IOP News, March 2026 / Issue 23 | | |
|
I hope everyone has had a great start to 2026!
Although the 2026 Legislative Session has been quiet for optometry in Idaho, the IOP was able to attend President’s Council in mid-January, where we were able to meet with leadership from other states. A big topic of discussion continues to be legislation regarding Vision Benefit Managers (VBM).
As previously discussed, Arkansas passed VBM legislation in 2025 that would require VBMs to reimburse at least the amount of Medicare reimbursements. This was a huge win for optometry nationwide. Since that legislation took effect, one of the VBMs has been reimbursing in accordance with the statute. Not surprisingly, other VBMs have not. We look forward to hearing more at AOA on Capitol Hill, Optometry’s Meeting, and other meetings about ways we can bring positive VBM legislation to Idaho. As always, scope modernization will continue to be a topic of discussion with current Idaho legislative leaders.
Please be on the lookout in April for registration for the IOP Annual Congress, which will be held October 8-10, 2026, at The Riverside Hotel in Boise. We’re excited for the lineup of great lectures as always, but are even more excited to provide something a little different. We’re going to have a ‘Workshop’ day that will include a didactic component, along with hands-on experience in injections, lesion removals, and cosmetics using IPL and plasma pens.
I look forward to continuing to work with you all throughout this year. As always, please let me know if you have any questions or concerns.
Kind Regards,
Doug Adams, OD
IOP President and Legislative Committee Chair
dradams@familyeyes.com
| |
|
|
2026 IOP Annual Congress
October 8-10, Riverside Hotel, Boise
2027 IOP Annual Congress
April 29 - May 1, Coeur d'Alene Resort
2028 IOP Annual Congress
April 27 - 29, Sun Valley Resort
|
| | |
|
Lobbyist Report
We have reached the mid-point of the 2026 Idaho Legislative Session. While there is no technical end date for Idaho’s Legislative Sessions, we have wrapped up Week Seven and are in the Middle of Week Eight. Typically, we usually go to the second week of April.
Based upon the way things are going, I think the Session will easily finish by the second week of April or even sooner. Because it is an election year, legislators want to get done as soon as possible so they can hit the campaign trail and get ready for the primary elections, which are May 19, 2026.
The Legislature has already passed, and the Governor has signed another tax cut, commonly referred to as the Conformity Bill, which mirrors President Trump’s “Big Beautiful Bill” and enacts his federal tax cuts (no taxes tips, no taxes on overtime, etc.) at the state level.
The Legislature is now working on a bunch of spending cuts to pay for the Conformity Bill and some of last year’s tax cuts. As a result, all agencies will have to reduce spending by about five percent. In addition, Medicaid and other programs will be slashed to balance the budget. So far, the Legislature has not balked at the cuts. Unless some budgets start failing on the floor or the Governor vetoes something, the session will be done quickly.
As far as the profession of optometry goes, there have been no bills that directly impact it. The one development we are keeping an eye on is that VSP has hired a lobbyist in Idaho. They have been very vague about why they hired a lobbyist and exactly what they are working on.
At the beginning of the session, I met with Speaker Mike Moyle, and he indicated that he was interested in talking with us over the interim on laser legislation, and that he was willing to get rid of the provision that would include a Ophthalmologist on the Optometry Board. Dr. Adams, Lisa White, and I are scheduled to meet with Speaker Moyle again on March 5, 2026, and see if that’s still the case and the best way to proceed.
IOP VBM Fact Sheet
Lance Giles
IOP Lobbyist
|
| | |
|
Insurance Advisory Committee | |
Hello IOP members,
The following is a summary of the most recent TPC regional call that took place last week.
1. VBM Investigations - In February, Jamie Comer, the House Oversight Committee Chairman, ramped up their probe into VBM abuses, issuing two new letters to the FTC and DOJ for immediate updates on their ongoing VBM investigations, saying things are getting worse and action is needed now.
2. Break Up Big Medicine Act (A new bill that has been introduced) - This bill targets health care vertical integration (steering, self-dealing etc.) and would prohibit a parent company from owning a medical provider or management services organization and a PBM or an insurer. It would also prohibit a parent company of a prescription drug or medical device wholesaler from owning a medical provider or management services organization. The bill also creates financial penalties and enables the Federal Trade Commission, Health and Human Services Department, and Justice Department to bring lawsuits against those who don't comply.
3. Coding Updates -
National Correct Coding Edit – 92137 (OCT-A) We want to make everyone aware of a current National Correct Coding Initiative (NCCI) edit that is impacting claims reporting. Specifically, CPT 92137 — OCT-A — is being disallowed when billed on the same date of service as an eye exam code.
Under the current edit structure, practices must append modifier 25 in order to bypass the edit. The AOA is actively working to have this edit eliminated and will share additional updates in the coming weeks. In the meantime, we recommend the modifier be utilized.
4. EyeMed: Medically-Necessary Contact Lens Processing
The AOA has been in direct discussions with EyeMed regarding their medically necessary contact lens processing procedures. There have been doctors reporting issues with delayed processing over the past few weeks and EyeMed is investigating those specific claims. However, they also received an update from EyeMed last Tuesday that they were changing some of their approaches. These changes will be implemented shortly, and the AOA will be monitoring them closely. EyeMed has indicated they have:
“launched a new capability in their online claims system that allows providers to submit MNCL claims electronically. With this update, providers will no longer be required to use a paper claim forms when submitting these claims.”
The AOA will continue to monitor the impact of these changes.
5. New Coding & MIPS Resources
https://eyelearn.aoa.org/learn
If you have any issues or concerns, please let me know or report them directly to the AOA, and we will assist you.
Dr. Kendon Seamons
Insurance Advisory Committee Chair
drseamons@familyeyes.com
(208)766-3228
|
| | |
|
Federal Advocay Relations | |
Dear Idaho Optometry,
The American Optometric Association has asked Idaho optometrists to contribute $13,000 to AOA-PAC this year, and I am asking for your support.
First, thank you to those who have contributed in the past. Your commitment has helped ensure that optometry maintains a strong and respected voice in Washington, D.C. Your continued support is essential.
For those who have not yet given—or for our newly practicing colleagues—every $20 matters. This is not someone else’s future; it is yours. We must reach our $13,000 goal before the AOA national meeting on June 17–20. This is a firm deadline for the midterm elections. Let’s ensure Idaho is at 100% participation before that meeting begins. The policies being written today will shape your reimbursement, scope, and practice environment for decades to come.
What is AOA-PAC?
The American Optometric Association Political Action Committee (AOA-PAC) is a voluntary, nonpartisan committee of optometrists. It is not affiliated with any political party. AOA-PAC allows our profession to support federal candidates—regardless of party—who understand the importance of independent eye care and patient access to services. Because incorporated associations cannot directly contribute to federal candidates, AOA-PAC is the mechanism through which our collective voice is heard.
How to Contribute
Donate securely through the AOA website: https://www.aoa.org/advocacy/federal/aoa-pac
If we do not invest in advocacy, others will shape policy for us. AOA-PAC is our profession’s voice at the federal level. Idaho optometry has always stepped up. Let’s do so again.
Thank you for your commitment to protecting independent optometry and ensuring continued access to quality eye care for our patients.
Respectfully,
Dr. James Bewley & Dr. Rodney White
Co-Chairs- Federal Advocacy Representatives.
Why It Matters Now
1️⃣ Vision Benefit Manager (VBM) Abuses DOC Access Act (H.R. 1521) & Vision Lab Choice Act (S. 1716)
These bills aim to:
- Stop VBMs from setting prices on non-covered services
- Prevent forced use of VBM-owned laboratories
- End one-sided, never-ending contracts
- Protect independent practices from consolidation pressure
Federal investigations into VBM market dominance are expanding. Independent optometry is under real pressure.
2️⃣ Medicare Physician Payment Reform (H.R. 4559 (Prompt and Fair Pay Act)
-
Medicare physician payments have declined 33% (inflation-adjusted) since 2001
- Optometrists are the only Medicare providers without automatic annual inflation updates
- Medicare Advantage plans are delaying payments and reducing reimbursements
We are urging Congress to:
- Permanently tie Medicare physician pay to the Medicare Economic Index
-
Support H.R. 4559 (Prompt and Fair Pay Act) to ensure fair MA reimbursement and prompt payment
3️⃣ Contact Lens Patient Safety H.R. 4282 – Contact Lens Prescription Verification Modernization Act
Online sellers are exploiting passive verification systems through robocalls, placing patients at risk. Contact lenses are FDA-regulated medical devices and require proper oversight.
Our Idaho Federal Delegation
Representative Russ Fulcher (202) 225-6611
Representative Mike Simpson(202) 225-5531
Senator Mike Crapo (202) 224-6142
Senator James Risch (202) 224-2752
|
| | |
|
|
Hello everyone!
I am always excited to plan education for our annual meeting- mark your calendars for Thursday, October 8th, and Friday, October 9th at The Riverside Hotel in Boise, Idaho. We will be offering 12 hours of education between the two days - and this year we will be offering the opportunity to attend one or both days.
We are welcoming Mary Schmidt, CPO, back to provide education on both days. Mary spoke in Boise back in 2023, and she is a favorite speaker, so we are excited to have her back. Have you wondered what happens at the lab when you submit your orders? Our other speaker is Charlie Saccarelli, ABOM, president of Chadwick Optical - he covers lab information and more!
If you are interested in helping plan some local education in your area of Idaho, please let me know! This was something we tried to do quarterly across Idaho prior to 2020 - I would love to be a support to you in planning anything! It can be as simple as a dinner with a contact lens brand with education on increasing your annual supply sales. If you are in the Treasure Valley, there are some classes coming up, so watch for them!!
As always, I encourage you to become certified in your area of practice at your office - there is a certification for everyone - from billers, to techs, to opticians! Perhaps your office offers a raise with certification - get that raise!! If you would like to know more about the different certifications, please email me at iop.para.cc@gmail.com.
Working hard to bring you some top tier education,
Tami Arnett, CPOA, ABOC
IOP Paraoptometric Committee Chair
|
| | |
|
|
Please welcome our newest members
- Drew Hargrove, Meridian
- Katelyn Doyle, Boise
|
| | |
|
|
Hello IOP Members,
Be on the lookout for registration to open in April for the 2026 IOP Congress. As Doug mentioned above, we will be offering a surgical workshop on Saturday, October 10th. Seating is limited to 50, and registration will be separate from Congress. The final details will be laid out in the registration brochure.
Would you and/or your staff be interested in attending an interactive, virtual workshop designed to make it easier to coordinate VSP benefits? Let us know...
| |
Looking for ways to educate your patients and community? Visit the AOA's education hub, https://www.aoa.org/educate-your-community, for customizable resources.
As always, please contact me with any questions, concerns, or comments.
Happy Spring!
Lisa White
IOP Executive Director
|
| | | | | |
