Support Congressmen Roskam and Lewis’ Effort to Preserve Your Medicare Fees

Ophthalmology’s champions in Congress need action from Academy members today to ensure that the loudest message is sent to the Centers for Medicare and Medicaid Services over its unfair fee cuts. Rep. Peter Roskam, R-Ill., and Rep. John Lewis, D-Ga., are sending a letter to CMS to reconsider its significant cuts to retina and glaucoma fees. Some of these cuts are as deep as 33 percent. Reps. Roskam and Lewis need your member of Congress to join them. Tell your representative to sign their letter today before this letter gets mailed.

For nearly a month, the Academy has worked diligently to enlist members in the U.S. House of Representatives to support our battle to limit Medicare fee cuts. So far, members of Congress from California, Florida, Illinois, Georgia, Oregon, Texas, Virginia, North Carolina, Kansas, Ohio, Pennsylvania, West Virginia, New Jersey and New York have pledged their support to our cause. But there are still dozens of states not represented. An issue as important as this one needs national support. Our message needs to come from all corners of this country.

Background

When CMS released its final Medicare Fee Schedule for 2016, it enacted significant cuts for specific retina and glaucoma procedures that went far beyond what was recommended by the AMA/Specialty Society Relative Value-Scale Update Committee.

The agency based its decision on a flawed methodology that focused solely on time. In doing so, CMS ignored other critical factors, such as intensity and complexity of the services. In fact, CMS’ methodology violates current requirements that physician work values be based on time and intensity.

CMS must revisit its decision. It should adopt the RUC’s recommendation.

What we’re doing about it

The Academy and others mobilized to push back on this issue immediately following the release of the final fee schedule rule in November. Representatives from the Academy and glaucoma and retina subspecialties took our case directly to CMS in an emergency meeting in December.

Now Reps. Roskam and Lewis are leading their congressional colleagues in pressuring CMS to rethink slashing these codes beyond RUC’s recommendations and establishing such a flawed methodology.