Ophthalmology’s “Dream Team” at the RUC

It is with great pride and pleasure that the Academy recognizes the Academy members who are involved with the AMA/Specialty RVS Update Committee (RUC) of dedicated physicians and staff, better known as our RUC Team, as a recipient of the Special Recognition Award.

Formed in 1992 by the American Medical Association and the national medical specialty societies, the RUC functions to develop physician work relative values for procedure codes that are revised or added by the Current Procedural Terminology (CPT) Editorial Panel. These values are an integral part of how payments are derived by Medicare and other payers. Overall, the RUC is composed of 26 members; 20 are appointed by major national medical specialty societies, including one seat for the Academy. Additionally, there is an alternate member for each of those 26 RUC members, and every medical group that has a seat in the AMA federation can also name an advisor to the RUC. It is this team of Academy physicians and the staff that supports them that we are recognizing here today.

Major accomplishments of the Academy’s RUC team over the past few years include helping defend the work value of cataract code, which CMS has consistently targeted as overvalued under the Five-Year Review Process, and revising the retina and vitrectomy series of codes without damaging their overall payment. This year the Academy’s RUC team scored a victory as CMS proposed to accept the RUC recommendation that payments for eye visit codes be improved and in line with the increases instituted in 2007 for evaluation and management (E&M) services. As a result, Medicare payments for ophthalmologists would be increased by $154 million annually, and that doesn’t count increases that will likely also come in the third-party insurance arena.

Upcoming projects for the RUC include preparation for the next Five-Year Review, which is already under way, oversight of efforts to implement updated practice expense payments, and ongoing work with the Academy’s Health Policy Committee to monitor and review new technology and procedures for ophthalmology. The RUC team is constantly finding ways to ensure fair and appropriate payments—Medicare and others—for the Academy and Ophthalmology.

The American Academy of Ophthalmology is proud to present the Academy’s RUC team with the 2007 Special Recognition Award:

William L Rich III MD, medical director of Health Policy for the AAO and chair, AMA Relative Value Update Committee
Gregory P Kwasny MD, AAO/Ophthalmology member, AMA Relative Value Update Committee
George A Williams MD, AAO/Ophthalmology alternate member
Stephen A Kamenetzky MD, AAO advisor to the AMA Relative Value Update Committee (and our chief presenter)
Trexlor M Topping MD, Immediate past member, AMA Relative Value Update Committee (and coordinator of the Academy’s most recent Five-Year Review effort)
Michael X Repka MD, AAO advisor to the AMA Current Procedural Terminology (CPT) Panel
Catherine Grealy Cohen, AAO Vice President of Governmental Affairs
Cherie McNett, AAO Director of Health Policy
Koryn Rubin, AAO Policy Analyst