News and views on the regulatory, legislative, and political issues impacting ophthalmology in Washington, D.C., and around the United States
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Featured News
2027 Fee Schedule Proposes Cutting Pay to Physicians by 1.68%
The Centers for Medicare & Medicaid Services (CMS) has released its proposed Medicare Physician Fee Schedule for 2027. Here are the highlights based on the Academy’s analysis. The Academy will work with our advocacy partners to ensure finalized policies support our members and their patients.
CMS Finalizes 2.9% Pay Increase for Hospital Outpatient, ASC Settings for 2025
The final rule could affect about 3,500 hospitals and 6,100 ambulatory surgical centers (ASC). Here are the key takeaways.
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October 30, 2024
Academy’s Congressional Champions Introduce New Medicare Pay Fix Bill
The bill would eliminate the nearly 3% cut proposed for 2025 and provide a one-year inflationary update. Urge your representatives to co-sponsor this critical legislation today.
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October 30, 2024
Academy Urges Insurers to Suspend Step Therapy Due to Potential Avastin Supply Issues
The Academy urged large commercial insurers and Medicare Advantage plans to suspend anti-VEGF step therapy requirements in response to Pine Pharmaceuticals discontinuation of repackaged Avastin (bevacizumab).
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October 14, 2024
Data Validation Audits Begin for 2023 MIPS Participants
MIPS participants who are randomly selected for the audit will receive email notifications between October 2024 and April 2025.
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October 14, 2024
Pine Pharmaceuticals Discontinues Avastin and Other Ophthalmic Product Manufacturing
The Academy is engaging with alternative suppliers and pushing CMS to intervene on Medicare Advantage plan step therapy requirements for Avastin.
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October 9, 2024
Academy Members Build Relationship With Key Senate Champion
Advocacy is built on relationships and OPHTHPAC, your Academy’s political action committee, is here to help you connect with your lawmakers.
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October 9, 2024
CMS Will Apply Automatic MIPS Exceptions for Practices Affected by Hurricanes Helene and Francine
The Oct. 10 announcement applies to specific counties in Florida, Georgia, Louisiana, North Carolina, South Carolina, and Tennessee.
Following sustained advocacy engagement with the Pennsylvania Department of Human Services Secretary Valerie Arkoosh and department staff, the Pennsylvania Academy of Ophthalmology won higher payment rates for numerous pediatric ophthalmology service codes in the state’s Medicaid program.
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October 9, 2024
New Coverage Policies for Medical Botulinum Toxin Injections Proposed
Regional Medicare administrators Novitas and First Coast Service Options on Oct. 10 proposed new coverage policies for medical botulinum toxin injections, which include injections for treatment of blepharospasm, strabismus, and hemifacial spasm.
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October 2, 2024
Final MIGS Medicare Coverage Improves on 2023 Policy Proposals
Persistent advocacy from our ophthalmology coalition has led to improvements in final MIGS Medicare coverage policies.
