Advocacy News

Medicare administrative contractor WPS said last week it will revise its recently released final local coverage determination policy for minimally invasive glaucoma surgery following objections raised by the Academy and our ophthalmic partners. 

After major Medicare contractors released identical coverage policies that would limit patients’ access to sight-saving care, the Academy spearheaded a joint effort with ophthalmic specialists to ask CMS to intervene and halt implementation.

Four more Medicare administrative contractors published their final local coverage determinations for glaucoma surgical procedures today, following the lead of WPS. The policies will take effect Dec. 24.

The Centers for Medicare & Medicaid Services final rule for the Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems includes a 3.1% payment boost for 2024.

Medicare administrative contractor WPS published its final local coverage determination for glaucoma surgical procedures today, after months of Academy advocacy and public input on this important coverage issue. The policy will take effect Dec. 24.

The Centers for Medicare & Medicaid Services’ Center for Clinical Standards and Quality was responsive to suggestions from the Academy and the American Society for Cataract and Refractive Surgery on how to improve the cataract cost measure for ophthalmology in a meeting Tuesday.

Committee action in the House and Senate this week focused on Medicare, with hearings on Academy priorities to improve patient access to care, including policies to reform prior authorization and update the Medicare physician payment system.

Veterans’ and military groups representing more than 2.5 million veterans, active duty and retired military personnel submitted statements to a key congressional subcommittee opposing the VA’s development of national standards of practice for optometry.

The Academy and other groups participated in an Oct. 4 meeting with CMS in which we successfully convinced the agency that the diabetes cost measure is not applicable to ophthalmology. Members who believe they have been incorrectly applied cost measures have until 8 p.m. ET Monday, Oct. 9, to submit a targeted review.

In a statement to a House Veterans’ Affairs subcommittee the organization reiterated its longstanding support for eye surgery by surgeons and found veterans prefer physician-led health care teams when accessing care in VA facilities.