On October 4, 2017 AFB and the 21st Century Agenda on Aging and Vision Loss hosted a teleseminar, "Medicare Should Pay for Low Vision Devices: Views Through Different Lenses." We would like to thank all of the panelists (listed below) and participants who joined us for this informative discussion. A special thanks goes out to VFO who generously sponsored the event.
Following are a few of the main takeaways from the call:
- Medicare must determine that low vision devices are eligible durable medical equipment (DME), create a coverage policy, code and categorize the devices and related services, and determine a payment level. The exclusion of Medicare coverage of low vision devices goes back 50 years but was made final in 2008 when a new rule issued by The Centers for Medicare & Medicaid Services (CMS) excluded any device with a lens from Medicare coverage. The exclusion is based on the assumption that almost all Medicare beneficiaries would need eyeglasses, so the cost would be prohibitively expensive. Reversing this exclusion will likely require congressional action. One potential path to get there would be HR 2050, Medicare Demonstration of Coverage for Low Vision Devices Act of 2017, which would authorize CMS to conduct a demonstration project to determine the fiscal impact of covering low vision devices.
- Medicare should cover low vision devices in order to ensure that older Americans can age in place and maintain their independence. By offering devices that promote independence, fewer older adults will need to enter institutions. Additionally, it does not make sense that Medicare covers most other organs and parts of the body but specifically excludes the devices that ensure function of vision.
- At the core of any effective Medicare benefit is the right device, right provider, and right process. For low vision devices to be effective, individuals must receive appropriate evaluation by a qualified ophthalmologist or optometrist, sufficient training in the use of the device, and receive a tailored package of devices to meet the goal of improving functional vision. Importantly, these services have to be provided by qualified providers working in a team. A physician writing the prescription will work with low vision therapists, occupational therapists, and even family members to deliver the appropriate services. Medicare recognizes the importance of a team approach to care and has options available to cover these services.
- The vision loss field needs to develop a consensus for action. So far, each organization has had its own policy objectives and strategies for achieving them, but organizations will need to work together to get CMS coverage of low vision devices—sending joint letters to CMS, working together on a demonstration project, or collaborating on a combination of these and related strategies further. One way to move forward is to get involved with Goal Four (Funding for low vision devices) of the Twenty First Century Agenda and Vision Loss. Contact Neva Fairchild to get involved.
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- Mark G. Ackermann, M.A., Executive Vice President & COO, Lighthouse Guild, New York; Board Chair, 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