NM center on law and poverty
 

Comments on Vision Services

May 3, 2004

Pamela Hyde, Secretary

Human Services Department

P.O. Box 2348

Santa Fe, NM 87504

Re: Comments on Proposed Regulations contained in Human Services Register, Volume 27, #7

Dear Secretary Hyde:

     The New Mexico Center on Law and Poverty submits its comments to the Human Services proposed regulations regarding the provision of vision services. 

Routine Eye Exams

8.310.6.12 (A) Exam:  Medicaid covers routine eye exams.  Coverage for adults is limited to one routine eye exam in a twenty-four month period.

     The Human Services Department proposes adding the above language in its entirety.  The Center on Law and Poverty is concerned that there is no provision for exceptions.  According to doctors we have consulted, all adults,  and in particular for individuals with diabetes who are at risk for developing diabetic retinopathy should have an eye exam yearly.  This is consistent with the standard of care in the medical community.   Costs associated with significantly impaired vision resulting from delayed detection of conditions like diabetic retinopathy can be substantial.  Early detection of these conditions can prevent blindness.  Significantly, the Medicaid Reform Committee indicated that eye exams should be performed yearly.  The Center on Law and Poverty recommends that the Human Services Department revise this regulation to indicate that Medicaid will pay for yearly vision examinations.

8.310.6.12 (H) – “Replacement: Eyeglasses or contact lenses that are lost, broken, or have deteriorated to the point that, in the examiners opinion, they have become unusable to the recipient, may be replaced for the following:

1.                  Recipients under twenty-one years of age; or

2.                  Recipients over twenty one years of age with developmental disabilities.”

 
     The Center on Law and Poverty recommends that the Human Services Department delete the two limiting conditions.  Allowing for at least one replacement of corrective lenses, when the referenced circumstances are met, for all individuals will enable individuals to maintain functioning and will prevent other adverse costly events like falls due to limited acuity. 

     Thank you for your time and consideration of these issues.  If you have questions regarding these comments please do not hesitate to contact me at 255-2840.

Sincerely,

Jama Fisk

Staff Attorney