The Virginia Society of Eye Physicians and Surgeons (VSEPS) appreciates the opportunity to provide public comment on the periodic review of the Virginia Medical Care Facilities Certificate of Public Need (COPN) Rules and Regulations, 12VAC5-220. VSEPS is a statewide, non-profit organization comprised of medical doctors and doctors of osteopathy (ophthalmologists). Our mission is to advocate for the best quality eye care through education, legislative efforts and community service.  

We believe Virginians should have access to high-quality, affordable health care, and eye care is an integral part of a person’s overall health. Virginia’s COPN regulations are not only burdensome to small businesses like those physician practices of many ophthalmologists throughout the Commonwealth, but they are also a barrier to health care access.

Eye surgery is a special case study. Ophthalmology is a unique medical specialty in that almost no eye surgery occurs in the hospital setting. According to Virginia Health Information’s data “Ophthalmologic Surgery Service Line in Virginia Hospitals Year: 2015,” of the 97 hospitals in Virginia, including the teaching hospitals and other hospitals at which ophthalmology residents perform surgeries, 81 had zero (0) eye surgery cases. Among the non-teaching hospitals, eye surgery cases represented only .04% of the case load at the facility with the highest number of those cases.

Having a robust supply of ambulatory and outpatient surgery facilities for eye care is therefore even more important so that patients have access to a variety of eye care options in their area. Many hospital systems argue that deregulating COPN will result in lost revenue. However, because eye surgery represents insignificant hospital case load, deregulating ophthalmology would have minimal impact.

Ophthalmology practices are small businesses. Current COPN regulations interfere with small business decision-making and expansion of patient services. When pursuing a COPN, applicants experience a costly and lengthy process which dissuades many others from considering a project. Deregulating COPN regulations for ophthalmology will introduce positive competition that could drive down costs for patients and employers. Virginia’s evolving health care system demands expanded outpatient options for an aging population. Let ophthalmology be a specialty that can respond.

We hope you will consider our comments during your review.

Thank you,

Suzanne Everhart, DO, President,

Virginia Society of Eye Physicians and Surgeons (VSEPS)