As reported by Maureen Duffy in a recent VisionAware blog post, the American Foundation for the Blind hosted a national teleseminar on October 4 to discuss this critical topic. Approximately 200 people across the nation participated to hear what the panelists (listed below) had to say and to make their own comments about the need for coverage and what that coverage should look like.
Panelists
- Mark G. Ackermann, M.A., Executive Vice President & COO, Lighthouse Guild, New York and board chair of VisionServe Alliance
- Dawn K. DeCarlo, O.D., M.S., MSPH, FAAO, Chair, American Academy of Optometry (AAO) Low Vision Section; Director, Center for Low Vision Rehabilitation, University of Alabama School of Medicine
- Neva Fairchild, M.S., Chair, AER Division on Aging; National Independent Living and Employment Specialist, AFB Center on Vision Loss
- Joseph Fontenot, M.D., CLVT, Chair, American Academy of Ophthalmology (AAO) Vision Rehabilitation Committee; Medical Director, Community Services for Vision Rehabilitation, Alabama and Mississippi
- Bhavani Iyer, O.D., Chair, American Optometric Association (AOA) Vision Rehab Committee
- Kelly Lusk, Ph.D, CLVT, Chair, AER Low Vision Rehabilitation Division; Cincinnati Children’s Vision Rehabilitation Program (CCVRP)
- Tony Stephens, Director of Advocacy and Governmental Affairs, American Council of the Blind
- Peter W. Thomas, Esq., Principal, Powers Pyles Sutter & Verville, Government Relations/Legislative
Synopsis
There was a consensus among panelists and call participants to pursue coverage for low vision devices. Panelists discussed and debated a variety of matters that must be addressed if Medicare coverage is to be achieved, including the types of specific devices to be covered, amount of coverage, visual acuity vs functional visual eligibility, and the need for appropriate low vision evaluation and training.
Peter Thomas laid out some concerns related to Medicare and their current policy of not providing glasses, including anything that has a lens. He also discussed some limitations of Durable Medical Equipment regulations, including the current rule that the equipment should be used in the home. This fact was of major concern to panelists and participants who felt that low vision devices, when properly prescribed and used, can be life-changing and also contribute to the prevention of falls.
Thomas further stated that if the current demo bill is passed, there are other hurdles such as development of coverage and coding policy. Plus, he mentioned that Medicare would be concerned about the costs of the program depending on what is allowed and projected numbers. Mark Ackerman stated that based on an article in the Archives of Ophthalmology from October 2010, there were 1.5 million Medicare beneficiaries with uncorrectable low vision or blindness that could make them eligible for these devices. However, a much smaller number—in the hundreds of thousands—would be able to use these devices or would comply with a prescription for these devices, so the number of people drawing on Medicare funds to receive these devices and services would be quite manageable.
Another concern that was raised is that there is little evidence-based research available to support the request. It was suggested that a research component should be built into the bill.
The program was recorded and is available through Dropbox along with the transcript.
This initiative is part of the 21st Century National Agenda on Aging and Vision Loss facilitated by AFB but embraced by national and local organizations throughout the country. Goal 4 is chaired by Tony Stephens of the American Council of the Blind. The current bill that has been introduced in Congress for a demonstration project is House Bill 2050: The Medicare Demonstration of Coverage of Low Vision Devices Act of 2017.
Next Steps
The Goal 4 group will be taking the initiative forward by inviting principals to the table to discuss and decide on critical next steps. All of the panelists indicated interest in going forward.
Find out more about the 21st Century Agenda on Aging and Vision Loss
References
Morse AR, Massof RW, Cole RG, Mogk LG, O’Hearn AM, Hsu Y, Faye EE, Wainapel SF, Jackson ML. Medicare Coverage for Vision Assistive Equipment. Arch Ophthalmol. 2010;128(10):1350-1357. Retrieved from https://jamanetwork.com/journals/jamaophthalmology/fullarticle/426338