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Congressional Advocacy Day 2018

Join us for Congressional Advocacy Day 2018 as we advocate for access to compounded drugs, funding for vision research, support for the National Institutes of Health, and simplification of the Merit-based Incentive Payment System. Let's work together to safeguard public health and ensure access to innovative treatments.

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Congressional Advocacy Day 2018

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  1. Congressional Advocacy Day 2018 Kevin Lowder, MD May 18, 2018

  2. Special Thanks • 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

  3. Mid-Year Forum Washington D.C. April 18-21

  4. Mid-year Forum 2018 • April 18 • Congressional Advocacy Day Briefing • April 19 • Congressional Advocacy Day • April 20 • Advocacy Ambassador Program/L.E.A.P Forward • April 21 • Council Meetings/Elections

  5. What is Advocacy? • Voice for our patients • Protect our profession • Safeguard public health • Ensure access to care • Speed access to innovative treatments

  6. Advocacy Ambassador Program • Collaboration between: • American Academy of Ophthalmology • State Ophthalmology Societies • Ophthalmic Subspecialty & Specialized Interest Societies • Training Programs

  7. Goals: Advocacy Ambassador Program • Learn about current legislative issues • Meet with legislators • Network with colleagues • Learn about the impact of state ophthalmology societies

  8. Congressional Advocacy Day • More than 400ophthalmologists 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 profession AAO President Keith Carter, MD

  9. Our Representatives U.S Congressmen Andy Barr of 6th Congressional District

  10. Our Representatives U.S Senator Dr. Rand Paul

  11. Our Representatives U.S. Congressmen John Yarmuth of 3rd District U.S. Senator Mitch McConnell Majority Leader Photo courtesy of biography.com Photo courtesy of votesmart.org

  12. Congressional Advocacy Day Issues 6 Top Priority Issues Presented to Members of Congress

  13. 1. Access to Compounded & Repackaged Drugs • FDA’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 2012 • Created a new class of large-scale “outsourcing facilities” which must meet the highest standards set by the FDA • Set strict beyond-use dates for repackaged Avastin • Dec. 2016: FDA released a prescription requirement for traditional compounding pharmacies (not for biologics, but for antibiotics and antivirals)

  14. 1. Access to Compounded & Repackaged Drugs • Ophthalmologists want access to safe & effective compounded drugs for use in their practices – critical for treatment for a variety of blinding eye diseases • SUPPORT: Preserving Patient Access to Compounded Medications Act(H.R. 2871)

  15. 2. Department of Defense:Peer Reviewed Vision Research Program • Deployment-related eye injuries & blindness have cost the U.S. $45.5 billion • Traumatic 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 Program • Advancements made from prior VRP funding include: • A portable, hand-held device to analyze pupils • An “ocular patch” which is a nanotechnology-derived reversible glue that seals lacerations and perforations on the battlefield while the soldier is transported for surgery • A validated computational model of the globe that has allowed for superior protection • A 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 Program • The 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 Million • For FY 2018 and FY 2017, Congress approved $15 million

  18. 3. National Institutes of Health / National Eye Institute • 2014 study released by Prevent Blindness: • Estimated the annual U.S. cost for vision disorders at $145 billion • Estimated cost will grow to $717 billion (inflation adjusted) annually by 2050 • Concluded that direct medical costs associated with vision disorders are 5th highest – only less than heart disease, cancer, emotional disorders & pulmonary conditions • SUPPORT: $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 feedback • Congress envisioned clinical registries to be a meaningful solution • Registries drive health care improvements by providing feedback on quality & appropriate use metrics • SUPPORT: 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 Requirements AMA survey results of 1000 physicians shows significant burden being placed on physicians due to prior authorization (PA) requirements

  21. 5. Regulatory Relief from Burdensome Prior Authorization Requirements • SURVEY DATA: • 2 hours administrative work per 1 hour patient care • Average 29 PA requests/physician per week • 34% doctors employ full-time staff members exclusively for PAs • annual time-cost of PA is at least $23 billion

  22. 5. Regulatory Relief from Burdensome Prior Authorization Requirements • SURVEY DATA cont: • 79% of PAs are eventually approved • 79% doctors had to repeat PAs for patients stabilized on treatment for chronic condition • 92% doctors reported delays in care for those patients whose treatment requires PA

  23. 5. Regulatory Relief from Burdensome Prior Authorization Requirements • New 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 authorization • Provide oversight to the PA requirements established by the MA plans & standardize processes including times & appeals processes • SUPPORT: 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 areas • At the beginning, 20% of participants had not seen an eye care provider in 5+ years • That 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 others • Refer these patients for f/u within 30 days (98%) • Provide glasses prescriptions through a trained interactive technician • The program is facing opposition from the American Optometric Association • SUPPORT: TECS Program as a proven vision saving service

  26. Lessons Learned • 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 do

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