Glaucoma survey provides insights into therapies

Patient compliance with therapies ranks as the biggest challenge among glaucoma specialists, according to the results of a recent survey by Glaucoma Physician, a sister publication of Ophthalmic Professional. In this survey of 68 U.S. glaucoma specialists, 48% reported that compliance was the biggest challenge, followed by prior authorizations (24%), patient scheduling (10%), and staff training (10%).

Looking at therapies, most specialists noted that glaucoma medications that are preservative-free are very important (48%) or somewhat important (45%). Also, medication cost was very important (61%) or somewhat important (32%) to the respondents’ chosen therapy recommendations, and 83% reported they offer a coupon card or access to programs that provide prescription discounts to the prescribed therapies.

In addition, two-thirds of survey respondents noted that their volume of glaucoma patients has increased in the last two years.

For more information on the allied health staff’s role in glaucoma care, including patient adherence to therapies, diagnostic testing, minimally-invasive glaucoma surgery, and selective laser trabeculoplasty, see the January/February 2023 issue of OP at www.ophthalmicprofessional.com/issues/2023 .

AMA praises CMS for prior authorization reforms

The American Medical Association has praised CMS for the final rule for Medicare Advantage (MA) that includes “important steps toward right-sizing the prior authorization (PA) process,” said Jack Resneck, Jr., MD, president, AMA, in a recent statement.

According to the “2024 Medicare Advantage and Part D Final Rule” fact sheet, the final rule streamlines PAs by requiring that:

• coordinated care plan PA policies may only be used to confirm the presence of diagnoses or other medical criteria and/or ensure that an item or service is medically necessary.
• coordinated care plans provide a minimum 90-day transition period when an enrollee currently undergoing treatment switches to a new MA plan, during which the new MA plan may not require PA for the active course of treatment.
• all MA plans establish a Utilization Management Committee to review policies annually.
• approval of a prior authorization request for a course of treatment must be valid for as long as medically reasonable and necessary to avoid disruptions in care in accordance with applicable coverage criteria, the patient’s medical history, and the treating provider’s recommendation.

According to Dr. Resneck, the final rule “will ensure greater continuity of care, improve the clinical validity of coverage criteria, increase transparency of health plans’ PA processes, and reduce care disruptions due to prior authorization requirements.”

Dr. Resnick continued, “The AMA has long advocated for such meaningful prior authorization reforms and Medicare Advantage enrollees will benefit from the important new protections. The AMA looks forward to working with CMS to bring a similar level of reform to Medicare’s drug benefit program.” OP