Comprehensive vision care under third party programs: increased services and increased scrutiny

Physician reimbursement under Medicare has been rising by about 15 percent each year. Part of this increase is due to an increase in unnecessary tests and procedures. To control provider billing, Congress passed legislation that will establish a Medicare fees schedule and expenditure targets. Increased surveillance and monitoring of Medicare claims are taking place. Diagnostic procedures are being questioned and denied when deemed inappropriate in relation to a diagnosis. Managed care techniques also are being implemented by private insurance carriers to prevent overutilization. Clinic practice guidelines are being developed by the health professions. Optometry, as well as all other health professions, will be subject to increased utilization and quality review.