Results 1 to 6 of 6

Thread: Prison made medicaid eyeglasses article...

  1. #1
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
    Join Date
    Dec 2004
    Location
    At a position without dimension...
    Occupation
    Dispensing Optician
    Posts
    5,077

    Prison made medicaid eyeglasses article...

    This is from a California MD who did find a charitable organization to help a newborn born with cataracts.

    How many of us know how important getting glasses without delay is for infants like this?

    How many of us know not to try to use poly?

    "Julius Oatts is a pediatric ophthalmologist and assistant professor at the University of California at San Francisco.

    Near the beginning of the pandemic, I performed eye surgery for an infant born with cataracts. To prevent irreversible blindness, it is necessary for children to start wearing eyeglasses immediately after surgery. For this child, I was told that the glasses would take at least six weeks to arrive — a serious and vision-threatening delay."

    https://www.washingtonpost.com/opini...-minimum-wage/

    Please do not turn this political as the thread will be shut down.

  2. #2
    Master OptiBoarder optical24/7's Avatar
    Join Date
    May 2006
    Location
    Down on the Farm
    Occupation
    Dispensing Optician
    Posts
    5,625
    Looks like you need a subscription to view.

  3. #3
    Master OptiBoarder
    Join Date
    Jun 2000
    Location
    California
    Occupation
    Dispensing Optician
    Posts
    2,753
    That means the surgery was over 2 years ago. Hopefully the situation was resolved and the child has not suffered irreversible damage.

  4. #4
    OptiBoardaholic
    Join Date
    Sep 2014
    Location
    California
    Occupation
    Dispensing Optician
    Posts
    270
    Quote Originally Posted by Uncle Fester View Post

    I was told that the glasses would take at least six weeks to arrive — a serious and vision-threatening delay."
    sometimes it takes 2 months with Medi-cal/Medicaid

  5. #5
    Compulsive Truthteller OptiBoard Gold Supporter Uncle Fester's Avatar
    Join Date
    Dec 2004
    Location
    At a position without dimension...
    Occupation
    Dispensing Optician
    Posts
    5,077
    "As for that infant who had cataract surgery and whose urgently needed eyeglasses were delayed, I ultimately was able to obtain them in a more timely way through a philanthropic organization that allows families to bypass the prison-based optical labs contracted by Medi-Cal. Such workarounds can help children avoid preventable vision loss, thankfully, but they’re not a long-term solution. Eventually, the current arrangement’s fundamental inequities will need to be addressed.


    In medical school, I took an oath to “do no harm.” Since then, I’ve had the chance to reflect on the meaning of harm and when it can occur far from the doctor’s office doors."

    This is the organization that is linked above:

    https://allmaysee.org/blog/the-augie-fund/

  6. #6
    Rising Star OptiBoard Silver Supporter
    Join Date
    May 2006
    Location
    il
    Occupation
    Optometrist
    Posts
    1,028
    The medicaid system in Illinois has been overrun by for-profit insurance companies, and now vision plans faking as insurance companies have lowered those fees another 30%. They get the state and federal contracts and block grants, I assume with the goal of running the system better than the state did and for less cost. It is not clear anything has gotten better for any of these patients. The offices still accepting the insanely low medicaid rates are still dinged another 2.7% because Illinois can't get its act together financially. They switched to adult glasses every two years instead of one, and that decimated my office and people just wouldn't show up if they didn't get glasses. Those could take 3-6 months even if they were covered. Prison lockdown meant another delay that could take months. The whole time if you submitted a claim with one I not dotted, they'd deny it and not start making glasses, and often not tell us.

    These new plans can take over six months to get credentialed. Another place I worked closed. Another place I worked dropped all the medicaid plans because they had trouble with billing and payments. Most of those medical insurance companies specifically limit what we can get paid, so an optometrist couldn't even get paid to see a kid with allergies or an eye infection. I've talked to local ophthalmologists who "oh, I had no idea, I never have that issue." At best, it seemed, we could get the laughable "routine vision exam" coverage for those things, or we could do it for free and not file anything.

    I spent some time talking directly with school nurses, teachers, and some local charity groups. The lions club near me said I could "help" by doing an eye exam, plus giving these kids two pair of glasses for like $69... and then openly wondered how the other businesses who already did that could afford to do so. Some nurses thought parents would drive their kids 90 minutes one way to come to my office... where I can't accept their plan...

    All the school nurses assume I'd get paid to see these kids with no problem. Many of the teachers I've talked with don't understand the difference between a two minute school vision screening, a pediatrician checking acuity at a physical, and an actual eye exam/refraction. Some think they have solved the issue because they discovered zenni optical does $6.99 eyeglasses, so they "just need me to do the free exams."

    I've seen nurses *milk* the system by charging $30-40 for each "vision screening" they perform and can do hundreds in a day and move on to the next school. None of those kids get the care I think they need, none get glasses, and the state pays lots of money for that somehow.

    I try to build up the courage to reach out and set up a system with some of these schools, but there isn't anything other than "sure, you can do it for free, we'd love to have you here." I would need some random philanthropist to donate $10,000 and then I'd just do some good work for a while and then ask for more money after I showed them all the stuff I'd done. It can't be this "bill the insurance and maybe they'll pay you" style of garbage or "sign all these forms and 8 months later we'll let you know."

    As the numbers of residents of Illinois on these plans go up, it will just get worse. The ONE place near me that accepts any of these plans is booked out over three months right now.

    I'm only depressing everyone with this because I went to optometry school specifically to deal with children. My internship a long time ago informed me the first exam I did in Maryland paid their office $6 and I remember thinking surely that isn't the norm. It took me a while to realize people value what we do so much that it MUST be free, and we must be making millions from everyone else anyway and who cares. Please help us for free. And almost all of these people telling me this have their own healthcare paid for, they get salaries, paid time off, vision plans forcing huge discounts (of course) and pensions. It is harder and harder for me to take any of them seriously.

    I've also seen ophthalmologists billing charities $3500 for a cataract surgery instead of what their medicare allowable is that they accept all day every day. That was 20 years ago, and it still burns me up they'd treat charities that way. Little tricks that some use to their advantage in this stupid crazy system we all are forced to interact with.

    If anyone has any bright ideas other than me personally going into more debt, I'm all for it. Please share. Any system I've ever seen ends up with the eye care providers getting screwed. This is why no one takes these plans. This is why the patient don't receive care. I see no end to this. I see more and more Illinois residents being given this form of healthcare, where large companies profit and small providers suffer and are sidelined or eliminated. Hadn't even really been on my mind that the state also used "slave labor" to produce the glasses and some random people were probably profiting off of that in some way.

    Anyone want to set up a charitable organization for me?

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Eyeglasses have made it to the legs .......................
    By Chris Ryser in forum General Optics and Eyecare Discussion Forum
    Replies: 12
    Last Post: 02-04-2015, 03:49 PM
  2. Authoritative Article on Eyeglasses
    By globaloptics in forum The Job Board
    Replies: 0
    Last Post: 08-12-2013, 07:33 AM
  3. USA Made Vintage Eyeglasses - $70.00
    By Steve Machol in forum Optical Marketplace
    Replies: 0
    Last Post: 05-09-2013, 11:43 AM
  4. Slate Article re: online eyeglasses
    By Alteaon in forum General Optics and Eyecare Discussion Forum
    Replies: 7
    Last Post: 09-01-2008, 12:19 AM
  5. NYT Article on Medicaid Fraud
    By Cindy Hamlin in forum Just Conversation
    Replies: 0
    Last Post: 07-20-2005, 02:18 AM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •