Optometrists and Medicaid patients in Virginia had a close call this summer. Far too close. Due to state budget cutbacks, “optional” optometric Medicaid services were actually eliminated. But then—thanks to legal research from the AOA on a 30-year-old law—the governor of Virginia was compelled to reinstate Medicaid services by optometrists.

Like many other states, Virginia legislators faced a budget shortfall this year. So, a number of Medicaid services landed on the chopping block, including routine vision services for adults, which would have trimmed about $764,000 from state expenses over two years.

“Cutting out services by optometrists for adult Medicaid patients was not an attack on optometry, but simply a result of Virginia facing a $4.1 billion shortfall in a political environment where tax increases were not on the table,” says Bruce Keeney, executive director and chief lobbyist of the Virginia Optometric Association (VOA).

In Virginia, Medicaid covers and reimburses O.D.s for both routine eye exams and medical eye care.

Just two weeks before the cuts were to take effect, staff from the AOA’s State Government Relations Center and its Washington office provided information that turned things around. This was a 1972 federal amendment to the Social Security Act, which required state Medicaid plans to include optometrists as Medicaid providers if the state had covered optometrists for Medicaid services previously and if the state Medicaid plan continued to cover physicians for services that optometrists are legally authorized to perform.

The VOA contacted the governor’s office with this information just one week before the cuts were to take place. Nevertheless, the services were still eliminated, effective July 1, while the governor’s office reviewed the VOA’s appeal.

Virginia optometrists had to turn patients away. Some O.D.s, especially those in rural and inner city practices, were forced to refer patients to hospital emergency rooms for care. Then, about six weeks after the budget went into effect, the governor’s office notified the VOA that services for adult Medicaid patients by optometrists would be restored and reinstated, retroactive to July 1.  

“While patient care remained our top concern, we do not tolerate any type of health insurance plan discriminating against our doctors,” Mr. Keeney says. “We also were confident of the outcome, knowing our governor appreciates the services provided by optometrists and his commitment to the delivery of quality health care services to all Virginians.”