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SlitLamp provides illuminating e-news for Colorado ophthalmologists. It keeps you in the know on the evolving Colorado health care scene by detailing the latest legislative and regulatory happenings. It also spotlights the information and resources you need for your practice.


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New CSEPS lobbyist: Chris Howes

Posted By Administration, Thursday, November 19, 2015

In September the CSEPS board of directors hired Chris Howes, president of the Howes Group, as the new CSEPS lobbyist. His selection concluded a months-long process to assess, focus and strengthen the organization’s advocacy efforts.

Chris founded The Howes Group, LLC in 2001. His twenty-year lobbying career has been built on representing a diverse group of associations and business industries in Colorado including hospitals, pharmacies, telecommunications, emergency responders, drug manufacturers and others.

“We are excited to bring Chris onto our advocacy team,” said CSEPS President Rob Fante, MD. “He brings a wealth of experience and a proven track record of getting things done at the state capitol – just what we need to continue to champion Colorado ophthalmology’s priorities and ensure excellence in eye care,” Fante said.

Chris will work closely with the CSEPS Government Relations Committee (GRC), chaired by Denver retina surgeon David Johnson, MD. If you are interested in advocacy, then send Chris an email or join the CSEPS GRC. Contact Chet Seward in the CSEPS offices for more information. Stay tuned for a forecast on what to expect during the 2016 legislative session. 

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Ophthalmologists to fare better under Meaningful Use after clarification of patient measure

Posted By Administration, Thursday, April 23, 2015

As a result of the American Academy of Ophthalmology’s persistent advocacy efforts, more ophthalmologists can expect to succeed in the Medicare Electronic Health Records Meaningful Use program. In a recent message to the AAO, the Centers for Medicare and Medicaid Services provided clarification on its patient portal measure.

Many ophthalmologists have difficulty in complying with the patient portal measure that requires physicians to provide at least 50 percent of their patients with timely online access to their health information because a majority of ophthalmic patients are elderly and may lack the necessary technological resources to access their health information online.

The agency defines access as when a patient possesses all of the necessary information needed to view, download or transmit their information. This could include simply providing patients with resources such as a web address to access the online patient portal, assistance with establishing a username and password, and other helpful information. Read more about the provision here. 

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CODEquest 2015 success

Posted By Administration, Thursday, April 23, 2015
Thanks goes out to all those that attended the successful CODEquest Ophthalmic Coding Conference on March 21. Over 130 physicians and their practice staff became better prepared for the biggest change to practice coding in decades when ICD-10 hits in October this year. The program was part of a larger series that CSEPS is sponsoring this year to help ophthalmologists with the business of medicine.

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My Time on Capitol Hill: The Power of Advocacy Ambassadors

Posted By Administration, Thursday, April 23, 2015

By Amy Cheroff, MD

This past week, I was able to partake in the AAO’s Mid Year Forum and Congressional Advocacy Day thanks to the support of the Colorado Society of Eye Physicians and Surgeons. My experience as an Advocacy Ambassador, the Academy’s advocacy leadership program for residents and fellows, was both productive and inspirational. Alongside the other Colorado MYF participants, Dr. Alan Kimura, Dr. Leo Seibold, and Chet Seward, I met with our congressional members Sen. Cory Gardner, Rep. Diana DeGette, as well as Sen. Michel Bennett’s aid. We discussed topics pertinent to the AAO such as the Truth in Healthcare Marketing Act, NIH/NEI/DOD research funding, and Electronic Health Records Meaningful Use reform. Additionally, to be in D.C. for the historic passage of the SGR repeal was an unforgettable experience, and to be able to thank our legislators personally for this accomplishment was quite rewarding.

The Advocacy Ambassadors program included insightful talks on leadership, engagement, advocacy, and practice management given by many of the Academy’s finest leaders from around the country. It was an honor to be able to network with them personally, in an informal and supportive setting. One of the most important and surprising take away points for me was the valuable role we can play even as residents and young ophthalmologists. Although our experience is limited, we can bring new ideas and questions to the table as well as supply the energy and passion associated with having our entire careers ahead of us. Our future in ophthalmology and medicine depends on our involvement in both state and national leadership and advocacy. It is exciting to know the AAO both supports and needs our involvement-even at this young stage in our careers.

This program opened my eyes to another aspect of medicine. Equally important to providing excellent patient care is ensuring our healthcare system continues to provide the structure and means for such care. I would like to thank both the Colorado Society of Eye Physicians and Surgeons for their sponsorship and the University of Colorado Department of Ophthalmology for their support of my participation. I am appreciative of my recent experience and certain it will not be my last.

 Attached Thumbnails:

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Legislative Report: April 17, 2015

Posted By Administration, Thursday, April 23, 2015

On Wednesday, April 22, we hit the 106th day of this 120-calendar day session. There will be no more than 14 calendar days remaining until adjournment sine die. When you consider that four of those days are weekends, we functionally have 10 working days for the legislature to complete its work – and there is a lot of work yet to be done. When the Speaker of the House gavels the session adjourned sine die, all works stops. Any bills remaining on the calendar are declared dead under the rules. Under the Colorado system, bills that were in limbo at the end of a session do not carry forward to the next session – they are just dead. If the sponsor wishes to have that bill in 2016, he or she will have to file it as a new bill.

So far there have been 366 bills introduced into the House and 269 bills introduced into the Senate. That does not include various resolutions and other issues. We are continuing to see new bills introduced and I think we could easily have at least a dozen new bills introduced over the next several days.

When does a 10-day Bill become a 30-Day Bill?

The answer is April 24.

The Colorado Constitution requires the Governor to act on a bill within 10 days of having received it while the General Assembly is still in session. If the Governor signs the bill into law, it is then returned to the house in which it originated to become part of the organic law of the State. This is not only just for the logistics of printing the Session Laws, the Governor’s letter specifies the date and time he signed the bill – a very important record to know exactly when a provision became enforceable law.

If the Governor vetoes the bill, then the General Assembly can consider his veto and determine whether to override it. But what happens when a bill is sent to the Governor and there are fewer than 10 days remaining before adjournment sine die? It magically becomes a 30-day bill. If he fails to act on a bill within the 10 day window, it becomes law without his signature.

Since the 10 day clock would become meaningless under those circumstances, the Governor has 30 days to act on a bill that has reached him. The ultimate final date for the Governor to act on such bills is 30 days from the date that the General Assembly adjourns sine die. Adjournment sine die must occur no later than midnight on May 6. If the Governor vetoes a bill during that period, there is no opportunity for the General Assembly to consider the veto and it stands unchallenged.

This calendar imperative is why the legislature pushes very hard to get the budget finalized and sent to the Governor before the 10 day window is closed. The Governor has line item veto authority which also includes the various headnotes and footnotes to the budget. If the long bill does not get to the Governor before April 24, the Governor can just wait until the legislature goes home before exercising any line item vetoes. This year, the legislature has closed the long bill and both houses have readopted it per the agreements reached by the JBC acting as conference committee. That bill is on its way to the Governor, so the long bill will be a 10 day bill.

Optometrist Insurance Bill

It is difficult to assess what exactly is going on with HB15-1297. As reported last week, the bill had been sent forward from the House Health, Insurance & Environment Committee (with a complete rewrite of the bill) to the full House. It has been on the House 2nd Reading calendar for more than a week. The sponsor has laid it over three different times presumably to give her more time to try to reach an agreement between the sides for a set of amendments that will satisfy both.

While the calendar is not yet a problem for the bill, it should be remembered that it has another house to navigate in these closing days. If the parties can reach an agreement, there is not much danger to the bill because an agreed upon bill can slip through the second house and go the Governor pretty quickly. However, if one of the two parties remains opposed, the second house consideration could become difficult. It is unlikely that the second committee of reference will be willing to spend 3 different meetings eating up around 8 hours of time.

Out-of-Network Provider Payment

The next scene in the melodrama of out-of-network provider payments plays out in Senate Business, Labor & Technology when SB15-259 by Senator Aguilar is set for hearing on April 20 @ 1:30 PM.

The introduced bill no longer includes the binding arbitration provisions to reconcile disputed billings by out-of-network providers. It retains most of the previous drafts with respect to prohibiting balance billing of covered individuals and various notifications of covered persons concerning the provision of out-of-network care.

We have been involved with this bill under the general umbrella of the Colorado Medical Society through the various drafts of the bill and Colorado CSEPS is listed on the CMS materials as being opposed to the bill.

The past couple of weeks have seen a flurry of activity concerning this bill. CMS has taken a strong and aggressive opposition to the bill and has been committing almost full staff resources to defeating it in committee. You may have seen the “Code Blue” alert issued by CMS last week since it was widely distributed to the physician community.

CMS has also retained some special analytical talent to look at the bill – both in its draft and final form. There has been a lot of communication among the physician groups. Last Wednesday evening, the CMS Council on Legislation held a conference call in lieu of its regular meeting. One of the subjects was an update of the status of SB15-259 and the ongoing discussions with the health plans concerning a possible summer study effort. There is a letter signed jointly by Alfred Gilchrist and Ben Price notifying Senator Aguilar and the committee about this summer effort. A copy of that letter has been attached to the email that transmitted this report.

CMS is organizing the committee presentation and preparing witnesses. If you have information that you think would be useful to CMS or wish to testify or submit a written statement to the committee, please contact Susan Koontz at CMS directly. There is so much information flying around that it needs to be centralized in one set of hands to stratify it. At this time, it appears that CMS has developed a cadre of about 20 persons to testify against the bill. While the majority of these witnesses is physicians, the CMS is planning to bring one of its financial consultants to testify about the assertions of the plans regarding the extent of out-of-network payment problem. The other consultant, Dr. Dranove, has submitted his analysis of the bill in the form of a written affidavit and that has already been distributed to the committee.

If you wish to listen to the hearing on April 20, you can do so via the Internet. Please contact me or Chet for information on how to connect to the committee room. It is quite easy and the audio is pretty good.

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Members build relationships at December mixer with COA

Posted By Kate Alfano, Thursday, December 18, 2014
Updated: Thursday, December 18, 2014
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Results of the statewide CSEPS poll

Posted By Administration, Thursday, December 18, 2014
Kupersmit Research conduced the CSEPS 2014 planning survey in September and November to probe attitudes among Colorado ophthalmologists on their impressions of CSEPS, importance and awareness of CSEPS services, and priorities for CSEPS. A total of 76 ophthalmologists completed the survey; 84 percent were current members, 7 percent were former members and 7 percent were nonmembers.

Overall, one-half rate CSEPS as "excellent" (14%) or "very good" (36%) in terms of having a 'positive impact on the practice of medicine for ophthalmologists in Colorado,' while 30% say "pretty good" and 4% say "not very good," while another 16% (mostly non-members) say they are "unsure."

Kupersmit found the greatest importance placed on ‘advocacy on behalf of ophthalmologists at the state capitol,’ with 80 percent saying this is "very" important and 17 percent saying this is "somewhat" important; just 2 percent say this is "not important" to them. Secondary was communications. The top concern for Colorado ophthalmologists is health reform, with a majority (53%) saying they worry about 'how the changes in health care will affect' them "all the time" or "a lot," and another 36% saying they worry about this "some."

Kupersmit concluded that CSEPS has a core group of members who are engaged with the organization. There is a larger group of less engaged members who are positive about the organization. The time is right to build the organization. Watch for the unveiling of a new engagement campaign in January 2015.

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ICD-10 resources from the Centers for Medicare and Medicaid Services

Posted By Administration, Thursday, December 18, 2014

With the Oct. 1, 2015, ICD-10 compliance date drawing nearer, now is the time to prepare for the transition. To support the health care community, the Centers for Medicare and Medicaid Services offers resources that explain ICD-10 for providers, payers, vendors, and non-covered entities.

Medscape Continuing Medical Education Resources
CMS has created two videos and one expert column to help educate health care professionals about ICD-10. Beyond providing tips and advice, these free resources offer continuing medical education (CME) and nursing continuing education (CE) credits. Anyone who completes the modules can earn a certificate. Note that, while free, viewers must have or create a free account to view the webinars.

Road to 10 Tool for Small Physician Practices
Available on the Provider Resources page of, the "Road to 10" tool is an online resource built with the help of providers in small practices. This tool is intended to help small medical practices jumpstart their ICD-10 transition and can help you:

  • Understand the basics of ICD-10
  • Build an ICD-10 action plan to map out your transition
  • Answer frequently asked questions
  • Learn how ICD-10 affects your practice with tailored clinical scenarios and documentation tips for Family Practice and Internal Medicine, Obstetrics and Gynecology, Orthopedics, Cardiology, and Pediatrics Resources
To support the health care community with the transition to ICD-10, the federal CMS has developed a variety of resources available at, including fact sheets, guides, and webinar presentations. They also distribute regular email updates with information about ICD-10. Subscribe today to stay up to date on the latest news and resources from the Centers for Medicare and Medicaid Services.

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Maintaining privacy protections in Colorado's Prescription Drug Monitoring Program

Posted By Administration, Thursday, December 18, 2014
Colorado's Prescription Drug Monitoring Program (PDMP) provides prescribers and pharmacists a secure database with immediate access to their patients' history of controlled substance prescriptions. The state Board of Pharmacy, which has oversight over the PDMP, is committed to protecting the confidentiality of patient medical records and information.

Since launching in 2007, there have been many privacy protections built into the PDMP system. Each day, pharmacies upload prescription data for controlled medications Schedule II to V that are dispensed to Colorado patients.

In 2014, a new law was passed that requires PDMP account registration by Colorado-licensed pharmacists and prescribers who are registered with the U.S. Drug Enforcement Administration for prescribing controlled substances. To make it easier for prescribers and pharmacists to get the information they need to provide the best care for their patients, the new law has a provision for prescribers and pharmacists to assign sub-accounts to up to three members of their health care team. To do so, the prescriber or pharmacist must have a registered PDMP account.

Under the new law, prescribers or pharmacists who delegate sub-accounts to members of their health care team will be accountable for the actions of their delegated team members. Additionally, prescribers and pharmacists with registered accounts (and their delegated team members) may only access information on patients under their care. Registered account holders may not share their username or password.

The information in the PDMP is considered a medical record and therefore falls under the legal provisions concerning the release, sharing and use of such health information. It is unlawful to release, obtain or attempt to obtain information from the PDMP for a use other than to make a prescribing or dispensing decision. Violations are punishable by civil fines of $1,000 - $10,000 per violation (12-45.5-406, C.R.S.). 

The State Board of Pharmacy enforces privacy protections in the PDMP and has handled five cases of unlawful use since the program’s inception in 2007. In one instance, a physician was fined $10,000 for a willful violation by accessing the dispensing history for a former spouse. 

Patients can access their data within the PDMP by completing a request form online and providing a copy of their driver's license or state-issued identification card. To improve public health research, the new law also permits researchers and public policy experts at the Colorado Department of Health and Environment (CDPHE) to access PDMP data. Use of the PDMP by CDPHE, however, is subject to the same HIPAA laws in effect for health care providers concerning medical records. 

For more information: To register an account and use the PDMP, visit or for general questions and information call 303-894-5957 or email Practitioners can find additional guidance in the Policy for Prescribing and Dispensing Opioids at and patients can obtain a copy of their medical information contained in PDMP by completing a form

Tags:  PDMP 

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Got stuff? Sell it with CSEPS

Posted By Kate Alfano, Monday, October 27, 2014

The new website has a classified ads section where, as an exclusive member benefit, CSEPS members can place their ads and other members can see these ads. Reach the top ophthalmologists across Colorado to find or sell the goods and services you need. Advertise your:

Situations and items wanted
Properties for sale or lease
Equipment of sale or lease
Practices for sale

Click here to view current ads and post yours in this online marketplace.

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