June 2023

Advocating for Our Future

From the SNAPP Board

Flying into the nation’s capital for Optometry’s Meeting, the annual meeting of the American Optometric Association, is a strong reminder that optometry is a legislated profession.

Local, state and national organizations that advocate for protecting and advancing the scope of practice are critically important to what we do in our community as Pearle professionals every single day.

We already know our communities need us. While there are localities where there seem to be an abundance of eye care providers, there are still many Americans who have trouble accessing eye care. Pearle professionals play a key role in providing access and serving as primary eye care locations for millions of Americans.

The more that we can do for patients in our practice locations, the more convenient it is for them. We will and should refer when necessary; that’s our role. But where we can help serve patients in or near their hometowns, it is better for everyone.

That’s why it’s so important to Pearle professionals to attend our annual SNAPP Meeting, too. There, we share ideas and strategies for efficiency and expanded service lines. We hear about new diagnostic technologies and advances in contact lenses and other products to assist our patients. We learn about nutraceutical supplements to help our patients live their best lives and improve their ocular health.

Yet as we focus on our patients’ and customers’ lifetimes of good, healthy vision, let’s not lose focus on the importance of protecting what we’ve worked so hard to accomplish.

Make Your Voice Heard

Industry Professionals Fan out Across D.C.

During Optometry’s Meeting, eye care professionals are taking advantage of the proximity to the halls of power to visit their elected representatives. Among the priorities is HR 2748, the Contact Lens Prescription Modernization Act, backed by the American Optometric Association and the Health Care Alliance for Patient Safety. The bill would ensure a safer, simpler contact lens prescription verification process for the millions of contact lens-wearing Americans by prohibiting online retailers’ use of automated robocalls to verify prescriptions.

This year, one focus is on the number of bills that have been introduced in state legislatures around the country sometimes referred to as “don’t say doctor” laws—and Florida Governor Ron DeSantis recently vetoed such a bill when it arrived on his desk.

But there are others that claim that optometrists who call themselves optometric physicians or doctors are skirting “truth in advertising” laws.

In California, AB 754 is “held for submission,” meaning that it has not advanced out of committee but could at a later date.

In Connecticut, SB 899 does not seem to be gaining traction. On a state general assembly page for public hearing information, there are 70 testimonials opposing the bill and 12 supporting it.

In Massachusetts, “An Act Relative to Health Care Transparency” (H 3606 and S 1348) was reintroduced this year as it was in the previous legislative session. There has been no action on the bill since February.

In Texas, HB 2324 was referred to the public health committee in March.

In Wisconsin, the Senate Committee on Health held a public hearing on May 24 on SB 143.

And in North Carolina, HB 576 / S 624, the Health Care Practitioner Transparency Act, has been referred to the Committee on Rules and Operations of the Senate.

Some of these bills are reactions to recent legislative wins that provide optometrists with expanded scope of practice. According to this article from Review of Optometry from late last year, 41 states now allow ODs to administer some injectable drugs, 16 states allow ODs to excise lumps and bumps, and 10 states allow optometrists to perform in-office laser surgery.

However, as the experience in California shows, even getting an optometry-friendly expansion of scope bill passed through the state legislature is no guarantee of success. Governor Gavin Newsome vetoed AB 223 in late December of last year.

These arguments over the scope of practice are not new. For decades, eye care professionals have sought to carve out and protect their practice turf. But as technology advances—allowing optometrists to do more for patients, safely and conveniently—it also becomes important to stay in touch with your local, state and federal organizations that are protecting your rights to provide eye care to the best of your ability.

SNAPP Meeting

Get Paid to Attend—Seriously

There are many good reasons to come to the annual SNAPP Meeting in Las Vegas, Nevada, Sept. 26-28 at The Palms Casino Resort. There’s a chance to connect with old and new friends, pick up great ideas, meet with vendors and listen to great speakers. But if that’s not enough, you can get paid to come.

Our Member Rewards Program allows you to receive stipends for attendance. Here’s how.

• One doctor plus one non-OD owner per store qualify for 100% stipend.

• One manager per store qualifies for 50% stipend.

• Register for the meeting at least four weeks before start date.

• Arrive on time, participate fully, and spend at least 10 minutes with each sponsor learning about its products and services.

The amount of the stipend will be determined by how many members qualify for it. Read full qualifications here—and register for the meeting here.

Billing Tip of the Month from VisionWeb

Get in Touch With Medical Billing

By Amanda Whitener,
Revenue Cycle Management Team at VisionWeb

Moving to a more medical model of practicing can seem like drinking water from a firehose! With such a copious number of rules and regulations to follow, sometimes providers feel it is not a great option for their practice; however, it can be very lucrative. Let’s take a moment to explore a few question/answer scenarios as they relate to billing to Medicare.

What is a Medicare MAC?

MAC stands for Medicare Administrative Contractor. There are seven unique Medicare contractors with 12 unique jurisdictions. The MAC acts as a processor for Medicare claims in its specific jurisdiction and is the main contact between Medicare fee-for-service and enrolled health care providers. Essentially, the MAC is the vehicle of communication between the Centers for Medicare and Medicaid Services (CMS) and providers. It also sets and enforces local coverage determinations (LCDs) and national coverage determinations (NCDs).

What is an NCD, and how is it different from an LCD?

An NCD is essentially a guideline set by CMS to determine whether a procedure or item should be covered by Medicare. For example, an NCD may indicate a certain procedure is not payable if CMS deems it experimental. If so, all MACs are advised to follow that decision when processing claims. An LCD, on the other hand, is a guideline set by a particular MAC. These may be implemented if CMS has not yet made a ruling on a procedure.

Both NCDs and LCDs help determine the diagnoses that denote the medical necessity of a particular procedure and whether it is reimbursable or not. They also indicate the MUEs, or medically unlikely edits, of a particular procedure. In other words, they outline the acceptable frequency of a specific procedure, i.e., once a year, twice a year, etc.

Is my MAC required to follow all LCDs?

Each MAC follows its own LCDs and is not required to follow the LCDs of other MACs, but all jurisdictions are required to follow the NCDs. Use your resources to determine if a procedure is covered before billing Medicare. In the event that a procedure does not have an LCD or NCD and it is unclear whether Medicare will cover it or not, an Advance Beneficiary Notice of Noncoverage (ABN) might be appropriate.

Reach out to the VisionWeb team with any billing questions you have at this link; we might have the solution for you.

HR Update From AmCheck

Federal Pregnant Workers Fairness Act Comes Into Effect

As of June 27, 2023, employers with 15 or more employees must provide pregnancy-related accommodations to employees and applicants under the federal Pregnant Workers Fairness Act (PWFA).

Under the PWFA, employees are entitled to accommodations for physical or mental conditions related to or affected by pregnancy, childbirth or a related medical condition, including morning sickness, gestational diabetes, post-partum depression and lactation.

This law expands employer obligations beyond what is already required by the Americans with Disabilities Act (ADA) in that being entitled to a pregnancy-related accommodation does not require that the employee’s condition rise to the level of disability. Also, employees are entitled to accommodations even if they can’t perform their essential job functions on a temporary basis.

This may mean providing more frequent or longer breaks; modifying a food or drink policy; providing seating or allowing the employee to sit more frequently if their job requires standing; observing limits on lifting; or providing job restructuring, light duty or a modified work schedule.

Employers can’t require an employee to take leave if a reasonable on-the-job accommodation is available. Like the ADA, the employer and employee should engage in the interactive process to determine what reasonable accommodations can be provided. However, if the employer is willing to grant the employee’s request, the interactive process is not required.

Action items

• Add a pregnancy accommodations policy to your handbook if you don’t already have one.

• If you’re subject to a state law that provides similar accommodations, make sure your policy captures the most employee-friendly aspects of the applicable laws.

• Ensure that managers are aware of the law and types of accommodations that may be required.

News of Interest

Colorful Foods Shown to Improve Athletes’ Vision

A study from the University of Georgia has found that athletes who fill their diets with colorful fruits and vegetables may have improved eye health and visual function. The best foods found to increase visual range include dark leafy greens (spinach, kale) and yellow and orange vegetables (carrots, peppers).

These foods contain high levels of lutein and zeaxanthin, plant compounds that build up in the retina. Read more here.

Another Solar Eclipse Coming in October

On October 14, 2023, a solar eclipse will be visible from parts of the Pacific Northwest of the U.S. all the way to the Gulf of Mexico (see yellow on map).

On April 8, 2024, a solar eclipse will occur across most of the U.S., with a small band of total solar eclipse stretching from Southwest to Northeast (see blue on map). Prevent Blindness is offering tips for safe viewing here.

Diabetes-related Eye Disease Remains High in the U.S.

A recent study highlights the importance of prioritizing eye care and diabetic retinopathy screening as the number of Americans with diabetes-related eye disease remains high. In 2021, an estimated 9.6 million Americans had diabetic retinopathy, and 1.8 million had vision-threatening diabetic retinopathy, according to this article in MedPage Today.

June 27 Is National Sunglasses Day

Get your sunnies ready. The Vision Council’s National Sunglasses Day is June 27. The day is meant to celebrate “the importance of wearing shades to protect the eyes from the sun’s harsh UV rays,” according to the website. Learn more about the day and view helpful materials here.

Post pics to social media using the official hashtags and tagging the Vision Council on Facebook, Instagram and Twitter:

#SunglassSelfie #SolarFlair #NationalSunglassesDay
Facebook/Instagram: @TheVisionCouncil
Twitter: @OpticalIndustry

Getty Images photo credits—capitol: Travelpix_Ltd; diabetic eye: PeopleImages; pregnant: PeopleImages; and voice counts: Alesmunt
Solar map photo credit: Prevent Blindness

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Visit snappgroup.org to learn more about SNAPP.