The Academy’s aggressive fight to protect your Part B drug payments from penalties is going public this week. We’re leading a coalition of medical specialties that implored Congress to prevent the Centers for Medicare & Medicaid Services from penalizing your 2019 Part B drug payments. We used coalition letters to lawmakers and a press release to call our elected officials to task for their reluctance to act on this issue.
CMS said last month it will apply Merit-Based Incentive Payment System penalties to these reimbursements. We believe our lawmakers’ inaction will cause “irreparable harm” to physicians’ practices in the communities that most need access to Part B treatments.
Our 14-member coalition also includes the following prominent medical specialty organizations:
- American Academy of Allergy, Asthma and Immunology
- American Academy of Dermatology Association
- American Academy of Neurology
- American Academy of Physical Medicine and Rehabilitation
- American College of Gastroenterology
- American College of Rheumatology
- American Gastroenterological Association
- American Society of Clinical Oncology
- American Society of Retina Specialists
- American Urological Association
- Infectious Diseases Society of America
- The Macula Society
- The Retina Society.
We warn of serious harm to patient access to care should Congress fail to prevent CMS from applying MIPS adjustments to Part B drug payments. This includes letters sent recently to the chairs and ranking members of the Senate Finance, House Ways & Means and House Energy & Commerce committees
“This policy will negatively impact patients’ access to critical life- and sight-saving treatments,” the letter states. The policy would put at risk specialists’ ability to provide the physician-administered drugs on which their patients depend.
The coalition believes that applying penalties to Part B drug payments contradicts Congress’ intent for the law that established the Quality Payment Program. Still, the financial realities of what’s happening are beyond troubling. The Academy’s analysis projects that these penalties could reach upwards of $100,000 annually for ophthalmologists. Retina specialists, in particular, stand to lose big because of this change, since they administer Part B drugs the most.
Because CMS’ action results from its interpretation of an existing law, only Congress can set the agency on the right path. Contact your elected representatives today to prevent this damaging policy that could cost you upwards of $100,000 in annual penalties in 2019.
Strengthen OPHTHPAC Today to Sway Congress Before It’s Too Late
Our Part B drug payment fight highlights the critical importance of having strong advocates in Congress who will speak for our profession. These issues arise quickly. When they do, we need to focus on educating members of Congress, not making new friends. You can help us focus on the issues by establishing a strong OPHTHPAC® fund to advance our relationships. OPHTHPAC is a powerful weapon to ensure specialty medicine receives the same fair shake in Washington, D.C., as those in other areas of health care — and that we already have friends in high places when the next issue emerges.
For this Part B drug-payment fight, we’re racing against the clock. We need to strengthen OPHTHPAC immediately. Congress is only in town for a few more weeks. If we can’t get to our elected officials now, it might be too late to save your revenue.
Retina specialists will be hit the hardest if the Centers for Medicare & Medicaid Services applies MIPS penalties to your Part B drug payments. This video message from George A. Williams, MD, Academy secretary for federal affairs, shows how you can avoid penalties that could result in thousands in lost Medicare revenue in 2019 and beyond.