March 31, 2023
DEA's New Opoid Training Mandate: What you need to know
Doctors of optometry and other physicians are bound by new, federal training and education requirements intended to expand access to and treatment of opioid use disorders.
 
Taking effect on June 27, 2023, all Drug Enforcement Administration (DEA)-registered practitioners will be required to attest that they have met an eight-hour training requirement on treating and managing patients with opioid and other substance use disorders. Doctors must attest to having met this one-time training requirement on the date of the practitioner’s next scheduled DEA registration submission, regardless of whether it is an initial registration or a renewal. Once indicating affirmation, doctors will not be required to attest on future registration renewals.
 
The new training and education mandate comes as a result of Congress’ December 2022 approval of the Consolidated Appropriations Act of 2023, wherein lawmakers eliminated previous requirements that physicians must first obtain a federal waiver to prescribe buprenorphine. Such prescriptions will now only require a standard, DEA registration number instead of the previously used DATA-Waiver (or X-Waiver) registration numbers. The new law also removes limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine.
 
Since December, the DEA and Substance Abuse and Mental Health Services Administration have worked to develop additional guidance to physicians with the AOA advocating on behalf of optometry. Such is the case, the AOA offers the following guidance for doctors of optometry to prepare to meet this federal requirement.
 
When will these requirements take effect?
Anyone applying for a DEA license after June 27, 2023, will be required to attest to taking education and training related to substance abuse identification and treatment.
 
What courses can I take to meet these requirements?
The Providers Clinical Support System has created the “Substance Use Disorder 101 Core Curriculum,” comprised of 23 modules that can be used for doctors to meet the eight-hour DEA education and training requirement. Developed by the American Academy of Addiction Psychiatry, the curriculum provides an overview of evidence-based practices in the prevention, identification and treatment of substance use disorders and co-occuring medical and psychiatric conditions. Each stand-alone module is available at no cost; registration is required to access these modules. When asked to identify your profession, select “other” and indicate optometry.
 
Will I be required to submit a course completion certificate to the DEA?
No, the DEA will ask that doctors simply attest to completion of the substance abuse education and training. Beginning on June 27, 2023, doctors will be required to check a box on their online DEA registration form—regardless of whether a registrant is completing their initial registration application or renewing—affirming they have completed the requirement. Doctors will not be required to provide certificates of completion; however, the AOA strongly recommends retaining any documentation or certificates for your own records.
 
Does the AOA have an educational course I can take?
The AOA is currently working with the DEA to develop an approved course for doctors of optometry. The course will be available within the AOA EyeLearn Professional Development Hub and will be announced when available.
 
Do I need to take additional training if I just graduated optometry school?
Doctors who graduated in 2019 or thereafter are not required to meet this additional training requirement.
 
I have previously taken related education approved by one of the recognized bodies, so does that count toward the DEA education and training requirement?
Yes, related education approved by one of the aforementioned bodies and taken prior to Congress’ action in December 2022 can count toward the doctor’s eight-hour requirement.
Register for OD Day at the Legislature
In an effort to have a more visible presence at the Alabama Legislature throughout this legislative session, we are dividing the state and holding 3 separate Optometry Days.
 
Please make every effort to attend and show your support for scope of practice expansion. It is crucial that your legislator see how important this bill is to you and your practice.  Your personal contacts with legislators is what will get this bill passed!
 
Wednesdays are usually committee days for legislators. This means that you will be able to contact your legislator(s) ahead of time and make an appointment with them and if possible, make plans to take them to lunch. We also will have a laser available at the statehouse for them to see.
 
We will provide a briefing with you by Zoom the week prior to the event. This will be an opportunity to go over talking points, get the latest update on the bill’s progress and get final details for the day’s events.

North Alabama Day at the Legislature
Wednesday, April 5th - 10:00 am - 2:00 pm
Register HERE

Central Alabama Day at the Legislatures
Wednesday, April 12th - 10:00 am - 2:00 pm
Register HERE

South Alabama Day at the Legislature
Wednesday, April 19th - 10:00 am - 2:00 pm
Register HERE
Discuss Dangerous Contact Lens Sales with HCAPS
Do you have a powerful patient safety story to tell or a personal impact from deceptive contact lens sales? We are looking for advocates to participate in short interviews and draft op-eds in support of HCAPS’ mission. If you have an interest in participating, reply directly to this email or reach out to Executive Director, Ralph Kohl (Ralph@patientsafetytoday.com).
AOA Decries Misleading Medicare Advantage Plan Advertising
Medicare Advantage (MA) plans’ misleading advertising practices face scrutiny by federal regulators’ newly proposed marketing requirements, as the AOA casts support and accentuates plans’ often-inaccurate portrayal of eye health and vision benefits.
In a proposed rule issued on Dec. 14, 2022, the Centers for Medicare & Medicaid Services (CMS) solicited broad feedback on Contract Year 2024 Policy and Technical Changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit Programs that included a range of proposals, including revising rules governing MA and Part D marketing and communications. Through more than 20 different regulation changes, the CMS seeks to address issues flagged by the AOA as well as a rise in beneficiary complaints—outlined in a recent U.S. Senate Finance Committee report—concerning misleading and deceptive advertising practices.

  • Requiring agents to explain the effect of an enrollee’s enrollment choice on their current coverage whenever the enrollee makes an enrollment decision.
  • Simplifying plan comparisons by requiring medical benefits be in a specific order and listed at the top of a plan’s Summary of Benefits.
  • Prohibiting marketing of benefits in a service area where those benefits are not available.
  • Prohibiting marketing of information about savings available to potential enrollees that are based on a comparison of typical expenses borne by uninsured individuals, unpaid costs of dually eligible beneficiaries or other unrealized costs of a Medicare beneficiary.
  • Requiring MA plans and Part D sponsors to have an oversight plan that monitors agent/broker activities and reports agent/broker noncompliance to CMS.
  • Placing discrete limits around the use of the Medicare name, logo and Medicare card.
  • Prohibiting the use of superlatives (e.g., words such as “best” or “most”) in marketing unless the material provides documentation to support the statement, and the documentation is for the current or prior year.

Subsequently, many of the CMS’ proposed rules in this area would strengthen regulations or impart new requirements of third-party marketing organizations that develop materials on behalf of MA plans and Part D sponsors, such as requiring a vetting process for such marketing materials and enhancing transparency.

Such requirements are necessary, advocates contend, as the number of Medicare beneficiary complaints over commercial MA plans more than doubled from 2020 to 2021 with the aforementioned congressional report finding “evidence that beneficiaries are being inundated with aggressive marketing tactics as well as false and misleading information.” Toward that end, the AOA submitted comments on the proposed rule in that urged CMS to focus in on MA plans’ misleading marketing and further encouraged scrutiny of marketing supplemental benefits for eye care.

In January, the CMS issued a final rule to hold commercial MA plans accountable for accurate payments as studies illustrate how medical records don’t always support the diagnoses reported by MA plans, leading to billions of dollars in overpayments and increased Medicare costs. By updating its Risk Adjustment Data Validation (RADV) Program, the CMS intends to recover $4.7 billion from insurers between 2023 and 2032.

While legal challenges are sure to arise, the rule indicates that the CMS is working to address MA plan concerns. The AOA will work to ensure these new policies do not cause undue burdens on doctors, and should doctors have concerns with documentation requests or requirements, they may report those to the AOA.
5 Common Malpractice Claims Optometrists Face
Knowing the most common claims facing optometrists is the first step to reducing your risk of a stressful and costly malpractice lawsuit. AOAExcel asked their malpractice insurance partner, Lockton Affinity, to identify some of the most common types of claims optometrists encounter. Find them HERE
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