To help ophthalmologists remain aware of the newest legislative changes and their effects on the field of ophthalmology, the American Academy of Ophthalmology (AAO) pledges its continued presence in Washington, DC, and the use of its influence to affect the debate, said Dr. Repka, medical director of governmental affairs for the AAO.
"Organized medicine faces a turbulent landscape. Washington is a difficult place to know exactly what is happening at any given time," added Dr. Repka, also professor of ophthalmology and professor of pediatrics at the Johns Hopkins University School of Medicine, Baltimore. "There are numerous issues that the AAO is monitoring."
Clear divisions exist within the house of medicine, particularly between specialty care and primary care.
"These are of great importance, and could lead to dangerous fractures in our future," he said.
The AAO continues to collaborate whenever possible with the American Medical Association (AMA) and the American College of Surgeons (ACS)—important umbrella groups representing medicine to Congress, Dr. Repka said.
"With the AMA, the AAO has been active in the scope of practice partnership," he said. "But, the AAO also visits independently with members of Congress and their staffs on an ongoing basis to discuss many issues of day-to-day concern and not just the new health-care reforms."
Truth-in-advertising legislation is one of many issues the AAO has been working on with the AMA. This calls for health-care providers to reveal their training, education, and licensing clearly.
The AAO also is working with the ACS on the Surgical Quality Alliance to develop a patient interview process to assess the quality of care delivered in ambulatory care centers and a surgical agenda for health-care reform.
"We are monitoring the development of surgical registries [by] the ACS," Dr. Repka said. "At present, these registries are not truly applicable to the outpatient surgery setting."
Within the ophthalmology community, the AAO continues to be active with the American Society of Cataract and Refractive Surgery in working to keep ophthalmologists able to participate in physician quality reporting system measures.
With the American Society of Retina Specialists and other retinal societies, the AAO has worked to reverse reductions in the reimbursement for the use of intravitreal bevacizumab (Avastin, Genentech), which had been inadvertently caught in a Centers for Medicare and Medicaid Services (CMS) action that temporarily ignored the costs of preparation for use in the eye.
The AAO also has worked with the American Glaucoma Society to secure a change in CMS and eye-drop policies. Thanks to this collaboration, noted Dr. Repka, seniors who run out of medications due to spillage and waste before the pharmacy benefit manager felt they should, now can obtain refills after 21 days.