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November/December 2010

 
Academy Notebook
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What's Happening 

New Academy Initiative Focuses on At-Risk Populations

The Academy has launched a new initiative—EyeSmart EyeCheck—to combat undetected eye disease and visual impairment among at-risk populations in the United States. The launch comes as research from the Los Angeles Latino Eye Study (LALES) shows that Latinos have higher rates of visual impairment, blindness, diabetic retinopathy and cataracts than non-Hispanic whites.

“What’s important about the LALES research is that it underscores the fact that eye disease affecting quality of life remains undetected in far too many individuals,” said Academy CEO David W. Parke II, MD. “Vision is one of our most valued and precious senses. Even seemingly small degrees of visual impairment can impact our daily activities, mobility and quality of life. It does not have to be this way, and ophthalmologists are going to do something about it.”

Through the EyeSmart EyeCheck initiative, the Academy and its partners will work to raise awareness and understanding of the impact of eye disease and visual impairment, particularly among minority populations who disproportionately lack access to care. The initial emphasis will be on the Latino community.

The program involves:

  • piloting and facilitating free screenings to help identify undiagnosed visual impairment and eye disease among populations at greatest risk and with limited access to health care services;
     
  • building and hosting a national inventory of community eye screenings that use the EyeSmart EyeCheck approach at www.geteyesmart.org/findaneyecheck; and
     
  • providing referrals to eye care and bilingual eye health information at the screenings as well as online.

The Academy’s EyeSmart EyeCheck program will be working with EyeCare America and local health departments and community clinics to provide referrals for care once a diagnosis is made. In addition, EyeSmart EyeCheck will work with local hospitals, community clinics and health departments to steer patients to treatment.

As reported in the May American Journal of Ophthalmology, the LALES findings reveal high incidence of visual impairment and high rates of worsening of visual acuity in Latino individuals. These rates are higher than any other racial/ethnic group studied in the United States. The incidence of multiple diseases in this community and in other at-risk populations is what prompted the Academy to adopt and promote a different approach to adult vision screenings.

For more information, visit www.geteyesmart.org and click “EyeSmart EyeCheck.”

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New President of the Foundation Advisory Board

The Academy has announced the appointment of Tony McClellan as president of its Foundation Advisory Board (FAB).

In his role, Mr. McClellan will work with Academy leadership to ensure that the FAB and the Foundation’s fund-raising program provide the philanthropic support necessary to advance the mission of the Academy.  

“Through their commitment and generosity to help prevent avoidable blindness and severe visual impairment worldwide, members of the FAB provide the leadership and example that inspires many others to philanthropically support our efforts,” said Academy CEO David W. Parke II, MD. “I am grateful for all they do and I look forward to working with Tony in his new role as president of the FAB.”

Mr. McClellan currently holds positions as chair of Montgomery Property Group, chair of Brookend Enterprises Management Services and director of Groupe Gifa SA. “I have been proudly involved with the Foundation and have served as a member of its advisory board for seven years,” said Mr. McClellan. “I am honored to have been given the opportunity to expand my role and help the Foundation continue its success in supporting the Academy’s mission.”

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Academy Supports Ban on Landmines

On Sept. 8, the Academy became one of 20 health associations, including the American Medical Association and the American Public Health Association, calling on the United States to support the 1997 Mine Ban Treaty in a letter to President Obama. Following are excerpts from the joint letter:

“Antipersonnel landmines injure and kill thousands of people each year. Hundreds of thousands more suffer from the agricultural, economic, and psychological consequences of living in mine affected communities, mostly in the world’s poorest countries. As health professionals see first hand, landmines kill, amputate, and blind men, women, and children. They propel shrapnel, vegetation, and contaminated soil and debris into soft tissue and bone, often producing severe infection. Inadequate hospital and surgical care further endanger landmine survivors . . . Many senior retired U.S. military leaders have also voiced support for the treaty, citing the danger mines pose to our own troops as well as the lack of need for mines on the modern battlefield . . . The U.S. now has the opportunity to lead by example on this issue and cooperate with the community of nations by joining the Mine Ban Treaty.”

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FYI 

Ask the Ethicist: Exaggerating Necessity

by Charles M. Zacks, MD
Chair, Ethics Committee

Q: A long-standing patient is concerned about her droopy eyelids, but she clearly does not meet insurance requirements to be considered “functional” for blepharoplasty surgery. She has asked me to exaggerate the necessity for the surgery in order to get her insurance to pay for the procedure. Is this ethical?

A: It is unethical to exaggerate your description of a patient’s condition in order to meet an insurance company’s documentation requirements for a particular cosmetic procedure. There is considerable legal risk for the physician who “miscodes” or misleads via documentation. In addition, there are significant medicolegal risks in the event of an untoward outcome. Rule 9 of the Academy Code of Ethics states, “An ophthalmologist must not misrepresent the service that is performed or the charges made for that service.”

With respect to the patient’s specific request, in most cases there is a relatively straightforward way to resolve this dilemma without upsetting the patient by refusal. Because most insurance carriers will only pay for blepharoplasty surgery in the case of documented functional disability, the carrier will require visual field tests and external photos of the patient to substantiate the authorization. Then the insurance carrier will either authorize the surgery or not based on its review of this objective data and not on the opinion of the surgeon. Once informed of this fact, the reasonable patient will understand your justification for declining her request. In the absence of that understanding, you may wish to suggest the patient obtain a second opinion or, in the case of a persistent patient, end the physician-patient relationship and offer referral to other practitioners.

For more information or to submit a question for this column, contact the Ethics Committee staff at ethics@aao.org. To read the Code of Ethics, visit www.aao.org/about and click “Ethics” and “Code of Ethics.”

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Seeking Outstanding Ophthalmologists

Would you like to nominate a colleague for next year’s Outstanding Humanitarian Service Award? The Academy must receive your nomination by March 14.

The award recognizes Academy fellows and members for outstanding contributions to humanitarian efforts, such as participation in charitable activities, care of the indigent and community service. It acknowledges those who have performed above and beyond the normal duties of an ophthalmologist.

To obtain a nomination form, please contact Member Services by phone, 866-561-8558 (toll-free) or 415-561-8581; by fax, 415-561-8575; or by e-mail, member_services@aao.org . You can also complete a nomination form online by visiting www.aao.org and selecting “Member Services” and “Learn about awards.”

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Continue Your Meeting Conversations Online

The valuable exchanges and connections that you made at this year’s Joint Meeting do not have to end when the meeting adjourns. Visit the Academy Online Community and join the alumni, subspecialty and special interest groups, where you can stay in touch with your ophthalmic peers and share insights, opinions, ideas and experiences. There is also an Annual Meeting group that is accessible year-round.

To post your photos from the 2010 Joint Meeting, visit www.aao.org/community and log in with your Academy username and password.

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Academy Store 

New DALK OTA

The Ophthalmic Technology Assessment of Deep Anterior Lamellar Keratoplasty as an Alternative to Penetrating Keratoplasty (#112073), which will be published in December’s Ophthalmology, summarizes the safety and outcomes of the procedure and concludes that DALK appears equivalent to penetrating keratoplasty for visual acuity outcomes and may be superior for preservation of endothelial cell density.

OTA reprints are $11 for members and $16 for nonmembers and are also available in the 2010 Ophthalmic Technology Assessment Collection (#112071). This collection contains all current OTAs and is $50 for members and $99 for nonmembers. OTAs are available free online to members.

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

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Check Out the New AAOE Coding Module

A new addition to the full line of updated AAOE coding products is the 2011 Ophthalmic Anatomy and Physiology for ICD-10 Coding Module (#0123008), part of the 2011 Ophthalmic Coding Series: Essential Modules Collection (#0123020). Developed by the Academy’s coding experts, this module prepares you for one of the most dramatic changes you will encounter in coding. It reviews the ophthalmic system to help you understand how the ICD-10-CM is used to identify the appropriate diagnosis or condition and offers one AMA PRA Category 1 credit and one JCAHPO Group A credit.

This module is $45 for members and $60 for nonmembers. The collection is $285 for members and $380 for nonmembers.

For a complete list of AAOE’s coding and reimbursement products, visit www.aao.org/codingproducts. Receive a 10 percent discount when you order four coding products together.

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Subscribe to Receive the Latest Patient Education Handouts

Download and print nearly 100 patient education handouts describing eye conditions and treatment options across all subspecialties. These full-color handouts feature peer-reviewed content, high-quality images and space to include your practice information. A subscription ensures access to the most up-to-date versions.

A one-year subscription is $275 for members and $370 for nonmembers.

For a complete list of handouts included in the subscription, visit www.aao.org/store and enter “pehandouts” in the search field.

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2011 Focal Points Subscriptions Now Available

The 2011 Focal Points CME program features 12 modules on clinical topics. Combining the latest research findings with clinical discussions on diagnosis and treatment of a specific disease or condition, every module also includes “Clinicians’ Corner”—an experts forum on controversial clinical issues discussed in the module.

Next year’s upcoming module titles consist of:

  • Cicatrizing Conjunctivitis
     
  • Update on the Management of Diabetic Retinopathy
     
  • Pediatric Cataracts
     
  • Facial Fillers
     
  • Laser Treatment of Glaucoma
     
  • The Anomalous Optic Nerve
     
  • Cataract Surgery in the Developing World
     
  • Headache and Facial Pain for the Ophthalmologist
     
  • Evaluation and Management of the Dissatisfied Multifocal IOL Patient
     
  • Antibiotic Use in Corneal and External Eye Infections
     
  • Prescribing Prisms
     
  • Management of Neovascular Glaucoma
     

Subscription options. Focal Points print modules are sent in quarterly mailings of three modules each. Print subscriptions include access to online modules that are posted monthly. These combined print and online subscriptions are $187 for members and $252 for nonmembers within the United States, Canada and Mexico. International subscriptions are $217 for members and $282 for nonmembers. Save up to $114 with a multiyear subscription. Focal Points online modules are also accessible from any computer with an Internet connection and include enhanced features such as surgical videos, note-taking tools and reference links to PubMed. One new module is available online each month. Online-only subscriptions are $155 for members and $209 for nonmembers. Save up to $92 with a multiyear subscription.

CME. Earn up to two AMA PRA Category 1 credits per module for a maximum of 24 credits per subscription.

To order a 2011 subscription, visit www.aao.org/focalpoints, or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540.

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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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Meeting Matters 

Mark Your Calendar for Orlando 2011

Join us in Orlando for the 2011 Annual Meeting. The meeting will take place Oct. 22 to 25 at the Orange County Convention Center. It will be preceded by Subspecialty Day on Oct. 21 and 22, which will feature meetings in refractive surgery, retina, cornea, glaucoma, neuro-ophthalmology and pediatric ophthalmology.

For Annual Meeting updates, visit www.aao.org/2011.

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Submit Abstracts for Papers, Posters and Videos

If you are interested in being a presenter at next year’s Annual Meeting, abstracts must be submitted online:

For instruction courses and Skills Transfer Courses, the submitter opens on Dec. 8 and closes on Jan. 11.

For paper, posters and videos, the online submitter opens on March 16 and closes on April 12.

For information on submitting an abstract, go to www.aao.org/presentercentral. For further information, e-mail meetings@aao.org.

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Revisit Highlights of Chicago 2010

If you missed a particular session from the 2010 Joint Meeting or Subspecialty Day, you can still catch up on the following highlights:

Go online for Scientific Posters. View hundreds of scientific posters from 2010 and other past Annual Meetings.

Buy a Chicago DVD-ROM. Seven DVD-ROMs cover the Subspecialty Day programs. DVDs are also available for Spotlight on Cataract Surgery 2010.

Download instruction course and Technology Pavilion handouts. Handouts from 2010 instruction courses and technology presentations will be available to download beginning in mid-December.

To take advantage of these highlights and more, visit www.aao.org/2010 and select “Scientific Program” and “Meeting Archives.”

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Claim Your 2010 Chicago CME Credits by Jan. 20

Beginning Dec. 15, the CME credits that you earned at the 2010 Joint Meeting and/or Subspecialty Day can be reported online. Credits must be reported by Jan. 20.

As a service to members only, the Academy maintains a transcript of Academy-sponsored CME credits earned, provided the member reports those credits to the Academy. Members may also report credits earned through other CME providers, so that a record of all CME credits earned is available on a single transcript.

To report your CME, go to www.aao.org/cme.

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Members At Large 

Puerto Rican Society Unveils Online Referral Program

On Aug. 11, La Sociedad Puertorriqueña de Oftalmología (SPO) helped the Academy Foundation launch the EyeCare America (ECA) online referral pilot program in Puerto Rico. “This was a wonderful opportunity to highlight ophthalmology’s commitment to the public and our patients and to further our message about SPO commitment to helping the underserved receive eye care,” said SPO President Ian K. Piovanetti, MD.

Leading up to the launch of the online referral program, SPO leaders—including Dr. Piovanetti and Odayls Mendoza, MD, chair of the SPO’s community relations committee—were hard at work ensuring that the event would receive good press as well as assisting with the translation of related ECA materials into Spanish. Their efforts paid off in panel discussions with a television interview on Puerto Rico’s Channel 4 Televicentro and a private meeting with Puerto Rico Gov. Luis Fortuño.

“The SPO is excited to collaborate on the new online referral program,” said Dr. Piovanetti. “In the first 24 hours following the launch, we received 71 referrals and only expect that number to continue to grow over time.”

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Passages

Steve Carter, former Academy vice president of Communications and director of State Affairs, passed away on Sept. 20 at the age of 61. He was most recently the executive director of the American Society of Nuclear Cardiology.

Mr. Carter served in the U.S. Naval Reserve from 1969 to 1974. He was a veteran of the Vietnam War and earned the Bronze Star Medal for bravery, acts of merit and meritorious service. Following his discharge, he earned a bachelor of arts degree from Washburn University and a master of public administration degree from the University of Kansas.

During his career, Mr. Carter served as legislative liaison for the State of Kansas Office of Judicial Administration, executive director of the Kansas Corporation Commission and executive director of the Minnesota Medical Society.

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Washington Report 

Options as Medicare Pay Cut Approaches

For the fourth time since last December, physicians face another significant sustainable growth rate (SGR) cut in Medicare reimbursement on Dec. 1. With Congress allowing the cut to be temporarily enacted and then reversed this year, physicians are frustrated as they weigh their Medicare participation options for 2011. Physicians across the country are forced to make difficult decisions about their practices and patient mix.

Members have indicated more than ever before that they are seriously analyzing and considering nonparticipation and other options under the Medicare program. However, the current options do not offer ophthalmologists real choices. While an Academy member survey released last spring indicated that a majority of ophthalmologists would change their Medicare participation status if the SGR cut was implemented, physicians are now looking at the disruption factor. And if Congress enacts the expected short-term fix, throwing the problem to the next Congress, physicians could be in for another disruptive year.

The Academy is joining with the American Medical Association and the American College of Surgeons to create workable participation options under Medicare. A new “private contracting” option, for example, would allow patients and physicians to freely contract—without penalty to either party— for a fee that differs from the Medicare payment schedule and in a manner that does not forfeit benefits otherwise available to the patient.

Ophthalmology is one of the highest participating specialties under Medicare. Ninety-seven percent of those ophthalmologists responding to the survey said that they are participating physicians. Nine of 10 ophthalmologists who said they would remain a Medicare-participating physician said the pay cut would force them to change their practice in some way, including:

  • deferring purchase of new medical equipment,
     
  • reducing staff,
     
  • limiting the number of Medicare patient appointments,
     
  • reducing time spent with Medicare patients, and
     
  • deferring purchase of information technology.

Medicare participation options are listed on the AMA website. We hope this information serves as a useful tool for you and your practice. Carefully review and consider the information about your options. The Academy will continue to provide up-to-date information on Medicare physician payments so that you may make an informed decision about your participation.

The Academy is joining with the AMA and American College of Surgeons to create workable participation options under Medicare.

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