h1

AOA partners with Illinois ODs to help win Medicaid physician recognition

November 14, 2011

The AOA and its state affiliate partners learned late last month that the Centers for Medicare and Medicaid Services (CMS) had approved a requested change to the Illinois State Plan for Medicaid to fully recognize optometrists as physicians under the Medicaid program in Illinois.

While Illinois ODs have always been treated as Medicaid physicians for payment purposes, optometrists would not have been able to claim the federal Electronic Health Records (EHR) incentives now being made available for Medicaid physicians without this change to the state plan. 

As Congress worked in early 2009 to complete action on American Recovery and Reinvestment Act, the AOA was successful in securing full inclusion of ODs as eligible providers in the bill’s $19 billion Medicare EHR program and was able to provide a pathway for OD participation in the Medicaid EHR incentives program as well.

Now, providers whose patient base is 30 percent Medicaid or more can now claim $66,000 under EHR instead of the $44,000 available as Medicare providers. This will have a major impact on the Illinois Eye Institute at the Illinois College of Optometry (ICO), an organization that worked very closely with the Illinois Optometric Association (IOA) in achieving this victory and will have a positive effect on other practices that serve the Medicaid population.

Besides practices that qualify, doctors working in hospital settings, clinic settings or in qualified MD/OD settings will also receive the increased benefit. In addition, this change will make optometrists, as a profession, eligible for increased funding and participation in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics throughout the state. Instead of the Medicaid rate, doctors practicing in these locations will be eligible to receive the encounter rate for the facility in which they work.

Illinois joins Kentucky in successfully amending its state plan, and several states are actively working to make this change as well. The AOA will continue assisting affiliates in the quest to secure greater OD participation in Medicaid EHR incentive program.

For materials on this important topic and to learn more about how you can become more involved in helping even more states recognize the important role ODs play in the delivery of health care, contact Brian Reuwer of the AOA Washington office at 703-837-1343 or via e-mail at breuwer@aoa.org.

One comment

  1. […] Besides practices that qualify, doctors working in hospital settings, clinic settings or in qualified MD/OD settings will also receive the increased benefit. In addition, this change will make optometrists, as a profession, eligible for increased funding and participation in Federally Qualified Health Centers (FQHCs) and Rural Health Clinics throughout the state. Instead of the Medicaid rate, doctors practicing in these locations will be eligible to receive the encounter rate for the facility in which they work.Source: newsfromaoa.org […]



Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: