Advocacy News

The Academy has asked the Centers for Medicare & Medicaid Services to reconsider proposed Medicare payment changes that could harm ophthalmologists, including new practice expense policies, proposed reductions for same-day evaluation and management (E/M) visits billed with Modifier -25 and global procedures, and major changes to Merit-Based Incentive Payment System (MIPS) reporting.

AAO 2026 is a great time to delve into the Academy's advocacy efforts and meet those who are making a difference in federal and state legislation. Whether you stop by the OPHTHPAC® and Safe Surgery Action Fund (formerly the Surgical Scope Fund) booths to learn about our work, join us at our reception, or attend one of our advocacy sessions, we’re looking forward to seeing you this year in New Orleans. All sessions are in Central Time.

The Centers for Medicare & Medicaid Services (CMS) has introduced a new pilot program requiring prior authorization (PA) for fee-for-service Medicare for certain services in ambulatory surgical centers (ASCs).

The final rule could affect about 4,000 hospital outpatient departments and 6,000 ambulatory surgical centers (ASC).

With the help of the American Society of Ophthalmic Plastic and Reconstructive Surgery, the Outpatient Ophthalmic Surgery Society, and the North American Neuro-Ophthalmology Society, the Academy has persuaded the Centers for Medicare & Medicaid Services (CMS) to delay the start of the prior authorization (PA) pilot in ambulatory surgical centers.

The Academy is pushing for a delay in implementation for the pilot, scheduled to start on Dec. 15.

What you need to know about CMS’ plan to expand prior authorization for some ambulatory surgical center services in 10 states.

The proposed rule could affect about 3,500 hospital outpatient departments and 6,100 ambulatory surgical centers (ASC).

The final rule could affect about 3,500 hospitals and 6,100 ambulatory surgical centers (ASC). Here are the key takeaways.

Aetna responded to the Academy's concerns on corneal tissue reimbursement for ASCs and outlined what to do if you encounter payment issues.