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What's Happening 

Academy Leader Tapped for Role with National Quality Forum

The Academy is proud to announce the appointment of William L. Rich III, MD, to the National Quality Forum’s (NQF) Efficiency Resource Use Steering Committee. Dr. Rich is the Academy’s medical director of Health Policy.  

NQF was established in 1999 as a unique public-private collaborative venture. Its mission is to improve the quality of U.S. health care by standardizing the measurement of quality-related information. The committee will provide guidance and lay the groundwork for endorsement of measures of health care resource use.

“The NQF is charged with a task that is critical to defining the future of quality patient care,” said Dr. Rich. “I am honored to serve with this distinguished panel of health policy leaders.”

Dr. Rich has served as the Academy medical director of Health Policy since 2005 and has been involved in health policy, managed care and practice management for 25 years. Currently, he serves as vice chair of the provider council of the National Quality Forum and is representative to the Ambulatory Quality Alliance. From 2003 to 2009, he served as chair of the AMA’s Resource-Based Relative Value Scale Committee, which determines the work values for all physician services, and also chaired the Resource Subcommittee, which investigated new ethnographic and quantitative approaches to physician work. At the Robert Wood Johnson Foundation and the Institute of Medicine, he has been involved with several panels concerning the future of fee-for-service Medicare, economic incentives for promoting quality, and health outcomes measures as a determinant of patient choice.

He has also served on the Academy’s Committee of Secretaries as the secretary for Federal Affairs and has played an active role in numerous other Academy activities since the 1970s.  

Dr. Rich received his medical degree from Georgetown in 1972. He completed a rotating internship at San Francisco General Hospital and completed a residency in ophthalmology at Georgetown, where he now serves on the clinical faculty. He practices currently as the senior partner with Northern Virginia Ophthalmology Associates.

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Candidates’ Views 

Meet the Board of Trustees’ Nominees for 2010 Election

In June, the Academy’s Board of Trustees nominated an official slate of officers for its 2011 Board of Trustees. The following have given their consent to serve if elected and therefore constitute the official slate. If the Academy’s membership approves all candidates, their respective terms begin Jan. 1, 2011. Academy members will be given the opportunity to vote online or by paper ballot for officers and trustee-at-large positions of the Board of Trustees.

Ruth D. Williams, MD
Board of Trustees’ Nominee for President-Elect

Ophthalmology is an extraordinary profession. We work within a community of intelligent, enthusiastic, diligent and creative individuals. At the center of this community is the American Academy of Ophthalmology: defining standards of care, setting ethical guidelines, creating professional networks, campaigning for public awareness of eye disease and providing superb ophthalmic education. With gratitude I accept the Board of Trustees’ nomination for President-Elect of this organization.   

I discovered years ago while serving as Academy Delegate to the American Medical Association that our organization is viewed as a leader among medical societies. Other medical organizations follow the Academy’s lead in establishing Preferred Practice Patterns, developing strategies for scope of practice, defining the knowledge base and creating global educational resources.

More recently, while a Trustee-at-Large and then Secretary for Member Services, I experienced the collaboration of Academy staff and dozens of ophthalmologists who have terrific ideas and the ability to implement them wisely. Examples include the Academy’s online community, the recently-launched EyeWiki and the Ophthalmic News and Education (ONE) Network.

As Secretary for Member Services, I have enjoyed working with the Young Ophthalmologists (YO) Committee. These physician-leaders in their residencies or in their first five years of practice are energizing our organization and challenging us to try new ideas. YOs are working throughout the Academy, bringing fresh ideas about how we communicate and educate.

My deepest professional satisfaction comes from the day-to-day work of seeing my glaucoma patients. From these experiences come countless examples of the true meaning and profound impact of our work. As president of the Wheaton Eye Clinic, a practice with 26 ophthalmologists in suburban Chicago, I am committed to ethical, high-quality, efficient eye care.

The American Academy of Ophthalmology has nearly 30,000 members in 143 countries. Although the Academy is large and its members are geographically diverse, technology increases our ability to connect to the individual and to provide customized services. The Academy is best when we engage all of our membership. My pledge, if elected, is to foster a multiplicity of ideas and broaden the participation of our members so that we can address the challenges ahead.

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Jonathan B. Rubenstein, MD
Board of Trustees’ Nominee for Secretary for the Annual Meeting

It is a great honor to be nominated for the position of Secretary for the Annual Meeting. Although the Academy has been very active in a variety of important areas, education and peer-to-peer networking has always been one of the Academy’s most important endeavors. The ideal venue for these activities is the Annual Meeting. It provides an opportunity for approximately 14,000 ophthalmologists from around the world to meet with each other and learn the latest developments in ophthalmology—ultimately enhancing their ability to provide the highest quality of care to their patients. Therefore, I am very excited for the opportunity to help create an outstanding Annual Meeting for our membership.

The Annual Meeting is made up of the Subspecialty Day meetings and the Annual Meeting program, which consists of scientific sessions, posters, videos, instruction courses, special projects and the skills transfer courses. Subspecialty Day attracts 6,000 to 7,000 ophthalmologists annually and occurs in the one or two days prior to the start of the Annual Meeting. Each year, a meeting is given in refractive surgery, retina and glaucoma. Other subspecialties like cornea, pediatrics, uveitis, neuro-ophthalmology and oculoplastics hold their events on alternate years. Subspecialty Day consistently receives excellent ratings from both the subspecialist and comprehensive ophthalmologist alike.

The scientific program of the Annual Meeting consists of targeted symposia (often cosponsored with our many subspecialty societies), free papers, scientific posters and videos, and instruction courses. The Annual Meeting– Special Projects Committee has created many exciting programs such as the special spotlight sessions, Breakfast With the Experts and the Academy Café. The concept of Cataract Monday with special spotlights on cataract complications and premium IOLs has arisen from this committee. The Skills Transfer Advisory Committee offers the membership an opportunity to learn the latest hands-on surgical techniques from experts. Courses in cataract, cornea, glaucoma, computers, neuro-ophthalmology, contact lenses, oculoplastics, refractive surgery and retina offer the attendees exposure to the newest surgical and diagnostic techniques in a laboratory setting. All of these parts of the Annual Meeting come together each year to provide our membership with the tools necessary to maintain and improve their ability to provide optimal care for their patients.

In recent years, special efforts have been made to tailor many of the Academy courses to residents-in-training and young ophthalmologists who have recently completed their training in order to supplement their education and attract these young ophthalmologists to the Annual Meeting. There has also been coordination with international ophthalmic societies to broaden the worldwide appeal of the Annual Meeting. Our meetings have paired with the Middle East Africa Council of Ophthalmology (MEACO), the Pan-American Association of Ophthalmology (PAAO), the European Society of Ophthalmology (SOE) and the Asia Pacific Academy of Ophthalmology (APAO) in an effort to emphasize the global nature of our mission to provide optimum care to our patients.

I have been an active member of the Academy for 24 years, receiving both the Achievement Award and the Senior Achievement Award, and have served on the Digital Media Committee, Skills Transfer Advisory Committee and the Annual Meeting Secretariat of the Academy. For the past five years, I have been Chair of the Skills Transfer Advisory Committee and have helped plan the Annual Meeting as part of my duties on the Annual Meeting Secretariat. I am an active member of the International Society of Refractive Surgery (ISRS), The Association for Research in Vision and Ophthalmology, the American Society of Cataract and Refractive Surgery and The Cornea Society. Although primarily in private practice, I am academically affiliated with Rush University Medical Center in Chicago where I hold the rank of professor and vice chair of the department of ophthalmology. In addition to directing the cornea and refractive surgery service at Rush, I also hold the Deutsch Family endowed chair in ophthalmology. At the Skokie Hospital of the North Shore University Health System, I am the director of the section of ophthalmology and am in private practice with my five partners in the University Ophthalmology Associates practice in Chicago and Skokie, Ill. Currently, I am an examiner for the American Board of Ophthalmology and am a past president of the Chicago Ophthalmological Society.

My experience in these various leadership roles and in my practice has prepared me well for the position of Secretary for the Annual Meeting. I look forward to helping the Academy and all of its membership by providing a first-rate Annual Meeting that continues the standard of excellence that we expect from the Academy.

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David A. Durfee, MD
Board of Trustees’ Nominee for Senior Secretary for Ophthalmic Practice

I would like to thank the Board of Trustees for the opportunity to serve a second three-year term as Senior Secretary for Ophthalmic Practice. Much of the business side of ophthalmology practice has stayed the same. We are all aware of the dynamics of decreasing reimbursement and increasing practice costs. Despite this common theme, the past three years have seen continuing change in the business side of an ophthalmology practice. Do we convert to an EHR and, if so, do we understand the complexities of this process? What is meaningful use and what are the implications if we do not understand this concept? What are the new codes and how do we properly use these codes? When do I need to switch from ICD-9 to ICD-10? These and other issues are constantly being monitored by your Academy. The importance of a partnership between the physician owner and his or her administrator has never been greater. Maintaining the bottom line becomes more challenging each year. To nurture this relationship, the Academy has facilitated the development of the AAOE, the Academy’s partner where practice management issues reside. Through the direction of its board of administrators and physicians and very talented AAOE staff, the AAOE continues to develop products and services that educate those responsible for managing an ophthalmology practice.

The AAOE also organizes a four-day educational meeting in conjunction with the Academy’s Annual Meeting. AAOE members have no registration fees and this meeting provides many courses and roundtables pertinent to both administrators and physicians. I would urge every Academy member to have at least one person on your staff become a member of the AAOE and consider sending an administrator from your office to the annual AAOE meeting.

If elected, I will continue to be responsive to your needs and support the delivery of the products and services you need to maximize the success of your practice.

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John R. Stechschulte, MD
Board of Trustees’ Nominee for Trustee-at-Large

It is an honor to be nominated by the Board of Trustees to serve as a Trustee-at-Large for the Academy. If elected, I will work diligently to serve all ophthalmologists by focusing on the Academy’s mission: to advance the lifelong learning and professional interests of ophthalmologists to ensure that the public can obtain the best possible care.

The Board of Trustees and the Committee of Secretaries lead in accomplishing the three key strategic goals of the Academy.

First, physician education is crucial in providing the finest quality of patient care. The Academy will continue to offer trusted and validated clinical programs and products to assist ophthalmologists in maintaining the highest level of education.

Second, advocacy is essential in order to obtain fair reimbursement, appropriate scope of practice laws and reasonable regulations. The Academy’s strong Federal and State Affairs legislative teams will continue to ensure that the needs of patients and ophthalmologists are fully represented in Washington, D.C., and all state legislatures.

Third, improvements in ophthalmic practices can be achieved by implementing evolving models of ophthalmology- led eye care teams and utilizing benchmark database results. Through the AAOE, physicians and their staffs can learn more efficient ways to better serve the growing number of seniors. Our Academy’s success in these three areas has led over 90 percent of U.S. ophthalmologists and thousands of international ophthalmologists to be continual members of our organization.

My previous Academy experiences have prepared me to serve as a productive member of the board. It was a privilege to serve on the board from 2004 to 2007 while completing my leadership roles as the Vice Chair and then Chair of the Academy Council. It was my responsibility to represent the views of all state and subspecialty societies to the Academy Board.

Diverse and even conflicting views of councilors and practicing ophthalmologists must continue to assist the Board of Trustees in making wise, fiscally-prudent, policy decisions and establishing sound long-term strategies.

I will strive to energetically complete the obligations of this office by working with the trustees, the secretaries and the Academy’s superb staff to accomplish the Academy’s goals. To best serve you and our outstanding organization, I will seek and value input from Academy members. Although we will successfully deal with the current challenges faced in the implementation of health care reform, declining reimbursement and the fragmentation of medical care, undoubtedly there will be unexpected issues that arise. I am confident that our Academy Board, with the assistance of many Academy volunteers, will succeed in their efforts to advocate for our profession, which is dedicated to the restoration and preservation of our patients’ health and vision. Your support for my candidacy and your participation in the Academy would be deeply appreciated.

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Academy Store 

Download Patient Education Videos

All nine Academy patient education video titles offered on DVD can now be downloaded as electronic files, giving practices more ways to show these videos to their patients. Videos can be loaded on a server to be shown in exam rooms, posted on a practice website or embedded in presentation slides.

Available video topics include AMD, cataract surgery, diabetic retinopathy, dry eye, glaucoma, IOL options for cataract surgery, LASIK and wavefront.

Files contain English and Spanish presentations with animations and come in a variety of file types (Flash, iPad/iPhone/iPod/iTouch, QuickTime and Windows Media).

Each title is $225 for members and $295 for nonmembers. Save up to 30 percent when you purchase the entire collection.

For more information about patient education videos or to order online, visit www.aao.org/patientedvideos.

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New Small-Gauge PPV OTA Available

The Ophthalmic Technology Assessment titled Small-Gauge Pars Plana Vitrectomy (#112072), published in September’s Ophthalmology, summarizes the safety and outcomes of the procedure. The assessment concludes that small-gauge pars plana vitrectomy has safety and visual-acuity results similar to 20-gauge pars plana vitrectomy but with lower levels of patient discomfort and ocular inflammation.

Small-Gauge Pars Plana Vitrectomy costs $11 for members and $16 for nonmembers and is also available in the Ophthalmic Technology Assessment Collection (#112071). The collection contains all current OTAs and is $50 for members and $99 for nonmembers. OTAs are also available free online to members.

OTAs are written and reviewed by the Ophthalmic Technology Assessment Committee of the Quality of Care Secretariat and of the Hoskins Center.

For more information, visit www.aao.org/one and click “Practice Guidelines” and “Ophthalmic Technology Assessments.”

Academy Store

To order products from the Academy Store, visit www.aao.org/store or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540

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Members At Large 

Oklahoma Eye M.D.s Participate in Community Clinic

The Oklahoma Academy of Ophthalmology (OAO) partnered with Remote Area Medical to provide glaucoma and diabetes eye screenings during a July event at an Oklahoma City community health center.

“We have an opportunity and an obligation to provide our citizens with quality eye care,” said OAO member Diana Hampton, MD. “State ophthalmology societies should be reaching out to community health centers to explore opportunities for partnerships.”

The event was heavily promoted and many people camped out overnight to receive eye care services. The volunteers’ eagerness to offer screenings to such a large number of patients was particularly inspiring to Annie Moreau, MD.

“Over the past 20 years, I have participated in many free eye care clinics for the underserved. This event was by far the most impressive of all,” said Dr. Moreau. “From dental to eye care, patients received high-quality services in a very efficient manner. We had all the tools to provide a comprehensive eye exam and a system was in place for referrals when needed.”

On Oct. 1, federal funding for over 1,200 community health centers will increase by one-third to $3 billion. These centers tend to operate as ambulatory health care facilities and currently provide service to 20 million Americans with limited financial resources.

“Community health centers will play a significant role in providing health care across the country, and ophthalmology should be providing a leadership role in ensuring quality eye care in these centers,” said Academy senior secretary for Advocacy Cynthia A. Bradford, MD.

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In the News

The Seattle Times quoted Thellea K. Leveque, MD, in a July 9 editorial regarding the trend among U.S. teens to use unapproved circle contact lenses to make their eyes larger—a cosmetic fad that has the potential to scratch the cornea and cause serious infection.

“If it is a severe strain of infection, you can lose vision and even in rarer cases lose the eye,” said Dr. Leveque.

The trend was most recently popularized in singer Lady Gaga’s “Bad Romance” music video, where she donned colored circle contact lenses to create the look of anime-style eyes.

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Washington Report 

Stronger Medicare Fraud Measures Enacted

The health care reform law enacted earlier this year adds new mechanisms that will increase scrutiny of fraudulent Medicare activity and require greater vigilance by practices—including ophthalmologists—in their dealings with the federal government. The law provides $250 million over 10 years for health care fraud investigations and prosecutions. Likewise, the U.S. Department of Justice has been boosting its investigative efforts. Be extra vigilant in monitoring your billings and Medicare payments, establish ethics requirements and training, and make compliance a key component in your daily business activities.

Whistleblower requirements loosened. Whistleblowers now do not have to be the “original source” of information when initiating a lawsuit alleging fraud (e.g., false billings and requests for payment, or improper Medicare overpayments). Now, information disclosed in private litigation, state or local administrative reports, hearings, audits or investigations may potentially be used as the basis of a whistleblower suit. Before, whistleblowers needed direct and independent knowledge of fraud; publicly disclosed information could not serve as the basis of a suit. With implementation of the new law, Congress hopes more instances of false claims will be disclosed, potentially resulting in more funds to be recovered.

Overpayment scrutiny. Providers who receive a Medicare overpayment must report that overpayment and return it to the government within 60 days of discovering the error. Failure to comply subjects the provider to liability, with civil penalties added to the overpayment amount. This may indicate increased liability for providers—not only for their errors that result in an overpayment, but for errors made by the Medicare contractor who paid the claim.

Anti-kickback statute expanded. Medicare now need not prove that a provider had actual knowledge of the 1987 Anti-Kickback Statute (AKS) or a specific intent to violate it; general criminal intent will suffice for additional liability. Also, claims that include items or services resulting from a referral made in violation of the AKS will automatically subject a provider to liability.

Interagency coordination strengthened. The Internal Revenue Service and Department of Health and Human Services are now authorized to share data to help identify both fraudulent and tax-delinquent physicians. The health care reform law also ensures that any physician who is terminated under Medicare is also automatically terminated from Medicaid.

For more information about Medicare fraud, visit www.oig.hhs.gov/fraud.asp.

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