Advocacy News

CMS has told Medicare Advantage plans that the two biosimilars, which are not clinically proven to treat eye disease and are potentially dangerous to ophthalmology patients, may not be used as substitutes for Avastin or be required in their step therapy programs.

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.

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 physician community is urging the VA to reconsider its project to establish national standards of practice.

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policy, the Academy and the American Society of Cataract and Refractive Surgery are ramping up efforts to get it rescinded and protect patient sight.

As concern grows about Avastin shortages, the Academy and the American Society of Retina Specialists this week are pushing health plans to halt step therapy and prior authorization requirements imposed on alternative therapies to avoid further patient care disruption.