News from the AOA's Blog

The American Academy of Ophthalmology (AAO) has successfully convinced the American Medical Association (AMA) to approve and formally adopt a new policy to unequivocally condemn and launch an aggressive lobbying campaign aimed at the repeal of the Harkin Amendment, the landmark AOA-backed patient access to care provision included in the national health care overhaul law approved by Congress and signed into law by President Obama earlier this year.

Bolstered by AOA Federal Keypersons, AOA-PAC investors, state affiliated association leaders and staff, and concerned doctors and students from around the country, the AOA led a successful effort in 2009 and 2010 to make new patient access safeguards to optometric care a key element of the health care reform debate in the nation’s capital, which culminated in late March with approval of the Harkin Amendment and final passage of the Patient Protection and Affordable Care Act of 2010 (PPACA).

The Harkin Amendment – sponsored by Sen. Tom Harkin (D-Iowa) and other access to care leaders in Congress as the first-ever federal standard of provider non-discrimination – will bar health insurers from discriminating in plan coverage and participation against ODs and other providers.

Although supported by the AOA as the centerpiece of optometry’s proactive, pro-access and pro-patient federal advocacy agenda, the provision was opposed by organized medicine and the health insurance industry at each step of the nearly 18-month long legislative process.

Beginning in 2014, the Harkin Amendment would prevent public and private health plans from discriminating against licensed and certified health professionals with regard to health plan participation or coverage.

Health insurance plans – including a number of large employer-sponsored programs organized under the Federal Employee Retirement Income Security Act (ERISA) – in many instances have made it policy to summarily deny coverage for the services of qualified health care providers as a cost containment measure, the AOA Advocacy Group says.

In the closing days of the AMA’s annual meeting earlier this year, the AAO’s “Harkin repeal resolution,” which was also sponsored by the American Society of Anesthesiology, was officially considered by the full AMA House of Delegates and promptly approved.

The new policy seeks to abolish the AOA-backed Harkin Amendment on claims of “massive confusion, patient safety issues and [the] waste of scarce health care dollars by patients seeking and being subjected to inappropriate or unproven treatments.” 

The AAO’s resolution did, however, acknowledge that “a large number of state medical and national medical specialty societies and our AMA opposed this language in various ways and its inclusion in PPACA, and despite our efforts and protests it was enacted.”

“The AOA rallied as never before to become a force in the Washington, D.C., battle over national health care reform, and the AOA-backed patient access provisions included in the final bill clearly show it,” said AOA President Joe E. Ellis, O.D. “But we also realize that there is little time to celebrate and still much work to be done. Right now, the AOA is working harder than ever to ensure that the new federal patient access/provider non-discrimination law and other pro-access, pro-patient provisions are implemented exactly as they were intended.”

The AOA is now closely monitoring the moves of the U.S. Department of Health & Human Services (HHS) as it works to implement the more than 2,000 pages of the new health reform law.

The HHS has already begun issuing guidance materials on several sections of the new law, including preliminary regulations on how immediate reforms will apply to certain health plans.

As proposed Harkin Amendment implementation guidelines – as well as other regulations – are released, the AOA will continue fighting to ensure real-world implementation echoes the full intent of the law.

“The simple fact is that whether anti-optometry groups like it or not, millions more Americans will gain access to their local doctors of optometry because the new federal law we fought for will target the discriminatory practices of health plans,” added Dr. Ellis. “The recent AMA approval of ophthalmology’s Harkin repeal resolution is a clear shot across the bow. But if we have to take on and defeat organized medicine all over again on this issue, then so be it.”