrelated information on claims. Plans cannot require reporting of unrelated or unneeded patient information to file a claim or receive reimbursement, e.g., prescription information or facial measurements and photographs.
- Extrapolation in audits. Vision plans cannot use extrapolation as a technique to complete an audit.
Further, Texas’ law requires plans to provide transparency about in- and out-of-network coverage for patients and doctors, as well as requires a 90-day notice for contract changes. Importantly, the law also empowers doctors to call out violations directly to the state.
Not long after H.B. 1696’s signing, Dr. Lucas says, the VBMs hatched plots to get around the law. Not only did they go to court, but they also made contracts with doctors “evergreen” so the insurer would not have to comply with parts of the new law.
The newly proposed H.B. 3211 details the conditions for applying for and inclusion in a plan, including specifying what kind of information can be sought by the insurer and key delivery dates.
Among its provisions:
- Applications for licensed optometrists and therapeutic optometrists must be available online on VBM websites.
- VBMs must utilize the same credentialing requirements for each applicant and allow each optometrist to be a plan participant to the full extent of their licensure.
- Not later than the fifth day after the date the VBM receives an application that meets credentialing requirements, the plan must deliver to applicants a contract, including reimbursement fee schedules, provider handbooks and provider manuals.
“H.B. 3211 strengthens patient choice by ensuring that any properly credentialed optometrist who agrees to the VBM’s contract terms can participate as an in-network provider—allowing Texans to see the optometrist of their choice when using their vision plan,” Dr. Lucas says.
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Just One Hour of Screen Time Increases Risk of Nearsightedness
HealthDay | By Dennis Thompson
February 25, 2025
Each hour a person spends squinting into a smartphone or staring at a screen increases their risk of nearsightedness, a new evidence review suggests.
Every daily one-hour increment in digital screen time is associated with 21% higher odds of myopia, researchers reported recently in JAMA Network Open.
What’s more, the risk continues to increase as more time each day is spent with screens, researchers found.
“Myopia risk increased significantly from 1 to 4 hours of screen time and then rose more gradually thereafter,” the research team led by Young Kook Kim, an associate professor of ophthalmology with the Seoul National University College of Medicine in South Korea, wrote.
The risk of nearsightedness is doubled for people who spend four or more hours with a screen every day, results show.
The review suggests a “potential safety threshold of less than 1 hour per day of exposure, with an increase in odds up to 4 hours,” the researchers concluded.
By 2050, nearly one-half of the world’s population is expected to be nearsighted, researchers said in background notes.
Nearsightedness is when close-up objects look clear but distant objects appear blurry, according to the American Academy of Ophthalmology.
For example, a nearsighted person can read a map but has trouble seeing well enough to drive a car without glasses or contacts.
“The projected surge in myopia cases is likely fueled by environmental factors prevalent in urbanized societies, with major contributors being increased near-vision activities and reduced outdoor time,” researchers wrote.
Smartphones, tablets and other screens have “introduced new forms of near-work activity,” researchers said.
"As children increasingly embrace smart devices at younger ages and spend more time on digital screens, there is an urgent need to better understand the association of digital screen time with myopia,” researchers said.
For the new paper, researchers pooled data from 45 prior studies involving more than 335,000 people.
The data showed a significant dose-response association. In other words, the more time people spent with screens, the greater their risk for nearsightedness.
This risk is independent of other activities that require people to work their near vision, like reading or writing, researchers said.
“It is also likely that digital screen use and other near-vision tasks collectively contribute to myopia risk, potentially influencing the overall dose-response trend,” researchers said.
“This suggests that simply reducing screen time in favor of traditional near-vision activities may not be an effective prevention strategy,” researchers added. “A more effective approach to the mitigation of myopia risk would involve minimizing overall near-work activities while promoting increased outdoor time.”
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Cataract Surgery Linked to Increased Risk of Worsening Diabetic Retinopathy
— Close follow-up can help reduce risk, experts say
MedPage Today | By Randy Dotinga
February 24, 2025
Cataract surgery was associated with an increased risk of worsening diabetic retinopathy in adults with type 2 diabetes, according to a retrospective analysis.
After propensity score matching, cataract surgery was linked to increased 1-year risks of proliferative diabetic retinopathy (PDR) without complications, vitreous hemorrhage, and a composite outcome (including PDR, vitreous hemorrhage, and tractional retinal detachment or combined tractional and rhegmatogenous retinal detachment) in both right and left eyes, respectively:
- PDR without complications: HR 1.45 (95% CI 1.09-1.92) and HR 1.58 (95% CI 1.17-2.13)
- Vitreous hemorrhage: HR 1.92 (95% CI 1.13-3.25) and HR 2.12 (95% CI 1.23-3.66)
- Composite outcome: HR 1.49 (95% CI 1.13-1.96) and HR 1.60 (95% CI 1.21-2.13)
A sensitivity analysis of those who had type 2 diabetes for at least 5 years showed that cataract surgery was tied to increased 1-year risks of PDR without complications (HR 1.52, 95% CI 1.06-2.19), vitreous hemorrhage (HR 2.50, 95% CI 1.20-5.20), and the composite outcome (HR 1.75, 95% CI 1.22-2.51) in operated eyes, reported Ahmed Sallam, MD, PhD, of the University of Arkansas for Medical Sciences in Little Rock, and colleagues in Ophthalmology.
There was no significant difference in the risk for tractional retinal detachment or combined tractional and rhegmatogenous retinal detachment in all analyses (all P>0.05).
"PDR may lead to severe and irreversible vision loss, with earlier detection and treatment generally leading to better long-term outcomes," Sallam told MedPage Today. "Identifying this risk factor for progression may allow for increased index of suspicion at follow-up postoperatively and lead to earlier diagnosis and treatment."
He added that while the overall risk of PDR in the study patients was low, "cataracts and diabetic retinopathy are amongst the most common conditions encountered in daily practice. Considering the very large and expanding at-risk population, this difference is clinically meaningful."
However, "despite the noted increased risk, cataract surgery provides substantial visual and quality-of-life benefits for patients with diabetes," Sallam said. "The key is not to avoid surgery but to be vigilant about diabetic retinopathy progression in the postoperative period."
Diabetes doubles the risk for cataracts and is a risk factor for complications due to cataract surgery. Older strategies for cataract surgery, such as intracapsular cataract extraction and conventional extracapsular cataract extraction, were linked to an increased risk of PDR.
However, "evidence about modern phacoemulsification has been scarce and conflicting," co-author Asad Loya, MD, of Baylor College of Medicine in Houston, told MedPage Today. "Some small studies suggested no significant increased risk, while others hinted at an elevated risk of diabetic retinopathy worsening."
What might explain the higher risk? Loya said cataract surgery creates a temporary pro-inflammatory state in the eye, which could accelerate diabetic retinopathy. In addition, "postoperative alterations in vascular endothelial growth factor, hepatocyte growth factor, and decreased pigment epithelium-derived factor may promote angiogenesis," he noted.
Ninel (Nell) Gregori, MD, of the University of Miami Miller School of Medicine, said that previous studies exploring the possibility of worsening diabetic retinopathy after modern phacoemulsification cataract surgery were small and inconsistent, while the new research relies on a large dataset.
The findings, she told MedPage Today, "highlight the need for patient education and close follow-up. Typically, we follow diabetic patients more frequently with regular dilated fundus examinations after cataract surgery."
Paolo Antonio S. Silva, MD, of Harvard Medical School in Boston, noted that preoperative assessment of diabetic retinopathy is important, "but cataracts may obscure severity."
Silva told MedPage Today that "optimizing diabetes control, considering anti-VEGF therapy for high-risk patients, and close follow-up can help reduce risk."
For this study, Sallam and colleagues used data from the TriNetX research network from June 2004 to June 2024, a period when phacoemulsification was the main cataract surgery method in the country, and compared adults with type 2 diabetes and non-proliferative diabetic retinopathy who underwent routine cataract surgery versus those who did not receive cataract surgery.
They included 7,178 patients in the right-eye analysis and 7,232 patients in the left-eye analysis. Mean age was 67.2 in the surgery group and 67.8 in the control group. The majority of both groups were women and white.
A limitation to the study was that TriNetX lacks visual acuity data, which the researchers could not account for while matching.
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Illinois Gov. Pushing for PBM Reform
NCPA | By Staff
February 27, 2025
This month in state advocacy news, we saw a group of state insurance commissioners outlining new rules auditing PBMs, the Illinois governor pushing for PBM reform, and an NCPA-supported PBM reform bill in Indiana clear a major hurdle, among other developments.
Here's a breakdown of the news:
- NAIC market conduct draft underway: The National Association of Insurance Commissioners began the drafting process for a new chapter dedicated to auditing PBMs in its market conduct manual. NCPA will be participating in all five working groups that were created to inform the draft. The new chapter is part of the NAIC PBM Regulatory Issues Work Groups' charges for 2024, along with a strengthened engagement of PBM compliance and enforcement.
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Illinois Gov. Pritzker gears up to tame PBMs: In his State of the State address on Feb. 19, Illinois Gov. J.B. Pritzker (D) dedicated significant time and attention to the needs of independent pharmacies and the importance of reforming PBMs. Watch his comments here. NCPA looks forward to supporting the Illinois Pharmacists Association's engagement on the Prescription Drug Affordability Act.
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PBM reforms clear the Indiana State Senate: SB. 140, PBM reform legislation spearheaded by the Indiana Pharmacy Association, passed the Senate on Feb. 20 with near unanimous support. Having gone through a series of amendments, the bill currently proposes the greater of a pharmacy benefits manager's reimbursement to their own affiliate (by NDC) or actual acquisition cost, plus a professional dispensing fee equal to the Medicaid fee-for-service program's. The amended bill also prohibits a health carrier from contracting with a PBM in which they have an ownership interest and prohibits a PBM licensed in Indiana from having an ownership interest in a pharmacy. You can find more on this at the Indianapolis public radio station WFYI.
- NCPA sends letters in support of improving payment models and expanding access to patients:
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NCPA submitted a letter of support for Hawaii's SB. 1245, a bill that requires public and private plans within the state to reimburse for services provided by licensed pharmacists at the same rate for services rendered by another provider.
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In California, the state's Department of Healthcare Services solicited public comment on regulations regarding AB 1114 (2016), titled "Medi-Cal: Pharmacists Services," a law passed that allows pharmacists within the state to be reimbursed for non-dispensing services at an 85 percent rate of other providers providing the same service under the state's Medicaid program. NCPA submitted comments to the DHCS requesting greater transparency from MCOs in contracts and publicly available reimbursement guidance for pharmacies.
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Immunization bill clears first chamber in Indiana on a unanimous vote: Pharmacists in Indiana hope to maintain momentum as Senate Bill 96, passed through the full Senate on a 49-0 vote and is now before the state's House of Representatives. SB. 96 expands the list of vaccinations pharmacists may administer by allowing all FDA-approved vaccines to be eligible rather than a specified list. The bill allows for the health commissioner to remove vaccinations otherwise approved by the FDA when the Indiana General Assembly is not in session. NCPA submitted a letter of support and looks forward to this expansion of patient access progressing through the House and being sent to the governor to become law.
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Mandatory off-label dispensing language in S.C. bill removed, will be heard again: The South Carolina Pharmacy Association is fiercely opposed to language mandating that pharmacists dispense medications without regard to their professional judgment and expertise. S. 54 will be heard on Feb. 26 by the Medical Affairs Committee within the South Carolina Senate. Section 4 of the bill limits the circumstances under which pharmacists may refuse to fill or refill prescriptions, compelling them to dispense a prescription that may compromise patient safety. Off-label prescribing and dispensing is a common and safe practice but completely removing a pharmacist from the process is a bridge too far. NCPA submitted a letter opposing this language in the earlier bill, S. 2, that was heard this year and has submitted a letter in opposition to similar legislation heard in Ohio last year.
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THANK YOU TO OUR INDUSTRY PARTNERS! | |
Illinois Optometric Association
217-525-8012
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