Focus on Low Vision
Legislative Update: Medicare bill now in both houses
By Steph De Long

As of February, bills designed to fill the coverage gap for Medicare recipients who suffer from low vision have made it into both Houses of the U.S. Congress. Called the "Medicare Vision Rehabilitation Services Act of 2002," the bill was introduced in the House of Representatives last July by co-sponsors from both parties--Reps. Michael Capuano (D., Mass.) and Mark Foley (R., Fla.)--and a companion Senate bill was introduced this February by Sen. John Kerry, also a Democrat from Massachusetts. They are officially called H.R. 2484 and S. 1967, respectively.

Capuano has been instrumental in spearheading this legislation, which is designed to cover therapy prescribed by ophthalmologists and optometrists. He has, in fact, been working on it in the House since 1999.

According to the Academy of Ophthalmology, only 18 states now legislate any coverage for doctor-prescribed vision rehabilitation services of such low vision professionals as orientation and mobility specialists, rehabilitation teachers, and low vision therapists. If passed, the bills would standardize Medicare coverage by these professionals for vision rehabilitation services performed nationwide.

"It is important to note," says Catherine Cohen, American Academy of Ophthalmology vice president, "that this is not a new benefit, but rather it standardizes coverage so that all Medicare patients in need of vision rehabilitation services have equal access to them regardless of where they live. In addition, the bill expands access to services even in states that have coverage by allowing certified vision rehabilitation professionals under a physician's general supervision to provide services in the home."

Those involved with the bills say they are encouraged by the changing climate as Congress, for the first time since last September, is now devoting more time to domestic issues such as Medicare.

SAVING TAXPAYER DOLLARS

Besides helping those who are vision impaired receive the treatment they need and deserve, supporters of this legislation argue that it would save taxpayers money.

According to Dr. Barbara Silverstone, president and chief executive officer of Lighthouse International, "Coverage by Medicare could save millions of dollars in costs to treat injuries such as broken bones from falls often caused by vision impairment. And vision rehabilitation can reduce the need for in-home care and nursing care."

Studies by the National Center for Health statistics and others find age-related visual impairment to be second only to arthritis and rheumatism as a cause of disability. And, according to an analysis of the Medicare Current Beneficiary Survey by the nonprofit Alliance for Aging Research, visual impairment is one of the four major conditions leading older citizens to lose independence. The June 1999 report found that loss of independence by older Americans costs the United States $26 billion each year.

Currently, a number of groups are funding additional research, including the Low Vision Council, whose 22 members are manufacturers and distributors of low vision products. According to council president Ron De Long, "We are the only developed country that doesn't provide some level of help for seniors with vision impairment. Our group is active in a number of consumer-awareness and reimbursement initiatives. Recently, we agreed to partially fund a study being conducted for the American Academy of Ophthalmology to measure the efficacy of low vision devices in a visual rehabilitation program. Hopefully, results from this study and others will convince Congress to finally approve this much-needed help."

WHAT'S NEXT?

The next step, according to the National Vision Rehabilitation Cooperative's Website, www.medicarenow.com, is to increase co-sponsors for H.R. 2484 and sign on co-sponsors for the new Senate bill. Lorraine Lidoff, director of the Cooperative, says the best thing you can do is call or fax your representatives and senators. The Cooperative's Website even has form letters you can send.

More specifically, the group suggests you check the list of sponsors and see if your representative is already supporting H.R. 2484. If so, send a thank you, and, if not, send a letter requesting support. Just as important, show support for the new S. 1967 bill by writing to your state's senators.

The National Vision Rehabilitation Cooperative--a network of private, non-profit vision rehabilitation agencies across the country--has been very active in pushing this legislation since it was first introduced by Capuano in 1999. In addition, nearly 60 national, state, and local organizations in the aging and vision fields have endorsed and actively support these bills.

Looking to the future, Silverstone says that legislation such as this will become even more important. "Reducing disability and maintaining the independence of Americans who are visually impaired is increasingly important," concludes Silverstone, "as baby boomers age and the costs of in-home care and nursing care grow."

To learn more about what you can do, or to find out names and addresses of your local senators and representatives, check out these Websites: www.lighthouse.org; www.medicarenow.org; www.aao.org; and www.aoanet.org.