Congressional Advocacy Day 2018 KAEPS for sponsoring the trip and coordinating logistics LAO for providing financial support University of Louisville DOVS for allowing me the time away from clinical duties ID: 1047378
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1. Kevin Lowder, MDMay 18, 2018Congressional Advocacy Day 2018
2. KAEPS for sponsoring the trip and coordinating logisticsLAO for providing financial supportUniversity of Louisville DOVS for allowing me the time away from clinical dutiesSpecial Thanks
3. Mid-Year ForumWashington D.C.April 18-21
4. April 18Congressional Advocacy Day BriefingApril 19Congressional Advocacy DayApril 20Advocacy Ambassador Program/L.E.A.P ForwardApril 21Council Meetings/ElectionsMid-year Forum 2018
5. What is Advocacy?Voice for our patientsProtect our professionSafeguard public healthEnsure access to careSpeed access to innovative treatments
6. Advocacy Ambassador ProgramCollaboration between:American Academy of OphthalmologyState Ophthalmology SocietiesOphthalmic Subspecialty & Specialized Interest SocietiesTraining Programs
7. Goals: Advocacy Ambassador ProgramLearn about current legislative issuesMeet with legislatorsNetwork with colleaguesLearn about the impact of state ophthalmology societies
8. Congressional Advocacy DayMore than 400 ophthalmologists went to Capitol Hill to meet with Members of Congress & their health care staff Over 175 residents & fellows served as 2018 Advocacy Ambassadors to support patients & our professionAAO President Keith Carter, MD
9. Our RepresentativesU.S Congressmen Andy Barr of 6th Congressional District
10. Our RepresentativesU.S Senator Dr. Rand Paul
11. Our RepresentativesU.S. Congressmen John Yarmuth of 3rd DistrictPhoto courtesy of votesmart.orgU.S. Senator Mitch McConnellMajority LeaderPhoto courtesy of biography.com
12. Congressional Advocacy Day Issues6 Top Priority Issues Presented to Members of Congress
13. 1. Access to Compounded & Repackaged DrugsFDA’s implementation of the Drug Quality & Security Act threatens timely access to compounded & repackaged drugs Restrictions placed on compounding pharmacies secondary to an outbreak of fungal meningitis in 2012Created a new class of large-scale “outsourcing facilities” which must meet the highest standards set by the FDASet strict beyond-use dates for repackaged AvastinDec. 2016: FDA released a prescription requirement for traditional compounding pharmacies (not for biologics, but for antibiotics and antivirals)
14. 1. Access to Compounded & Repackaged DrugsOphthalmologists want access to safe & effective compounded drugs for use in their practices – critical for treatment for a variety of blinding eye diseasesSUPPORT: Preserving Patient Access to Compounded Medications Act(H.R. 2871)
15. 2. Department of Defense:Peer Reviewed Vision Research ProgramDeployment-related eye injuries & blindness have cost the U.S. $45.5 billionTraumatic eye injuries and TBI tied for #2 most common (hearing loss #1)Only 20% return-to-duty rate for eye injuries (compared to 80% for other trauma injuries)
16. 2. Department of Defense:Peer Reviewed Vision Research ProgramAdvancements made from prior VRP funding include:A portable, hand-held device to analyze pupilsAn “ocular patch” which is a nanotechnology-derived reversible glue that seals lacerations and perforations on the battlefield while the soldier is transported for surgeryA validated computational model of the globe that has allowed for superior protectionA vision enhancement system using modern mobile and wireless technology to assist visually-impaired veterans undergoing vision rehab
17. 2. Department of Defense:Peer Reviewed Vision Research ProgramThe Vision Research Program (VRP) is the only dedicated funding source for extramural vision research into DOD-identified research gaps (non VA / NIH / NEI)SUPPORT: Fiscal Year (FY) 2019 VRP Funding at $20 MillionFor FY 2018 and FY 2017, Congress approved $15 million
18. 3. National Institutes of Health / National Eye Institute2014 study released by Prevent Blindness:Estimated the annual U.S. cost for vision disorders at $145 billionEstimated cost will grow to $717 billion (inflation adjusted) annually by 2050Concluded that direct medical costs associated with vision disorders are 5th highest – only less than heart disease, cancer, emotional disorders & pulmonary conditionsSUPPORT: $39.3 Billion for NIH Funding in FY 2019 ($37.1B in FY 2018) SUPPORT: $800 Million for NEI Funding in FY 2019 ($772M in FY 2018)
19. 4. Simplify Merit-based Incentive Payment System (MIPS): Expand Credit for Participation in Qualified Clinical Data Registries (QCDR)MIPS falls short of Congressional intent due to complexity & lack of timely feedbackCongress envisioned clinical registries to be a meaningful solutionRegistries drive health care improvements by providing feedback on quality & appropriate use metricsSUPPORT: The AAO’s efforts to expand the credit that physicians receive for participating in a QCDR (such as the AAO’s IRIS Registry) under MIPS
20. 5. Regulatory Relief from Burdensome Prior Authorization RequirementsAMA survey results of 1000 physicians shows significant burden being placed on physicians due to prior authorization (PA) requirements
21. SURVEY DATA:2 hours administrative work per 1 hour patient careAverage 29 PA requests/physician per week34% doctors employ full-time staff members exclusively for PAsannual time-cost of PA is at least $23 billion5. Regulatory Relief from Burdensome Prior Authorization Requirements
22. SURVEY DATA cont:79% of PAs are eventually approved79% doctors had to repeat PAs for patients stabilized on treatment for chronic condition92% doctors reported delays in care for those patients whose treatment requires PA5. Regulatory Relief from Burdensome Prior Authorization Requirements
23. 5. Regulatory Relief from Burdensome Prior Authorization RequirementsNew subsets of Medicare (such as Medicare Advantage) are now requiring PAs beyond traditional Medicare plans (illegal)Academy is requesting that CMS:Supports our regulatory relief initiative on Medicare Advantage (MA) prior authorizationProvide oversight to the PA requirements established by the MA plans & standardize processes including times & appeals processesSUPPORT: The Standardizing Electronic Prior Authorization for Safe Prescribing Act (H.R. 4841)
24. Technology-based Eye Care Services inDepartment of Veterans Affairs Ophthalmologists at Atlanta VA Medical Center have developed innovative tele-eye program, Technology-based Eye Care Services (TECS)TECS Program: Expands access to basic eye care services for veterans, especially in rural areasAt the beginning, 20% of participants had not seen an eye care provider in 5+ yearsThat number has dropped to 5%
25. Technology-based Eye Care Services inDepartment of Veterans Affairs Eye exams are not comprehensive:Screen for most common eye conditions (cataracts, glaucoma, AMD, diabetic retinopathy) among othersRefer these patients for f/u within 30 days (98%)Provide glasses prescriptions through a trained interactive technicianThe program is facing opposition from the American Optometric AssociationSUPPORT: TECS Program as a proven vision saving service
26. Our elected officials want to make informed decisions. If we are not there to inform them of our position, they will only hear others’ perspectives.Advocacy is easier than you think; it just takes a conscious effort and appreciation of its impact.Our elected officials truly enjoy hearing the physicians’ perspective and they respect the work that we doLessons Learned