Article: Self-organizing optic-cupmorphogenesis in three-dimensional culture

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Article: Generation of complex organs in vitro is a major challenge in regenerative medicine. But it is not an impossible one: an entire synthetic retina has now been generated from embryonic stem cells.

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Legislation Introduced Regarding Corporate Practice of Optometry

April 25, 2011

COA is opposed to AB 778 by Assembly Member Tony Atkins. This bill would authorize a registered dispensing optician or optical company to own a health plan that provides vision care services. The sponsor of the legislation, Luxottica and its subsidiary LensCrafters, have been involved in litigation with the State of California over the business model utilized in the LensCrafters and Pearle Vision Center optical dispensing outlets. The litigation generally revolves around Luxottica (an optical manufacturer) and LensCrafters' (a registered dispensing optician) relationship with optometrists employed by EyeMed (a vision plan owned by Luxottica). The Attorney General contends, and COA agrees, that the business model utilized violates California statutes that prohibit economic relationships between optometrists and opticians. Thus far, the litigation has not gone well for Luxottica/LensCrafters and, accordingly, they seek to avoid adverse court decisions by utilizing legislation to create an exemption to the statutes in question that would allow optical manufacturers and dispensing opticians to control the activities of optometrists and ophthalmologists. California has a long history of protecting the independence of optometrists and physicians from lay control. COA opposes this bill in its current format.


Optometrists Rank #50 Best Jobs for 2011, 6th in Healthcare Jobs

The Outlook:
The American population is quickly becoming more elderly. So demand for visual aids is expected to grow considerably. But eye-care technology is improving as well, allowing each optometrist to care for more patients. Still, the Bureau of Labor Statistics expects more than 24 percent growth, or 8,500 new jobs, for the profession through 2018.

Education and Preparation:
Don't overrate the fact that you don't have to go to medical school to be an optometrist. Becoming an optometrist is still quite competitive, as there are only 20 schools that teach optometry in the United States and Puerto Rico. These are four-year institutions at universities that all require a bachelor's degree for applicants. Each school has its own additional admission requirements. According to the Association of Schools and Colleges of Optometry, during undergraduate years an applicant should take "at least a year of biology, chemistry, organic chemistry, general physics, and microbiology; English; college mathematics; and other social science and humanities courses." [Find online degree programs in healthcare.]

Real Advice from Real People about Landing a Job as an Optometrist:
Networking should be the number one goal for job-seeking optometrists, says Dr. Barbara Horn, independent practitioner and chair of the American Optometric Association's Clinical & Practice Advancement Group Executive Committee. "Get involved early as an optometry student and become a member of the AOA and your state affiliate organization. Networking is key, so don't overlook participation in local optometric societies as well," she says. Also, if you specialize in an area, like sports or geriatric vision, be sure to target practices that don't already offer those services. Often, new skills are sought after. "If you bring a different speciality into a practice, you can grow that practice," she says. For online job seekers, Horn recommends the AOA's Optometry Career Center, the of the optometry profession. -US News Online 1/19/11.

New Appointment Time Standards Effective January 17

January 14, 2011 New regulations that establish standards on how long it should take to receive health care will take effect January 17, 2011. The regulations, promulgated by the California Department of Managed Health Care, establish two new response time standards: 1. The regulations generally require health plans to ensure it takes no more than 10 days to see a doctor in most routine cases and no more than 48 hours in many urgent care situations. The rules break down maximum appointment wait times in several categories: 48 hours for most urgent care appointments. 96 hours for urgent care that requires prior authorization. 10 business days for regular primary care. 15 business days for a specialist. 10 business days for a mental health specialist. 2. When health plan members call for an appointment, their call must be screened by a qualified health professional to determine the urgency. This triage service must respond to a member's call within 30 minutes, informing the caller of the length of wait for a return call from the medical provider. The health plan's customer-service representative must respond to a member's call within 10 minutes during normal business hours. The new rules apply to all full-service health plans licensed by the Department of Managed Health Care and Blue Cross and Blue Shield PPOs. While the law sets these time frames, health care providers can be flexible in scheduling appointments if a longer time frame is appropriate for the member�s health. It must be noted in the member�s record that a longer waiting time will not be harmful to the health of the member. The rules additionally require vision plans to ensure that contracted providers employ an answering service or a telephone answering machine during non-business hours, which provide instructions regarding how enrollees may obtain urgent or emergency care including, when applicable, how to contact another provider who has agreed to be on-call to triage or screen by phone, or if needed, deliver urgent or emergency care. The new rules place the burden of compliance on the health plan, not the doctor. A health plan must ensure that it has contracts with a sufficient number of doctors in each geographic area to serve its members. This means that plans must have a strong and varied provider network to enable appointments to be made within the specified timeframes. The full text of the regulation (28 Cal. Code Regs. � 1300.67.2.2) is available by clicking here.



Medical Doctors File Lawsuit to Invalidate Glaucoma Regulations

January 11, 2011 The California Academy of Eye Physicians and Surgeons and California Medical Association (CMA) jointly filed a lawsuit in San Francisco Superior Court challenging the glaucoma regulations adopted by the State Board of Optometry. A copy of the complaint and CMAs press release are available on CMAs website. The glaucoma regulations stay in effect unless the court decides to grant the injunction, which can take three to four months. COAs legal arm, Public Vision League (PVL), plans to take whatever action may be necessary to uphold the regulations.

Budget Proposes Deep Cuts to Medical Services

January 14, 2011 The governors budget proposes deep cuts to all segments of the budget. The Legislature will consider this budget under a condensed timeline of 60 days. The Legislature will attempt to complete work on the budget by March, so that a revenue package and related budget proposals can go to the voters by June 2011. Some temporary taxes expire July 2011, and if they do � either through legislative inaction or because the voters vote to end them � then the Legislature will need to make additional, much steeper, cuts. COA is working collaboratively with other organizations to oppose these proposed cuts. Medi-Cal � Governor Brown proposes to make $1.7 billion of cuts to Medi-Cal by limiting care, increasing cost sharing, reducing payments to doctors and providers, and other reductions. Medi-Cal Provider Rate Cuts: Payments to Medi-Cal providers, including medical doctors, optometrists, pharmacy, clinics, and some hospitals and nursing facilities, would be reduced by 10% Medi-Cal New Hard Caps on Care: The budget proposal would limit care and coverage for Medi-Cal patients: Limit doctor/clinic visits to 10/year Limit prescription drugs to 6 per month (with no exceptions unless for life-saving drugs) Establish maximum benefit dollar caps on medical supplies (e.g., wound care, incontinence supplies) and durable medical equipment (e.g., wheelchairs and hearing aids) Medi-Cal New Co-Payments: Beneficiaries, many of whom earn less than $1000 per month, will now have to pay new copayments for medical doctor, clinic, and optometrist visits as well as prescription drugs,hospitalization, and emergency room visits: $100/day for hospital stays, up to a maximum $200; $50 copayment for emergency room visits; $5 copayment for doctor visits and prescriptions. Healthy Families � The State Children�s Health Insurance (SCHIP) in California that covers nearly one million children of low income families, will see a $38.5 million reduction: Healthy Families Elimination of Vision Coverage: About $11.3 million of the cuts are proposed to be achieved by eliminating vision services. Healthy Families Increased Premiums and Co-Pays: Increase monthly premiums for families between 200 and 250 percent of the Federal Poverty Level (FPL) by $18 per child; and for families between 150-200% FPL by $14/child. 150% of FPL is $27,500 for a family of three. Raise emergency room co-payments from $15 to $50 and raising hospital inpatient services co-payments of $100 per day with a $200 maximum.

Glaucoma Certification Approved

December 10, 2010 COA Applauds Office of Administrative Law for Approving Glaucoma Certification � Allowing Californians Greater Access to Quality Eye Care Sacramento, CA- The California Optometric Association (COA) applauds the decision made today by the Office of Administrative Law (OAL) to approve glaucoma certifying regulations promulgated by the California Board of Optometry. The Legislature directed the California Board of Optometry to promulgate these regulations to address the shortage of primary eye care doctors in rural and underserved communities � a problem that is only expected to worsen with the recent passage of health care reform by the federal government. The glaucoma certifying regulations were initiated by the unanimous passage of SB 1406, by Senator Lou Correa, which was signed by Governor Arnold Schwarzenegger in 2008. This legislation allows graduates after May of 2008 from schools of optometry to treat certain forms of glaucoma. It also requires a glaucoma certification process for optometrists who graduated prior to that date. SB 1406 expands the scope of practice for California optometrists and allows greater access to primary eye care needs to Californians. There is a California optometrist in nearly every county in California and they are providing care that is cost effective and of the highest quality. The regulations approved today are the strictest in the country. Currently, 49 states allow some form of glaucoma treatment. �Anytime there is an expansion of scope for any profession it is given particular scrutiny, and we are strongly supportive of that process,� said Dr. Harue Marsden, O.D. and President of the California Optometric Association. �However, we always expected that after close review it would be evident that the glaucoma certification regulations being proposed in California will absolutely result in California patients being the most protected and best-served in the country. We look forward to helping more Californians access quality primary health care.� The regulation for a glaucoma certification process for optometrists who graduated prior to 2008 will be effective January 8, 2011.

Medi-Cal Optometry Services to Be Reinstated July 26, 2010

Sacramento, CA � Thanks to the work of the California Optometric Association�s legal arm, Public Vision League (PVL), optometry services will be reinstated for dates of service on or after July 26, 2010. This past January, PVL sent a letter to the state Department of Health Services (DHS) explaining that the law requires coverage of optometry services if the same services are covered when performed by an ophthalmologist. If DHS did not begin to cover optometry services, PVL was prepared to file a lawsuit. Optometry is the only �optional� benefit that will be reinstated. Optometry services include diagnostic, ancillary and supplemental procedures used for the evaluation of the visual system. Current optional benefit exclusion policy involving services relating to eyeglasses and other eye appliances will remain unchanged with the reinstatement of optometry services, with the exception of bandaged contact lenses HCPCS code V2599, which will be covered for eligible beneficiaries based on Medi-Cal necessity. For a list of optometry services now payable for adult beneficiaries under the Medi-Cal program, refer to the Rates: Maximum Reimbursement for Optometry Services section of the Medi-Cal Vision Care manual. About the California Optometric Association California Optometric Association was established in 1899, and is California�s oldest organized community for optometrists. Representing more than 2,700 optometrists, COA is dedicated to ensuring the highest quality of health care for the public through the advancement of optometry.