Advocacy News

The Academy will raise scope concerns over CMS’ plan to create a combined new ophthalmology and optometry specialty set under the Merit-Based Incentive Payment System, a concept the agency unveiled in its 2023 proposed Medicare Physician Fee Schedule.    

The Centers for Medicare & Medicaid Services proposed rule for Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System includes a 2.7% payment boost for 2023.  

The Academy has joined 120 state medical and national specialty societies to help develop and endorse the American Medical Association’s Characteristics of a Rational Medicare Physician Payment System.  

The Academy has joined the AMA and other medical groups in an effort to change the Medicare physician payment system to improve the financial viability of physician practices and ease their administrative burdens.  

Nine out of 10 physicians surveyed by the American Medical Association said for patients whose treatments required prior authorization, the process had a somewhat or significant negative effect on their clinical outcomes. The Academy continues to work with our members and partners to press for reform.

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 Centers for Medicare & Medicaid Services has finalized a payment increase for hospital outpatient departments and ambulatory surgery centers in its 2022 Medicare Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center (ASC) Payment System rule. This rule affects hospital outpatient departments and ambulatory surgery centers only.

Overall rate increases of 2.3%, yes. Extended pass-through status for some drugs and biologics, yes. Inadequate payment for newly combined MIGS and cataract codes, no.

Global surgical payments and values for MIGS, cataract surgery and strabismus codes are among the key targets of our latest effort to show CMS where it needs to adjust its proposed 2022 Medicare physician fee schedule.

What Medicare reimbursement and physician payment reforms are on the horizon and how does Medicine break out and restore equity for physician payment?