Optometrist Satya Verma, of Blue Bell, Pa., watched with interest as Congress voted to override President Bushs veto of legislation passed to stop massive cuts in the Medicare program.

Dr. Vermas interest comes as a private practitioner with half his patient base comprised of Medicare patients. Also, his interest comes as the chair of the Public Policy Committee for the National Council on Aging.

If the cuts had continued on as suggested by President Bush and Medicare, some practitioners may have withdrawn from seeing Medicare patients, not only in optometry but also in the health-care field, Dr. Verma says.

H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008, prevents a looming 10.6% cut in Medicare payments to physicians and managed-care plans.

It also blocks implementation of a proposed DMEPOS (durable medical equipment/prosthetics, orthotics and supplies) accreditation restrictiona measure the American Optometric Association says could deny Medicare patients access to post-surgical eyewear.

The act also:

Prevents the 5% pay cut scheduled to begin January 1, 2009.

Extends a 0.5% payment update through December 31, 2008.

Provides a positive payment update of 1.1% for 2009.

President Bush vetoed the legislation on July 15. That same day, however, Congress voted to override the veto by 383 to 41 in the House of Representatives and 70 to 26 in the Senate.

Not only would the cuts have affected patients access to care had they gone into effect, but they also would have affected the bottom line of optometrists, especially geriatric-based practices.

I know doctors who only see older patients, whether in nursing homes or facilities or in practice, Dr. Verma says. I would say as a practice grows, so does the number of Medicare beneficiaries.

Unlike Dr. Verma, optometrist Jason R. Miller, M.B.A., of Powell, Ohio, has a patient base of only 10% to 15% Medicare patients. But he, too, is relieved that Congress voted to override the veto.

Even though Medicare payments are one of the lower sources of revenue in our practice, it is extremely important to maintain that revenue stream, which allows us to provide the highest quality eye care to our patients and community, he says.

But, Dr. Miller sees a larger impact on his and other practices. Insurance companies look to Medicare as to how theyre going to drive their reimbursement, he says. Had these cuts gone through, Dr. Miller believes they may have led plans to reduce their fees as well. Its just not a good trend to start, he says. From a practice-management aspect, its a huge win for optometry as a whole to have those cuts blocked.

But, Dr. Verma warns that optometrists must remain vigilant, as similar cuts could be introduced in the future as health-care costs continue to rise.

Vol. No: 145:08Issue: 8/15/2008