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By rdnewsNOW staff

PATIENT IMPACT EXPECTED

Alberta Association of Optometrists hopes to halt upcoming coverage changes

Jan 16, 2025 | 4:38 PM

Changes are coming to optometric coverage for Albertans at the beginning of February.

Earlier this month, Alberta Health announced on its Opto 35 bulletin that changes will go into effect on Feb. 1.

The Alberta Association of Optometrists (AAO) says the changes will have impacts on those with chronic eye health conditions, and will also impact children, seniors, vulnerable populations and rural Albertans.

The AAO, which features 70 optometrists in central Alberta, was blindsided by the release of the Opto 35 Bulletin and the potential impact on Albertans.

Dr. Sophia Leung, AAO President and principal optometrist at Seema Eye Care Center in Calgary, said they didn’t get any heads up notice from Alberta health prior to making the changes.

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“These changes were implemented with all negative impact without any prior consultation with the AAO or any Alberta optometrist for that matter,” she said.

“We represent over 900 optometrists serving over 100 communities and with consultation, Alberta Health would have learned the actual impact of these decisions. We were completely surprised and extremely disappointed by these changes.”

At the end of the month, these changes will occur:

1. Partial vision examination for children and seniors, B651 in the Schedule of Optometric Benefits, will be delisted.
2. Fees for Computer Assisted Visual Fields (CAVF) technical (B906) and interpretation (B907) components will be reduced.
3. Fees for retinal imaging (technical (B908) and interpretation (B909) components) and retinal photography (technical (B910) and retinal interpretation (B911) components) will be reduced.
4. Retinal imaging and retinal photography (technical and interpretation) may be claimed up to twice per patient per benefit year regardless of the practitioner providing the service. Only one interpretation is payable per technical service. May be claimed to a combined maximum of four services per benefit year.
5. Basic eye services (B650) will not be allowed to be billed on the same day as medically necessary eye care (B900-B904) for the same patient by any provider in the children and seniors’ category.

Leung explained that with partial eye exams delisted, if a follow up is needed during a full eye exam, there is no covered option for bringing the patient back.

For example, children’s eyes are changing throughout the year and without proper assessment they could have blurry vision without knowing it. It could also lead to potential vision complications down the road.

With retinal imaging and photography, there will be a decrease in how often optometrists can see their patients by 50 per cent. This will make it more difficult to follow up with patients as frequently as needed, the AAO says.

When it comes basic eye services and medically necessary eye care, they will not be able to be billed on the same day. This means optometrists will no longer able to complete all the needed vision care in one appointment; patients will need to re-book and come back on a different day.

Leung said the AAO would like to reestablish communication with Alberta Health and hope they reconsider the changes before they go into effect at the end of the month.

“We’ve had one meeting with Alberta Health since their announcement and there was no real outcome from that. We’re waiting for another meeting to get some communication going,” Leung said.

“It is our hope that Alberta Health will stop these changes. Give the impact and that Albertans are concerned, we’re also concerned. We want to be able to continue to provide quality care.”