Advocacy News

The Centers for Medicare & Medicaid Services has acceded to Academy-led efforts to eliminate or at least reduce the unnecessary burden imposed by CMS’ prior authorization program for hospital outpatient department services, including removing CPT code 67911, a type of corrective lid surgery, from the list.

The Academy and the American Society of Cataract and Refractive Surgery are calling upon Congress, members and their patients, and the public to support our efforts to ensure timely access to sight-restoring care.

The Academy questions Aetna’s new statement on the percentage of cataract surgeries that are unnecessary, while Academy members throughout the country validate the high level of disruption the policy has already caused their patients and staff.

You play a critical role in our multipronged effort to overturn these new prior authorization requirements. 

As Aetna refuses to change its harmful policy, the Academy and the American Society of Cataract and Refractive Surgery are ramping up efforts to get it rescinded and protect patient sight.

Aetna recently announced, without proper notice and without educating Academy members, that it will soon require preapproval for all cataract surgeries (PDF) in ambulatory surgery centers and outpatient departments.

The promised exemption takes effect May 1 for facilities with 90% initial approval rate. 

The agency's final rule promises a better health care experience for patients, burden reductions for providers.

The Centers for Medicare & Medicaid Services (CMS) on Wednesday finalized a rule that includes a 2.4% increase in payment for ambulatory surgery centers in 2021, but expands prior authorization for procedures performed in hospital outpatient departments.

We raised your concerns about timely approvals; agency pledges improvement.