Spring PDF - Missouri Optometric Association

VISION
The Journal of the
Missouri Optometric Association
Spring 2012
MOA Goes to Washington

PRESIDENT’S MESSAGE
Occupy Jefferson City
According to Wikipedia, the Occupy Movement is “an international protest
movement directed towards social and economic inequality, its primary
goal being to make the economic structure and power relations in society
fairer.” Because much of the emphasis is related to the financial system, the
movement has also been described as “anticapitalistic.”
After recent events in Jefferson City and hill visits in Washington, DC, I
better understand the protestors’ discontent, and I am perhaps becoming “anti-
Capital-istic” myself.
Our representative democracy allows us to elect leaders to represent us in our
state and national Capitals, ostensibly to listen to arguments and make just
decisions in the best interest of the electorate.
Dr. Jeffrey Weaver
MOA President 2011-2012
Our fight is not over yet, but I am beginning to believe that our system may
have failed us. Even on issues on which there is a clear right and wrong,
our leaders can be influenced to support the wrong decision. The system has
embittered me to the extent that when phoned for support of issues for which I used to eagerly grab my checkbook,
I emphatically demand to be taken off of the call list. For those of me who know me well, yes, that includes the
Republican Party.
So, despite my 30 years of commissioned military service in support of our way of life, I think we may have made a
mistake. Perhaps we would be better off with some type of monarchy, even a dictatorship, if only we could be assured
of one with the wisdom approaching that of Solomon. Surely, Solomon could solve our biggest issue of the year just
by asking who is willing to have their own child have only a vision screening.
Perhaps the best
hope for
Missouri Optometry
is knowing that our
colleague Terry
Swinger is running
for the Missouri State
Senate!
But even when things seem bleak, there is always hope. The
governmental affairs committee has been busy, and MOA staff
and lobbyists even busier, trying to ensure the best futures for the
children of Missouri. We still have a few critical weeks left!
Perhaps the best hope for Missouri Optometry is knowing that
our colleague Terry Swinger is running for the Missouri State
Senate.
While I can’t fathom the length of his speeches if we ever made
him dictator, nor do I believe he is quite as wise as Solomon,
he will represent optometry and his constituents with honor,
sensibility and passion. Terry is one person for whom I will
open my checkbook these days, and I hope you will do so as
well. He is surely Missouri Optometry’s best hope to Occupy
Jefferson City!
2

MOA Goes to Washington
34

Optometrists and optometry students met in Washington DC for the AOA Congressional
Conference and the AOA State Government Relations Center (SGRC) and the Third Party
Center(TPC) meeting held concurrently.
We arrived in DC just in time to enjoy the 100th anniversary of the gift of 3,000 cherry blossom
trees from Tokyo to Washington DC. What an incredible sight!
Dr. Scott Ream, Missouri’s Third Party Committee Chair attended the TPC lectures while Dr.
Lee Ann Barrett made a presentation on grass roots politics at the SGRC meeting.
Drs. Scott Burks, Tom Cullinane and Jeffrey Weaver represented Missouri at the Congressional
Conference. Dr. Howard McAlister attended as the faculty liaison from the UMSL-College of
Optometry.
UMSL Optometry students joined the MOA for the visits to Capitol Hill. A total of 17 UMSL
students attended the meeting with 8 of those joining their home state delegations on hill visits.
Missouri welcomed an SCO student to our delegation as well.
Student Delegation Enjoying Washington DC
We were able to speak to the offices of the entire Missouri legislative delegation. Topics
covered included:
• the addition of optometry as participants in the National Health Service Corps(NHSC)
• and the classification of optometrists as physicians under the Medicaid system.
Congressman Emanuel Cleaver is a cosponsor of the Equity in Medicaid legislation and
Congressman Todd Akin and Congresswoman JoAnn Emerson are cosponsors of the NHSC
legislation.
A big thank you to the doctors and students that took the time out their busy schedules to lobby
on behalf of optometry!
ODs in Washington with AOA
• Lee Ann Barrett, OD
• Scott Burks, OD
• Howard McAlister, OD
• Scott Ream, OD
• Tom Cullinane, OD
• Jeffrey Weaver, OD
• Steve Branstetter
• Robert Ensley
• Kevin Hoang
• Matt McCoy
• Carrie McDowell
• Jenna Osseck
• Emily Pike
• Evan Strong
• Alan Wegener
• Inna Timshina (from SCO)
Optometry Students
• Neil David (CA)
• Neha Dharia (IL)
• Jennifer Dovich (CA)
• Aaryn McComb (TX)
• Tareq Nabhn (AR)
• Andrea Peterson (AR)
• Jen Sidun (OH)
• Tuesday Warner (CO)
At left: Optometry students enjoying their stay in Washington, D.C.
3

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Congratulations
MOA Members
Elected to National
Academies of Practice
Thirteen (13) distinguished optometry professionals were recently elected to
the National Academies of Practice (NAP) in honor of their achievements and
contributions to the health care profession.
Two of them were members of the Missouri Optometric Association.
• William McAlister, OD, MA, MPH,
Distinguished Scholar and Fellow, St. Louis, MO
• Timothy Wingert, OD,
Distinguished Scholar and Fellow, St. Louis, MO
Founded in 1981 in recognition of the need for interprofessional collaboration
in health care, NAP is a non-profit organization representing 10 health care
disciplines— dentistry, medicine, nursing, optometry, osteopathic medicine,
pharmacy, podiatry, psychology, social work and veterinary medicine.
Practitioners and scholars are nominated and elected to NAP based on strict criteria
that ensure the highest level of professionalism among members.
The MOA congratulates Drs. McAlister and Wingert on their stellar accomplishment
6

MOA Assistant Executive Directory, Jay Hahn, and Scott Burks, OD, at the 2012 Corneal Classic
UMSL Hosts Corneal Classic
The University of Missouri-St. Louis College of Optometry AOSA chapter held its annual Corneal
Classic golf scramble on April 21st this year and it was a great success!
The tournament was held at Normandie Golf Club and close to seventy golfers participated. Many
optometry students participated as well as many optometrists and suppliers around the area. The course
was in great condition and the weather cooperated perfectly.
After the round, the golfers enjoyed catering by the famous Pappy’s Smokehouse while we raffled off
some amazing prizes. The winners of the Optic Cup this year were Jason Riley, Dan, Mike, and Jay
Wright with an amazing score of 59!
A portion of the golf tournament’s proceeds will be donated to the St. Louis Society of the Blind and
will also help fundraise events such as the Eyeball, a formal held in honor of the graduating fourth
year students.
87
The UMSL AOSA chapter would like to thank all the golfers, hole sponsors, and volunteers who made
this beautiful day so enjoyable.

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MOA’s I n d u s
In 1994, the MOA, under then President Carter Glass, developed the Industry Alliance program to foster
a working relationship between organized optometry and the ophthalmic industry and to recognize them
for their contributions to the MOA.
The program is now 18 years old and despite the many changes occurring in the industry, the program is
still going strong.
The Industry Alliance Program has three levels of participation, supporting level, director level and the
executive level. The current members of the Industry Alliance are:
Executive Level
• Duffens/Essilor
• HOYA
• Midland Optical
• Ozark Optical
• Sutherlin Optical
Supporting Level
• Firestone Optics, Inc.
Over the next several issues of the VISION, we will be highlighting our Industry partners and urge you
to support the folks that support your profession!
Part 1 – Duffens Optical
Meet Duffens Optical.
At left: John Anderson, Sales Representative
Essilor of America
At right: Dennis Bruns, General Manager Essilor
of America Duffens Optical Lenexa Kansas.
9

t r y A l l i a n c e
We have exciting events happening at Duffens/Essilor. The biggest
news is Digital Surfacing is coming to Duffens Lenexa! We have been
awaiting the launch of in house digital at the Lenexa facility for quite
some time, and now we are seeing it come to fruition. The date is set
for May 9th to begin operating this digital line.
Besides our great employees, ability to run digital in several of our
labs, we are also very excited about new product that launched this
year.
Thank you for allowing us to shine a spot light on the most innovative
technologically advanced anti-reflective lenses on the market today.
We at Duffens/Essilor are thrilled about offering the revolutionary new Crizal UV lenses. These lenses
are currently available in Crizal Avance UV and Crizal Sapphire UV.
We look forward to the launch of Crizal Easy UV and Crizal Alize UV later this summer. Crizal UV
lenses continues to give the WOW, factor to its wearers for being the clearest, easiest to clean, most
scratch resistant no-glare lenses on the market today. Now, we can add to that long list the benefit of
maximum UV protection for long-term eye health.
UV Light Transmission
and Reflection
Essilor’s R&D departments have spent countless hours researching the harmful damage done to the eye
by reflective UV rays.
In addition, to aiding in reversing the UV damaging trends; we are committed to fighting this enemy
of healthy eyes by eliminating harmful UV reflection. Crizal UV lenses stamp out those harmful UV
reflections. Now, the WOW factor of the clearest, easiest to clean, most scratch resistant no-glare lens to
ever hit our industry also gives the best protection against UV, promoting long term eye health.
Duffens /Essilor has partnered with the Missouri Optometric Association’s Industry Alliance for many
years. We are proud to continue this partnership now and in the years to come.
10

NO!
WHAT TO DO
When a
Managed Care Organization Says
Take the Right Approach and Know State Law can Overturn a Rejected Application
Many optometrists drop the issue once an HMO or PPO rejects their application. Or maybe they didn’t
even get the application form in the first place. When the MCO was contacted, a provider relations
representative told then the panel does not include optometrists or that the plan isn’t taking applications
right now.
When an HMO or PPO tells you no, there are steps you can take to appeal the case. The following looks
at the most common reasons MCOs reject a doctor’s application, and how to overcome them.
Resubmit the Application
In some cases a low-level plan employee erred or the application when to the wrong person in the
organization. Some HMOs and PPOs have local or regional offices; where the application ends up could
determine its outcome. Resubmitting it to the right person in the right office can save you much trouble.
Follow Through
Many optometrists make a phone call, or have a staff member call, to ask for an application, only to
be told that optometrists are not allowed to participate on the panel. Unfortunately for many, that call
is the end of contact with that plan, yet in many cases the plan representative is passing on incorrect
information.
Document the phone call with the time, date and notes on what transpired. Make sure you have the name
of the representative that you dealt with and the person’s extension and title. Try to get a letter from the
HMO stating the reason for denial. Without this letter, you will have a difficult time pressing any further
actions.
11

Explain Full-Scope Optometry
Even if the HMO or PPO does not include routine eye exams and materials, medical eye exams and
diagnostic services should still be reimbursable. Explaining to the plan executives that optometric
participation does not mean new benefits is critical. It shows them that including optometry is a
relatively simple process. We use the same diagnosis and treatment codes as other providers. And plans
that don’t have supplemental vision care benefits for routine eye exams should still include ODs to
provide services that fall within the scope of optometric practice.
Know the Law
Perhaps the plan is flaunting state laws. Be sure to check the state laws regarding managed-care
organizations and providers.
ERISA Plans
This federal program supersedes all state laws regarding anti-discrimination, freedom of choice or
any willing provider. But these laws only apply to self-funded, company-sponsored plans, usually set
up by large corporations. Some ERISA plans are not easy to identify. Sometimes they appear to be an
insurance company plan regulated by state laws, but actually the insurance company acts only as plan
administrator. So if you contact the insurance company, you could be contacting the wrong entity. The
plan’s key decision makers can be halfway across the country.
The Harkin amendment in the new Patient Protection and Affordable Care Act (Obamacare) addresses
discrimination in ERISAs, but does not take effect until 2014.
Automatic Disqualification
Among factors that can cause this to happen: pending or past malpractice litigation, criminal charges,
state board disciplinary action and more. Some HMOs and PPOs will not consider you if any plan has
dropped you from its panel for any reason.
The best strategy here is prevention. You should realize that plans expect you to act in a responsible,
business-like manner.
Other reasons are that the optometrist does not meet the credentialing requirements, or that the
optometrist has to belong to a specific vision plan in order to participate in the medical plan (a problem
the MOA is working on currently).
Closed Panels
This happens when a panel already has too many of one class provider in a certain geographic area. You
might still be able to convince the network to add you if you provide a specialty that it does not offer,
such as low vision or vision training.
You should try to obtain a provider list to find out whether the plan has enough optometrists or if it
has based its eye care needs on ophthalmologists. You may be able to check the provider finder for
optometrists on the managed care plan’s website.
Continued on page 13
12

CyberAccess Optical
Help Tips
For those of you that are MOHealthnet providers,
you are aware that there have been some changes
to the CyberAccess program that allows you to
precertify exams and materials for our Medicaid
patients.
Kimberly Hicks with ACS has provided us
with some helpful hints for using the improved
multiple service feature on now on CyberAccess.
• Make sure you save www.cyberaccessonline.
net to your Favorites
• Turn off the pop up blocker
• If using Internet Explorer 8 or 9, you will
need to adjust for “compatibility view” by
going to Tools and adding the CyberAccess
website
• Allow the demographics page to completely
load before proceeding with precertification
requests
• Be aware that there is a Help Text in the
upper right hand corner of the web portal
(question mark in the upper right hand
corner next to the printer icon, under the MO
HealthNet logo).
• DO NOT use decimal points when entering
the diagnosis code
If using the multiple services feature, you select
“multiple services” on the menu.
Please Note: You are not to use the multiple
services feature for exams and lenses/frames
in the same request. However, you could order
lenses and frames together, just do not include
the exam in the same pre-certification request.
If you have questions, contact the ACS Help
Desk at 888-581-9797 or contact your Provider
Outreach Representative.
What to Do, continued from p. 12
Reasoning with MCO executives is always best,
especially when they can choose between you
or a colleague down the street. Do not threaten
litigation, legislation or bring an attorney to
the initial meeting. This puts the plan on the
defensive and will end the open dialogue you
are striving for. Remember many insurance plan
representatives do not understand what services
optometrists can provide and may not realize
why your issue is even an issue.
Keep your focus on providing them with
information, helping them solve a business issue
or prevent a small issue from developing into
something larger. Be a resource and positive
solution. The plan providers may not know that
ODs can prescribe medicine, manage ocular
and systemic diseases, use the same diagnosis
and treatment codes as other providers, and
can improve their HEDIS score. They may not
realize ODS are in more areas for better access,
and optometric care can be cost effective for the
MCO. There is a PowerPoint available from the
AOA Third Party Committee to help with your
presentation.
Know the options and the chances before you
apply. Afterward, if you don’t like the answer,
retrace the steps, so you are sure you covered
all the bases. Your inclusion in the panel may
not happen immediately, but over a period of
time positive and persistent communication with
managed care organizations can yield positive
results for optometry.
If you have been denied, let the MOA and the
AOA’s Third Party Center assist you. The more
optometrists that report the denial, the more
likely action will be taken.
13

SOCIETY REPORTS
Missouri Optometric Society Trustees
Central Society (5) — Jeffrey Gamble, OD | P: 573-874-2030 | jmgamble@socket.net
Greater Ozark Society (8) — Katie Robertson OD | P: 417-886-5444 | robertson.kt@gmail.com
Kansas City Society (3) — Melanie Linderer, OD | P: 816-781-2100 | jmlinderer@sbcglobal.net
Northeast Society (2) — Mindy Blackford, OD | P: 660-665-6262 | mindymblackford@hotmail.com
Northwest Society (1) — Stephanie Erker, OD | P: 816-322-1872 | serker@bso-ae.com
Southeast Society (9) — Dan Obermark, OD | P: 573-471-1080 | dro@obermarkeyehealthcare.com
Southwest Society (7) — Justin Stilley, OD | P: 417-781-9900 | justinstilley@hotmail.com
St. Louis Society (6) — Thomas Cullinane, OD | P: 314-579-0909 | seeingme@sbcglobal.net
St. Louis Society (6) — Robert Goerss, OD | P: 636-272-1444 | drgoerss@yahoo.com
West Central Society (4) — Jason Lake, OD | P: 660-747-2000 | lake.od@juno.com
Central Missouri Optometric Society (COS)
In February, we were fortunate to have AMO sponsor
our evening at CC’s City Broiler in Columbia where
Scott Ghormley informed the group on the benefits
of Revitalen contact lens solution. The current status
of the Children’s Vision Law was discussed and a
reminder for Keypersons to contact legislatures was
made.
Our March meeting was held at The Grand Cru in
Columbia. The evening was sponsored by Allergan,
who provided dinner and a presentation by glaucoma
specialist John Lind, MD. The presentation was well
received.
April took the group back to CC’s City Broiler in
Columbia to hear about the tax and liability advantages
of incorporating the right way from a company called
Legally Mine.
The Central Optometric Society meets together on the
fourth Tuesday each month.
Greater Ozark Optometric Society (GOOS)
The Greater Ozarks Optometric Society had a good
turnout at our most-recent GOOS Meeting at Mr.
Yen’s restaurant in Springfield on April 17th, 2012.
Dr Carol Scott presented a one hour CE course for
our members titled ‘Amblyopia as a Window to
Neuroplasticity in the Visual System.’ Dinner was
sponsored by HTS computer system and drinks by
Missouri Eye Institute.
Our next meeting is May 15th at 6:30pm at
Metropolitan Grille in Springfield. It will be a regular
business meeting with a guest speaker from Zioptan.
During the summer months, we will take our annual
break and then return for an August Election Meeting.
A Fundraiser for Rep. Lincoln Hough will take
place on May 3rd at 5:30pm-7:30pm at Bruno’s in
Downtown Springfield. Rep. Hough is running for
the 135th District and would like Optometry’s help.
Please come and show your support.
Kansas City Optometric Society (KCOS)
The next meeting of the Kansas City Optometric
Society is May 7 2012.
Furthermore, mark your calendar for our legislative
BBQ schedule on June 4 2012. Please remember to
support Dr. Terry Swinger with a contribution to his
Senate campaign. Dr. Swinger is running for Senate
and would be a huge asset for optometry and the
citizens of Missouri as a senator.
14

SOCIETY REPORTS
Northeast Optometric Society (NEOS)
The NEOS met Feb 1 2012 at The Pear Tree in for our
presidential visit. Special guests were Dr Jeff Weaver,
Dr Leeann Barrett and Jay Hahn. Topics of discussion
included Children’s Vision and Board Certification.
Our society day is scheduled for Feb 28.
The NEOS society day was Feb 28. Dr Duane
Thompson and Dr Bob Sloan visited with our elected
officials and educated them on the Children’s Vision
bill. The other society members who were unable to
attend our society day made personal calls to their
senators and representatives.
Northwest Optometric Society (NWOS)
No Report Available
St. Louis Optometric Society (SLOS)
The January meeting was sponsored by Eye Solutions
and a presentation by Dr. Jerome Sherman from SUNY
was given where he discussed establishing an AMD
center of excellence.
February’s meeting was sponsored by Bausch and
Lomb, and a grand rounds presentation was given by
the UMSL College of Optometry.
will be held in June at the Living World at the St.
Louis Zoo.
Southeast Optometric Society (SEOS)
No Report Available
Southwest Optometric Society (SWOS)
On February 21st, the Southwest Optometric Society
joined the Greater Ozarks Optometric Society in
Jefferson City. Doctors from both societies gave
testimony in the Senate Committee Hearing regarding
Senate Bill 649.
On April 17th, the Southwest Optometric Society
met at Mythos Greek restaurant in Joplin. The
meeting was sponsored by Shane Helmig of Ista
Pharmaceuticals, and Dr. Chad Betts presented on the
topic of ocular allergy treatment.
West Central Optometric Society (WCOS)
The West Central Society has not met this quarter.
There have been significant emails regarding
legislative efforts in Jefferson City. We will be sitting
up for our Presidential Visit soon.
At the March meeting, Ciba Vision/Alcon sponsored
Dr. Dwight Akerman.
In April, Alcon sponsored Dr. Art Epstein, who
discussed various fresh technologies and therapies for
detecting and treating anterior segment disease.
The St. Louis Optometric Society continues to meet
at the Marriott West in Chesterfield, MO on the
second Tuesday of the month. May’s meeting will
be sponsored by AMO and the benefits of their new
Revitalens solution and Blink family of products will
be discussed. The annual installation of new officers
14

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MOA CALENDAR
June 14 - 16
MOA Leadership Retreat
Camden on the Lake
Lake Ozark, Missouri
January 26 - 27. 2013
MOA Legislative Conference
Capitol Plaza Hotel
Jefferson City, Missouri
February 15-17
Heart of America
Hyatt Regency
Kansas City, Missouri
2012
June 27 - July 1
Optometry’s Meeting®
Chicago, Illinois
2013
May 31 - June 1
MOA Leadership Retreat
Stoney Creek Inn
Columbia, Missouri
October 11 - 14
MOA Annual Conference
Chateau on the Lake
Branson, Missouri
June 26 - 30
Optometry’s Meeting®
San Diego, California
October 11 - 14
MOA Annual Conference
Ballpark Hilton
St. Louis, Missouri
WELCOME
NEW ODs
WELCOME
NEW PARAs
16
MOA members, please take every chance to
encourage optometrists and paraoptometrics
who are not currently members of the MOA to
join us in supporting the optometric profession.
To those of you who have reached out and
brought a new member to the MOA membership
roster–THANK YOU!
OD Members
• Mahnaz Bangash
• Jerri Birsinger
• Diane Curry
• Julia Dombek
• Kamron Hunt
• Scott McSpadden
• Douglas Nosacka
• Angel Rivera
• Shelley Williams
The MOA Paraoptometric Section urges all
paraoptometrics to become part of this
important professional organization.
Join the MOA’s Paraoptometric Section
today, then encourage your friends who
work in optometry to become part of the
paraoptometric section, too!!
Para Members
• Cynthia Doss

Hannibal
800-325-4676
Lenexa
800-397-2020

MOA LEADERSHIP
Central Office
Executive Director
LeeAnn Barrett, OD | moaed@moeyecare.org
Assistant Executive Director
Jay Hahn | jay@moeyecare.org
Finance / Membership Manager
Sue Brown | sue@moeyecare.org
Legal Counsel
Marc Ellinger
P: 573/634-2500 | mellinger@blitzbardgett.com
Officers
President: Jeffrey Weaver, OD
P: 314-983-4244 | jlweaver@abopt.org
President-Elect: John Gelvin, OD, FAAO
P: 816-525-3937 | jgelvin@omnikc.com
Treasurer: James Hunt, OD
P: 573-996-3937 | drhunt204@yahoo.com
Secretary: Scott Burks, OD
P: 417-345-2901 | smbod1@gmail.com
Immediate Past President: Duane Thompson, OD
P: 660-258-7409 | datbat@cebridge.net
Governmental Relations Consultants
Jerry Burch: P: 573/636-4599 | jburch@embarqmail.com
Scott Marrs: P: 573/636-5873 | smarrs@embarqmail.com
ABOUT VISION
VISION is published bimonthly by the Missouri Optometric Association.
100 East High Street, Suite 301 | Jefferson City, Missouri 65101
P: 573-635-6151
Editors of Publications: LeeAnn Barrett, OD and James Hunt, OD
Contact Dr. Barrett
Missouri Optometric Association
100 East High Street, Suite 301
Jefferson City, Missouri 65101
P: 573-635-6151
lbarrettod@sbcglobal.net
Contact Dr. Hunt
Vision-Improvement Clinic
204 Washington St.
Doniphan,MO 63935
P: 573-996-3937
drhunt204@yahoo.com
Send all unsolicited articles, news, and advertising to the MOA Central Office. All opinions and statements of
supposed fact in signed articles do not necessarily reflect the views and policies of the Missouri Optometric
Association.
18