Summer PDF - Missouri Optometric Association

VISION
The Journal of the
Missouri Optometric Association
MOA Leadership Retreat
Optometry’s Meeting®
ICD-10
Spring 2013

PRESIDENT’S MESSAGE
A Report from Optometry’s Meeting®
Optometry’s Meeting® this year was filled with both questions and debates
regarding our nation’s Affordable Care Act (ACA). The AOA team has
remained in close contact with the major players in Washington who
continue to push this massive plan forward. We do know that eye exams
for children are considered an essential benefit under the ACA so we must
stay prepared to see an increase in young children in our offices.
In Missouri, a mega-committee examining Medicaid reform being chaired
by Representative Noel Torpey (R-Independence) is holding listening
meetings around the state this summer. Torpey and Representative
Jay Barnes (R-Jefferson City) will prepare a report at the beginning of
September. This group of 50 will attempt to help reform Medicaid coverage
Dr. John Gelvin
MOA President
for those in need in Missouri while being cognizant of the needs of the providers and hospitals as well.
We must remember that healthcare reform will be lead by both fiscal and medical productivity and
accountability. We are now seeing the formation of Accountable Care Organizations (ACO) which will begin
escalating throughout the country in 2014. ACOs begin by creating an organization recognized by Medicare
as a part of the open Medicare fee-for-service network, not closed panels like managed care organizations. All
ACOs must have enough primary care MDs and DOs to be accountable for the care of at least 5,000 patients.
While ACOs are not required to include optometrists, the AOA has made sure that the law and regulations
allow ACOs to include optometrists.
As optometrists, we need to be engaged in discussions with the team members creating ACOs throughout the
state. To ensure involvement, we need to be able to show our own accountability.
Our own involvement in participating in PQRS, using meaningful use EHRs, using ERx and following AOAs
Evidence-based Clinical Guidelines put each of us in a good position to be involved in an ACO. We need to
proactively approach our local ACO or the think-tank teams attempting to create ACOs and begin discussing
our worth as a profession in this organization. There are currently 250 Medicare ACOs which involve only
10% of the US Medicare population. Thus, there are many more to be formed. There are four ACOs recognized
by CMS in Missouri.
Stay tuned to more information through your society and the MOA. These changes will be coming faster now.
We will work hard to keep you informed.
2

2013 MOA Leadership Retreat
MOA volunteers and board members met at the Stoney Creek Inn in Columbia, Missouri, on May 31st
and June 1st to review the 2013 legislative year and to lay plans for the MOA future endeavors.
The Industry Alliance members enjoyed lunch with the Board at the Columbia Country Club, but the
annual golf outing was rained out for most golfers. Those die hard docs and industry titans drove to
Eugene, Missouri, to avoid the weather and fit in 18 holes before the deluge struck!
Back at the Inn, the MOPAC committee met to assess the status of our political donations. That
evening, a reception featuring Shakespeare’s Pizza was held at the hotel for all our volunteers.
3

Saturday morning began with a look at the MOA legislative history as a way to introduce some of our
new volunteers to the legislative process and battles. A panel discussion featuring Drs. Don Vanderfeltz
and Mike Nichols, Jay Hahn, Scott Marrs, Jerry Burch and moderated by Dr. LeeAnn Barrett brought
everyone up to date as to how we got to where we are now. Key similarities and differences were
discussed between then and present day.
The retreat concluded with committee meetings to discuss plans for 2014.
Thank you to all our members who participated by donating their time and talents for the profession of
optometry.
34

Dr. Mary Beth Rhomberg gives a report.
Dr. Wes Kemp addresses the group.
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6

What About
Your Preparations
for ICD-10?
by Charles B. Brownlow, OD, FAAO
7

October 1, 2014, is the date that ICD-10 will replace ICD-9 for reporting medical conditions in patient records
and on insurance claims in the US. Anyone paying attention to the vendors of educational/informational/training
products and services for ICD-10 implementation would think that the changeover will be extremely complicated,
the training will be deep and wide, and that it will cost thousands of dollars to get an office converted to the new
coding system.
Rest assured that ICD-10 is different, very different, completely different than ICD-9.
ICD-10 offers more than 70,000 potential choices for coding diagnoses, causes of medical conditions, etc., compared
to about 17,000 choices in ICD-9. It is the complexity though, that will make the preparation easier. I know that
doesn’t sound logical, but it’s true.
The system is so complex that one will need to rely upon software to aid in the choices. The software that currently
exists already makes the process simple. In the near future, you will be able to purchase subscriptions for ‘ICD-10
calculators’ that take the guesswork out of the process. In the near future, offices utilizing electronic medical records
systems will have ICD-10 capability built right into the EHR, automatically choosing (or recommending) ICD-10
codes just as they currently recommend choices of ICD-9 codes, based on the content of the patient’s record for the
day. The choice of ICD-10 code will be an automatic, single-entry system, converting the words of the diagnoses
into ICD-10 codes.
Most ODs receive at least one email a day; unsolicited, of course; from some consulting group offering to train
doctors and staff in your practice via webinars, face to face seminars, online consultation, whatever, for the low
fee of $295/person, $495/session, $999 for six monthly online sessions with the consultant, etc. Please continue to
ignore those ads, but don’t ignore the need for preparation.
Here’s what I suggest you do to prepare your doctors and staff for the October 1, 2014, ICD-10 Implementation:
• Go online soon and Google ‘ICD-10 calculator’ or ICD-10 preparation. You’ll see lots of great opportunities
for consultants to separate you from your money, but you’ll also find a couple of free ‘calculators. Log on and
test it out. Type in primary open angle glaucoma, or diabetic retinopathy. Type in a common ICD-9 code and
convert it to the ICD-10 code, etc. You will be surprised at how well software does the job.
• Examples: http://www.aapc.com/icd-10/codes/ or http://www.icd10data.com/ . By entering an ICD-9 code, eg
365.11, the calculator provides the ICD-10 code and description, H40.11XX, primary open angle glaucoma,
stage unspecified. All that’s left for the doctor/staff is to indicate right/left/both eyes where the X appears in the
third space after the decimal point, (1=right eye, 2=left eye, 3=both eyes) and to specify the stage as the final
digit (0 = unspecified, 1 = mild, 2=moderate, 3=severe, and 4=indeterminate.)
Note: The ‘X’s’ are used as placeholders, indicating that other information is needed to choose the correct
code, such as laterality or severity of condition, etc.
• Visit the CMS website for more good, practical, unemotional information on this important subject:
http://www.cms.gov/Medicare/Coding/ICD10/index.html
• Call one of your semi-annual monthly staff meetings to discuss ICD-10…January 2014 will be early enough…
Seriously. In the meantime, try to encourage doctors and staff in your practice to concentrate on current
challenges and worry about ICD-10 less.
My prediction is that when October 1, 2014, arrives, you will be very happy that you did not obsess over ICD-10,
and that you didn’t drop tons of money on training and preparations for the ‘big day’!
Please direct specific questions to Dr. Brownlow at brownlowod@aol.com.
8

VOSH Wants
Your Used
Equipment
Particularly requested for this program are
• trail lens sets and frames
• phoropters
• projectors
• slit lamps
• lensometers
• keratometers
• hand scopes
• reference books
VOSH also gratefully accepts
• unused frames
• uncut lenses
• optical tools
• edgers
9 10
Donate those used ophthalmic instruments that are gathering dust in your storage room for the valuable purpose of
training students at optometry schools in the developing world.
Volunteer Optometric Services to Humanity (VOSH) through its Technology Transfer Program (TTP) will refurbish
this equipment, help pay for shipping to the destination, and provide a tax receipt.
•
Schools that receive equipment become acquainted with the VOSH model. They form new VOSH chapters and
treat the disenfranchised within their own country, which is one of our ways of becoming sustainable. Please
contact VOSH/International at www.vosh.org and help us eliminate preventable blindness.
Thank you for taking the time to consider our request. Please feel free to contact me for more information at any
time.
For more information about this program please contact:
David R. Stacy, OD, Director VOSH/International TTP
2974 N Alma Road #3, Chandler, AZ 85224
stacy@vosh.org | 480 899-0188 office | 480 899-0199 fax
www.vosh.org | www.facebook.com/vosh.org

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Are You Ready?
New HIPAA Guidelines
will Take Effect Soon
The new HIPAA privacy and security regulations will require most optometric practices to review their privacy and security
policies, update the Notices of Privacy Practices (NPP) they provide to patients and take a few additional measures to ensure
the privacy, security, and accessibility of patient information in their practices,” said Jon Hymes, AOA Advocacy Group
director. Mostly, the changes affect patient requests and approvals, breach reporting, and business associates. The new rules
became effective March 26, but optometrists have until September 23, 2013, to revise their HIPAA procedures.
Patients will now be allowed to request an electronic copy of their electronic health record if the optometrist maintains
electronic records. The new regulations specifically require health care providers to provide electronic information to a
patient in the electronic form requested by the patient, if it is readily producible, or , if not, in a readable electronic format
as agreed by the health care provider and the patient. Also, with both paper and electronic record requests, the office has
only 30 days to produce the information. There is no more 30-day extension for records that are inaccessible or kept off site.
Patients will have the right to instruct their doctors to not share information about treatment with the patient’s insurance
company when the patient pays cash in full for the services rendered.
The NPP must include a statement that uses and disclosures of any protected health information for marketing purposes or the
selling of protected health information to a company by a health care practitioner will now require a patient’s authorization.
If you contact individuals for fundraising, the NPP must already state this as a separate use and disclosure. Under the
new rules, you must also include a statement that the individual has the right to opt out of receiving these fundraising
communications.
Additional information will be required regarding patient’s right following breaches of protected health information. Until
now, offices have followed the harm standard, which said a breach was reportable only if it posted a significant risk of harm
to the patient’s finances or reputation. The new regulations say that any loss or inappropriate disclosure of data is presumed
to be a breach unless the office can show there is a low probability the information will be used improperly. Health care
practitioners may be required to notify affected patients, the HHS, and even the media in the event of a breach.
12

To determine that, the office has to do a documented risk assessment that covers four elements.
1. The type of information. Information about sexually transmitted diseases, for example, could
harm a patient’s reputation. Credit card numbers and Social Security numbers could be used for
identity theft. Risk is high.
2. The recipient of the information. If the office doesn’t know who has accessed the information,
assume there has been a breach. However, if the other person is a HIPAA-covered entity, misuse
probability is low and so is the risk.
3. Whether the data was actually seen or used. Suppose a stolen computer is recovered and forensic
analysis shows the data was never accessed. Risk is low. If the information is secured by encryption,
then the privacy is generally not considered compromised. If a patient’s record was mailed to the
wrong person and the envelope is returned unopened, risk is low. But if it’s returned opened or not
returned at all, risk is high, and the office has to assume there has been a breach.
4. How well the risk has been mitigated. The mitigating factor might be that the office gets
assurance the information won’t be used or disclosed or will be destroyed. That makes the risk low
and probably not reportable. However, who that other party is makes a difference. Assurance from a
business associate is probably worth relying on. Assurance from an unrelated person or company with
no obligation to comply with HIPAA is another story.
In addition to making sure their practices are in compliance with the updated federal privacy and security rules,
practitioners should make sure any business associates with access to protected health information, such as billing firms
or claims clearinghouses, are aware of the new rules and are taking steps to adhere to them.
Under the new revisions, the privacy and security rules will apply not only to health care practitioners and their business
associates but also to the subcontractors of those business associates. They have to have business associate agreements
with their own subcontractors.
The penalties for non compliance have gone up. The amount depends on the level of negligence. Previously the limit
was $25,000 per violation; now its $50,000, with an annual limit of $1.5 million. The Office of Civil Rights, which
enforces HIPAA, cautions that it’s looking hard for violations and plans to enforce HIPAA “vigorously.”
If you have questions about how to implement these changes in your practice visit www.excelod.com/HIPAA. There are
also sample privacy notices and security manuals.
13
If you have specific questions regarding the new HIPAA Privacy and security Rules, you can contact Kara Webb in the
AOA Washington office at KCWebb@aoa.org.

2013 MOA Annual ConventioN
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14

In Memoriam: John Scott, Jr.
Dr. James E. Rudd died at his home on Oct. 10, 2012. He was born
July 17, 1928, in Wichita, Kan., the son of Ward H. and Pauline
(Cushman) Rudd.
He was united in marriage to Willa Don Graves on June 3, 1956, at
the South Joplin Christian Church.
He was a member of the Neosho United Methodist Church, thehe
Southwest Missouri Optometric Society, and thehe Missouri
Optometric Association, of which he was a past president.
Preceding him in death were his parents; his wife of 49 years, Willa
Don; two daughters, Robin Sue and Rose Ann; and one son, Ward
Douglas.
Survivors include: his son, Will James Rudd and his wife, Stacy,
of Dallas, Texas; and five granddaughters, Kristin, Carolyn,
Lauren, Kathryn and Camryn; one sister, Eleanor Rudd Calvert and
husband, Paul, of Kansas City; two nephews, Ken Calvert and his
wife, Trisha, and Craig Calvert and his wife, Christina; his wife,
Avis Lankford Rudd, and her children; Pat Cole, Larry and Carol
Lankford, Peggy and Ron Becknell, Pam and Kenneth Link, Garry and Cathy Lankford; 13 step-grandchildren;
and 20 step great-grandchildren.
A memorial service was held at 10 a.m. Saturday, Oct. 13, 2012, at the Neosho United Methodist Church, with Rev.
Sara Chaney officiating.
If you’re on Facebook, please friend the Missouri Optometric
Association and connect with your MOA friends.
• See Dr. Jeffrey Weaver in his natural habitat.
• Enjoy a shot of the UMSL White Coat Ceremony.
• Catch the Summers at Mizzou kids dissecting eyeballs.
• Be part of the fun!
Friending us is as easy as 1-2-3!
1. Log in to Facebook.
2. Click here!
3. Click on the Friend button!
15

SOCIETY REPORTS
Missouri Optometric Society Trustees
Central Society (5)—Chris DeRose, OD
P: 573-874-2030 | c_derose@hotmail.com
Greater Ozark Society (8)—Katie McElvaine OD
P: 417-886-5444 | docmcelvaine@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)—Brandon Lorenz, OD
P: 816-279-2339 | sj@ieseyecare.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
—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)
The Central Society met on Tuesday June 25th. The
meeting was at D’Rowe’s restaurant and was sponsored
by Allergan. Dr. Brett King gave a very educational
presentation on “Insights on the risk of glaucoma
progression.”
The Central Missouri Optometric Society meets on
the fourth Tuesday evening of every month. All MOA
members are invited to attend.
Greater Ozark Optometric Society (GOOS)
During the summer months, members of GOOS
have been taking our summer sabbatical. We will
gather again on August 20th at 6:30pm for our election
meeting at Mr. Yen’s in Springfield.
We encouraged all members to support Senator
Wasson’s Fundraising event on July 18th from 5:30-
7:00pm at the Oasis Conference Center.
Please visit GreaterOzarksOptometric.org for more
information about our active society!
Kansas City Optometric Society (KCOS)
No Report Available
Northeast Optometric Society (NEOS)
The NEOS met on June 20th at AJ’s in Macon for
the annual Presidential Visit. Guests were Dr. John
Gelvin, Dr. LeeAnn Barrett, and Mr. Jay Hahn. The
society members were informed on the results of the
2013 Missouri Legislative Session and MOA goals for
the upcoming year.
16

SOCIETY REPORTS
Northwest Optometric Society (NWOS)
The new trustee for the Northwest Optometric
Society is Dr. Brandon Lorenz. If you would like to
contact Dr. Lorenz, you may do so at :
blorenz@od.sco.edu or sj@ieseyecare.com.
St. Louis Optometric Society (SLOS)
The St. Louis Optometric Society continues to
hold its monthly meetings at the Marriott West in
Chesterfield, Missouri on the second Tuesday of the
month.
The April meeting was hosted by Diopsys,
and Dr. Sohpia Chung spoke on papilledema and
pseudopapilledema.
The May meeting was presented by Dr. Navin
Tekwani who discussed “Advanced Treatment
Options In Ocular Surface Disease” and “A Primer on
Femtosecond Laser Cataract Surgery.” Lisa Salmon of
IOP Ophthalmics co-sponsored the meeting with Dr.
Tekwani.
The June meeting consisted of the annual
installation of officers and awards banquet which was
held at the Kemp Auto Museum in Chesterfield. Dave
Glover of Talk Radio 97.1 was the guest speaker. Dr.
Larry Davis officially installed the officers to serve
the St. Louis Optometric Society for the coming year,
reminding each of their new responsibilities with the
office. He presented new president, Dr. Jason Riley,
with a Sacagawea Gold dollar to toss for making
important decisions; President-Elect, Dr. Kim Layfield,
a whistle; Secretary, Dr. Erin Niehoff, a pad and pencil;
Treasurer, Dr. Joe Castellano, received a stack of play
money; the Sgt. at Arms, Dr. Drew Biondo was given a
badge; and retiring president, Dr. Paul Whitten, a hand
clapper. The new “consulting” Vice-President, Dr. Steve
Rosen, received a white colonial judge’s wig which he
promptly donned!
Dr. Scott Tomasino was presented “Optometrist
of the Year” by his business partner Dr. Robert Goerss
who composed a barber shop style song to honor Scott
for all his years of hard work and contributions to
the optometric profession. Dr. Edward Bennett was
presented to “R.A. Koetting Memorial Award.” Mike
Jobe of Midland Optical was given the “Friend of
Optometry” award.
Visit the SLOS online at:
www.stlouisoptometrticsociety.org
Southeast Optometric Society (SEOS)
On July 17th, at 6:30 pm, at the Hickory Log
Restaurant in Dexter, Missouri we were pleased to
welcome Dr. Donald Vanderfeltz who presented
“Patients’ Vision Correction, Address Your Presbyopic
Needs” A Case Based Learning Dinner hosted by
Alcon. There was a short business meeting following
Dr. Vanderfeltz’s presentation.
Southwest Optometric Society (SWOS)
The Southwest Optometric Society held a meeting
on Tuesday, July 16, 2013. It was the MOA Presidential
visit. MOA President Dr. John Gelvin addressed our
group speaking about the legislative session as well as
the projected path of the MOA for 2014.
On Thursday, July 11th, Dr. Dan Brothers, Teresa
Brothers, Dr. Justin Stilley, Dr. LeeAnn Barrett, and Jay
Hahn attended a bowling fundraiser for Senator Ron
Richard.
West Central Optometric Society (WCOS)
The last meeting of the MOA West Central Society
was Thursday, July 18 at 7 pm in Warrensburg, Missouri.
The main items at the meeting was the annual election
of society officers and discussions of MOA issues.
17

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MOA
2013 CALENDAR
CALENDAR
2013
September 7 - 12
AOA Congressional
Advocacy Conference
Washington DC
October 11 - 14
MOA Annual Conference
Ballpark Hilton
St. Louis, Missouri
2014
2013
January 12 - 13
MOA Legislative Conference
Capitol Plaza Hotel
Jefferson City, Missouri
February 14-16
HOACLS
Sheraton at Crown Center
Kansas City, Missouri
April 28-30
AOA Congressional Conference
Washington, DC
June 7-8
MOA Leadership Retreat,
Chateau on the Lake
Branson, Missouri
June 25 - 29
Optometry’s Meeting®
Philadelpha, Pennsylvania
October 2 - 5
MOA Annual Conference
University Plaza
Springfield, Missouri
WELCOME
NEW MEMBERS
Please welcome the following new
members of the MOA!
• Tyler Bradford
• Steven Branstetter, Jr.
• Jennifer Bulmann
• Michelle Derheimer
• Robert Ensley
• Carrie Hartigan
• Kyle Henderson
• Jacqueline Ladd
• Brandon Lorenz
• Laura Nennig
• Glen Pate
• Catherine Radakovic
• Alan Wegener
If you’re an OD, please encourage the
paraoptmetrics in your practice to join the
MOA Paraoptometric Section.
The MOA para section is a great way
to meet other paraoptometrics, grow
professionally, and gain continuing
education credits toward certification. Join
the MOA’s Paraoptometric Section today!
• Abbi Alverson
• Elaine Barrett
• Bailey Eggen
• Taryn Elder
• Catherine Jacobs
• Janae Johnson
• Carie Ogden
• Jeanne Nichol
• Melissa Rogers
• Alyssa Simmons
• Lilly Smith
19

Hannibal
800-325-4676
Lenexa
800-397-20

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: John Gelvin, OD, FAAO
P: 816-525-3937 | jgelvin@omnikc.com
President-Elect: James Hunt, OD
P: 573-996-3937 | drhunt204@yahoo.com
Treasurer: Scott Burks, OD
P: 417-345-2901 | smbod1@gmail.com
Secretary: Jeff Gamble, OD
P: 573.874-2030 | jmgamble@socket.net
Immediate Past President: Jeffrey Weaver, OD
P: 314-983-4244 | jlweaver@abopt.org
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 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.
21