The AAO is acutely aware that the delisting of optometric clinics and doctors by certain insurance companies has escalated significantly in recent weeks. We have heard directly from many of you — your frustration, your concern, and your calls for action. I encourage you to please continue to reach out directly to our CEO, Dr. Gabrielle Betts at gbetts@optometrists.ab.ca. Let us be clear: this issue is a top priority for our organization.

We recognize that the impact on your practices, your patients, and your professional integrity is serious and unacceptable. Moreover, we understand that this is not just about individual clinics — this is about protecting the professional reputation and livelihood of optometrists in Alberta. You deserve a fair, transparent, and accountable process. Thus, we have been moving to a more assertive phase of advocacy on your behalf.

Here’s what we are doing immediately:

1. Engaging Directly with Insurance Firms: We are seeking meetings with leadership at the insurance companies involved to demand clarity, transparency, and due process for all affected practitioners.
2. Coordinating National Pressure: We are collaborating with other impacted health professions and their associations to amplify our collective voice at both the national and provincial levels. This is paralleling efforts being taken by the CAO.
3. Assessing All Strategic Options: We are actively evaluating all possible avenues to address this issue — including legal pathways — to ensure clinics and doctors are treated fairly and with due process. At this time, we are consulting with partners and experts to fully understand what options may be appropriate and effective.

The CAO is forming a Task Force with representatives from CLHIA and Canadian optometry networks to develop educational resources that will help members avoid billing mistakes and prevent fraud and fraud investigation of their practices. We have asked and received from the CAO the addition of an Albertan OD on this committee. We wanted to ensure Alberta OD voices were being heard.

The CAO has also provided cautionary guidance in the interim, noting that investigations typically focus on the following areas. We encourage members to monitor these closely for any abnormal business practices and/or changes from historical trends:

1. Above average dispensing of low-prescription eye wear, including sunglasses
2. Above average dispensing of high-prescription eyewear to youths
3. Inappropriate dispensing of company gift cards
4. Above average purchases of uncut lenses
5. Patient order cancellations
6. Above average Patient returns
7. Above average order redos
8. Price matching and discounting
9. Billing that does not precisely match services rendered or products dispensed

In addition, the CAO in collaboration with the Canadian Life and Health Insurance Association (CLHIA), will be hosting a webinar on October 6 at 7:30 p.m. (ET) focused on insurance fraud and awareness in relation to the recent delistings. This session will provide important context and insights into the current situation affecting optometric clinics. Registration details will be shared with members shortly.

We will continue to communicate frequently and candidly as this issue develops. If you have been affected and have not yet connected with us, we strongly encourage you to reach out.

Thank you for your continued strength and support.

— Dr. Sophia Leung, AAO President

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