CMS Demonstration Project to Launch April 1

WASHINGTON – The American Academy of Ophthalmology (Academy) congratulates Sen. John Sununu, R-N.H., for his outstanding commitment to making the new Centers for Medicare and Medicaid Services’ (CMS) Low Vision Rehabilitation Demonstration (LVRD) project a reality. CMS formally announced the project Feb. 22. The LVRD project is the result of Academy-backed legislation intended to expand access for patients by having Medicare cover vision rehabilitation services by a larger group of authorized vision rehabilitation professionals. The Academy has worked with Sununu to implement the program since late 2003 when Congress directed CMS to develop the demonstration project. In recognition of his leadership in Congress on vision rehabilitation issues, the Academy awarded Sununu with its Visionary award in 2004.

The five year project is scheduled to launch April 1, 2006. Due to cost limitations, the demonstration is limited to six sites:  New Hampshire, Atlanta, New York City (all five boroughs), Kansas, North Carolina, and Washington state.

The project will provide CMS with important information in its consideration of the feasibility and advisability of standardized national Medicare coverage of vision rehabilitation by an expanded group of authorized providers. Medicare currently covers vision rehabilitation services when provided by certain Medicare qualified therapy providers (occupational or physical therapists) who are supervised by a qualified physician. Under the demonstration, Medicare will cover vision rehabilitation services provided by certified low vision therapists, orientation and mobility specialists, rehabilitation teachers, and occupational therapists. These vision rehabilitation professionals will be authorized to provide covered services in appropriate settings such as the beneficiary’s home without the supervising physician having to be on the premises.

Vision impairment or “low vision” means significant loss from disease, injury or degenerative condition that cannot be corrected by conventional means like medication or surgery. Vision rehabilitation has been shown to provide significant improvement in the quality of life of individual’s with “low vision.” 

The Academy’s interest in expanding the pool of authorized vision rehabilitation providers results from monitoring the eye health needs of a rapidly growing Medicare beneficiary population. With this unprecedented growth comes rapid increase in age-related eye disease and conditions likely to lead to vision impairment. Access to high quality vision rehabilitation has become an important quality of life issue for the country’s aging population and an adequate pool of authorized providers must be available to meet these needs.

“The Academy is gratified to see the vision rehabilitation demonstration project get underway. We have a strong commitment to expanding patient access to vision rehabilitation services because we know first hand how important rehabilitation services can be in the lives of people with vision impairment,” said Catherine Cohen, Academy vice president of Governmental Affairs. “The Academy will continue to work with CMS and Sen. Sununu to monitor the demonstration project and ensure its success.”